Epidemiology and Infectious Diseases

BACKGROUND: The introduction into clinical practice of drug therapy with anthelmintic drugs from the carbamate-benzimidazole group has reduced the need for aggressive surgical interventions in the initial stages of parasitic cyst development. However, no consensus has been reached in which cases and for what size of cysts the use of monotherapy with carbamate benzimidazoles will be sufficient and in which cases a combination of surgical and therapeutic treatment methods is necessary. Experimental studies with human participants are impossible to solve this problem.

AIM: To evaluate the proximity of the developed experimental model of liver echinococcosis to real clinical practice, including the response to the use of carbamate benzimidazoles.

MATERIALS AND METHODS: Modeling of liver echinococcosis in laboratory animals was performed by suturing a part of an echinococcal bladder (Echinococcus granulosus) to the liver capsule. The model provides a high survival percentage of laboratory animals, in which after 60 days a typical hydatid cyst forms in the liver. The effects of albendazole and praziquantel were studied using this echinococcus model. One group of animals (n = 10) received albendazole through an intragastal tube for 28 days and the other (n = 10) received praziquantel for 15 days, after which the animals were autopsied.

RESULTS: When using albendazole, destructive changes were microscopically determined in the structure of the walls of the echinococcal cyst on day 28 of therapy. Similar changes were observed when using praziquantel; however, they were characterized by more massive cellular infiltration of all cyst layers.

CONCLUSIONS: The developed experimental model of liver echinococcosis in laboratory animals allowed us to experimentally examine the effect of various drugs on the larval stages of E. granulosus development and evaluate their effectiveness.

The survival of patients with severe COVID-19 depends on timely and adequate assessment of the risk of adverse disease outcomes. Currently, conflicting data on the prognostic value of various laboratory parameters in severe COVID-19 caused by different SARS-CoV-2 variants require analysis and systematization. The leading clinical and laboratory signs that determine the severity of COVID-19 include the syndrome of systemic inflammatory reaction and hemostasis disorders, which, in conditions of high viral load, hypoxia, and toxic exposure, contribute to the development of cytolytic syndrome, cytopenia, and multiple organ failure. Biological and immunological features of SARS-CoV-2 variants have an important influence on the severity of the infection. Based on literature sources, we have listed the most significant laboratory parameters, which, combined with clinical criteria, serve as an accurate guide for physicians both in monitoring patients and selecting therapy in Russia and abroad. Some SARS-CoV-2 variants exhibit reduced susceptibility to monoclonal antibodies and recombination plasma, which requires a revision of the therapy strategy. Detailed analysis of pathognomonic laboratory parameters and understanding of the immunological response to a particular SARS-CoV-2 variant will quickly and accurately identify the vulnerable patient groups, timely change in their therapy, and prevent complication development.

Botulism has unique clinical picture; however, some of its manifestations, when analyzed separately, are similar to the manifestations of other, both infectious and noncommunicable diseases. This contributes to the occurrence of diagnostic errors because botulism is not one of the most common infectious diseases; as a result, most practitioners are familiar with the clinical picture of botulism purely theoretically and clearly insufficiently. The article analyzes the course of botulism in a group of family diseases when, at the first visit to specialists, botulism was diagnosed in any of the patients not receiving medical care. In addition, the causes and effects of prolonged toxemia (20 days) in one of the patients are discussed.

The widespread of mumps and its medical and social significance determine the relevance of further study of the etiology, epidemiology, diagnosis, treatment, and prevention of mumps infection. Despite the lack of mortality, the possible occurrence of complications that affect the suppression of male reproductive function makes mumps a priority. Official statistics show the annual incidence of mumps in the Russian Federation, estimated in hundreds of cases up to several thousand (2017–2018). The continued spread of mumps is associated with violations of immunization regimens, underestimation of the unvaccinated population or unreliability of the reported data, introduction of new viral genotypes capable of bypassing vaccine immunity, and natural weakening of post-vaccination immunity.

The presented clinical case refers to an outpatient case of mumps in a 53-year-old man with a delayed diagnosis despite the typical clinical manifestations. The clinical case demonstrates the lack of awareness of outpatient practitioners about the manifestations of mumps. The causes of mumps in older age groups and possible ways to solve the problem are discussed.

The origins of surgery and the improvement of surgical practices did not always guarantee a favorable surgical outcome. Even a masterfully performed operation could lead to a purulent-inflammatory process. Even at the stage of empirical development of medicine, before the great microbiological discoveries, an understanding was formed about a certain “substrate” that penetrates the surgical wound from the external environment and causes its suppuration. Supporters of the contagionist theory called it contagium, and supporters of the miasmatic theory considered the external (air) environment as such a source. The ideas of the supporters of the contagionist theory of the occurrence of purulent-septic complications in surgery in the middle of the 18th century are reflected in the works of D.S. Samoilovich and I.F. Semmelweis; the latter proved the transmission of the infectious principle by the surgeon’s hands, which became the starting point for the development of preventive antiseptics.

In historical retrospect, the technology and means used for surgical hand antisepsis in Russia were analyzed from the mid-18^th to the early 20^th centuries.

Moreover, literary sources for the period from 1783 to 2023 were analyzed, containing information about the antiseptic treatment of surgeons’ hands. Historical, descriptive, evaluative, analytical, and bacteriological research methods were used. As an experiment, the original antiseptic recipe described by D.S. Samoilovich (1783) was restored, and its effectiveness was confirmed.

During surgical practices in Russia, starting from the mid-18^th century, facts about the use of drugs with antiseptic activity for hand treatment are described. It is shown how, in historical retrospect, views on the final result of surgical antisepsis changed: from partial to complete destruction of microorganisms, preventing their entry from the deep layers of the skin, to the destruction of transient microflora and reduction of the abundance of resident microflora. Despite the influence of the English (J. Lister) and German (P. Fürbringer, J.F. Ahlfeld) surgical schools on the development of antiseptics in Russia, it retained its originality, determined by the needs of society and the possibility of using certain chemical antiseptics and their compositions for its implementation. The contribution of domestic surgeons to the improvement of antiseptic technologies and drugs in military field conditions is shown (N.I. Pirogov, A.M. Zabludovsky, D.I. Tatarinov et al.).