卷 15, 编号 4 (2010)

The paper presents the results of analyzing the influence of major factors for globalization on the clinical and epidemiological manifestations of communicable diseases. Globalization is shown to considerably change the essence of an epidemic process and to affect its all component elements, by substantially accelerating the emergence and prevalence of communicable diseases. All five major aspects of globalization, such as economic, environmental, political, demographic, and technological ones, are closely related and affect both the prevalence of communicable diseases and the possibility of their prevention, control, and treatment. It is concluded that, by taking into account the global pattern of the threat associated with communicable diseases, a comprehensive approach that, in addition to international law on health care service, comprises the regulations and principles of other branches: international law of human rights, international environmental, commercial, humanitarian, and criminal laws, is the most effective method for counteracting this threat. The political will of states and the mechanism for financing the setting up of global and national infrastructures to follow all determinants of the epidemic process are of great importance in providing epidemiological security.

The paper characterizes tuberculosis morbidity among the healthcare workers of Moscow versus its adult population. Its considerable rise has been established. Occupational factors and tuberculosis risk groups have been determined in this professional category. Tuberculosis facilities, forensic medical examination bureaus, first-aid stations, hospital departments of morbid anatomy, and clinical and postmortem laboratories have been found to be of high epidemiological importance in determining the incidence of tuberculosis among Moscow healthcare workers. Its further studies and development of present-day programs to prevent nosocomial tuberculosis among the staff of health care facilities are needed.

The results of examining 100 case records of the neonates transferred from obstetric hospitals to the neonatal units of children's hospitals for signs of pyoseptic infections (PSI) at various sites (conjunctivitis, omphalitis, dermal PSI, and concomitant forms of PSI) and 22 case records of the women admitted to the gynecological units as diagnosed as having puerperal endometritis were used to estimate economic damage per case of nosocomial PSI in newborn babies and puerperas as the cost of laboratory tests and antibiotic and general health-improving treatments plus the basic tariff without the average value of diagnostic and therapeutic measures. The economic losses per case of major PSIs averaged 7510.1 rbl., which was equal to 306 USD or 209 EUR (as of January 1, 2008). The economic damage caused by a case of puerperal endometritis was 8722.8 rbl, which was equal to 355.4 USD or 242.8 EUR.

The Russian Federation holds the lead in the highest growth rates for the number of new cases of HIV infection and its prognosis remains poor for the years immediate ahead with the rapidly increased rates in the scope of its epidemic being borne in mind. In the Far Eastern Federal District, the Primorye Territory rates first in the number of cases of HIV infection. The aim of this study was to determine the incidence and clinical characteristics of secondary and opportunistic diseases that were a cause of death in HIV-infected patients in the Territorial Clinical Center for Prevention and Control of AIDS and Infectious Diseases, Vladivostok, in 2007. In this year, the mortality rate was 13.6%, which was 1.6 times higher than that in 2006. Tuberculosis the incidence of which was 48.5% occupied the first place in the structure of secondary diseases resulting in a fatal outcome in HIV-infected patients. The proportion of hepatic cirrhosis was 22.9% in the structure of fatal outcomes.

The authors have examined the clinical manifestations of Ixodes tick-borne borrelioses (TBB) in the Ulyanovsk Region and the obtained first results of indication of TBB virus antigen in the ticks. The specific prophylactic measures implemented among urban dwellers so far are noted to be insufficient and to require to be revised in the shortest possible time, by taking into account the specific prevention of TBB in strictly specialized professional population categories (geologists, operators, as well as gas and oil workers on rotation).

В обзоре представлены данные о формировании нестабильности генома соматических клеток при действии различных инфекционных агентов - вирусов, бактерий, простейших. Рассмотрены основные механизмы формирования данного феномена. Показана роль инфекционного агента, состояния метаболизма и некоторых физиологических систем организма в формировании мутаций на уровне целого организма. Многочисленные исследования позволяют сделать вывод, что нестабильность генома следует рассматривать как типовой патологический процесс в разнообразной дизрегуляторной патологии. Знание этого феномена, своевременное выявление его у больных, использование современных приемов коррекции позволят существенно влиять на течение болезни, лечение и исход.

The paper systematizes the data available in the literature on the results of virological and clinical studies of the concomitant forms of viral hepatitides. It gives the results of the authors' epidemiological surveys of this problem and shows it necessary to study the latter at all hierarchy levels of the epidemic process.

The paper considers whether specialists should be trained in particularly dangerous infections. Main directions for training the audience of courses are characterized. Data are given on the training program, its tasks, and the mechanisms of its implementation, methodical provision, and the audience's capabilities during and after learning the courses' program.