Vol 18, No 6 (2013)


Morphological changes in the liver in patients with pulmonary tuberculosis and HIV infection on a background of chronic hepatitis "C"

Babaeva I.Y., Avdeeva M.G., Gedymin L.E., Chumachenko G.V., Adamchik N.Y.


The purpose of the study. The establishment of the features of the course and morphological manifestations of tissue responses in liver in chronic hepatitis "C" in patients with disseminated pulmonary tuberculosis on a background of HIV infection. Materials and methods. The results of the pathomorphological studies carried out on autopsy material of 11 observations of patients with diagnoses of TB associated with HIV and hepatitis "C" are reported. The comparison group was consisted of 3 patients with HIV and hepatitis "C" and one patient with generalized hematogenous tuberculosis and chronic hepatitis "C". The results of the study. Changes in the liver in the combination of TB with HIV and hepatitis "C" have a different intensity, depending on the stages of combined pathology. At the early stages of HIV infection (2B), in presence of localized tuberculosis, there is possible rapid progression of hepatitis "C" into cirrhosis of liver, which becomes the main cause of death. For the later stages of HIV infection ( 4B-5 ) there is typical the development of generalized forms of tuberculosis with the appearance of confluent caseous necrotic lesions in all organs and tissues. In these cases in the structure of the liver there are determined severe circulatory disorders, pronounced dystrophic and necrotic changes in the parenchyma, inflammatory responses caused both generalized tuberculosis and hepatitis "C". In generalization of disseminated lungs tuberculosis in the liver, monocytoid response and lymphopenia are established to take place, and at the late stage (4B - 5) stage of HIV infection there is noted aplasia of elements of lymphoid series and diffuse plazmatization. The correlation between the severity of the process and the intensity of exudative changes was revealed. Conclusion: The liver disorders in patients with HIV infection, tuberculosis and hepatitis "C" may determinative in the outcome of the disease and should be considered when choosing a scheme of etiotropic and pathogenetic treatment and the staging of therapy.
Epidemiology and Infectious Diseases. 2013;18(6):4-8
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Clinical and epidemiological characteristics and gene variant structure of HCV-infection in the area of the Krasnodar Territory

Avdeeva M.G., Gorodin V.N., Konchakova A.A., Dubinina V.A., Kotova N.V., Strikhanov K.S., Zapashnyaya O.V., Eremina G.A., Sotnichenko A.S.


The purpose of research - based on analysis of the clinical-epidemiologic data, the level of viral load and the prevalence of HCV genotypes to determine current consistencies and epidemiological trends of the development of HCV-infection in the area of the Krasnodar Territory. Patients and methods. Population incidence of hepatitis C in the Krasnodar Territory was studied for the period from 2004 to 2011. Clinical manifestations of the disease we evaluated on the base of a retrospective analysis of 1913 hospital records of patients with chronic hepatitis C. There were investigated the results of 19,338 qualitative PCR studies of RNA-HCV, 2041 studies for genotyping and 363 results of quantitative evaluation of RNA-HCV Results. In the Krasnodar Territory there is revealed circulation of 1a, 1b, 2, 3a HCV genotypes. In a population of genotypes 1b (48 %) and 3a (38 %) prevail. In recent years there has been visible trend to displacement of genotype 1b by the increase the incidence of genotype 3 a in a set of areas. Social Portrait of the patient with hepatitis C: a man aged 28 to 48, a city resident, a salary earner or unemployed. There were established gender peculiarities: males are more often infected with hepatitis C genotype 3a, females - genotype 1b. In most cases (65%) viremia is characterized by moderate viral load. In the studied population there is revealed the relationship between the activity of the process and infection with certain genotype. Moderate grade of hepatitis activity is significantly more frequently recorded in the disease caused by 1c and 3 a virus subtypes. Minimal activity of hepatitis is not typical for the process caused by genotype 2 and in genotype 3 a occurs much less frequently than in cases caused by genotype 1b. Conclusion. Epidemiological analysis of the incidence of hepatitis C should take into account trends in the spread of various genotypes of the virus. Hepatitis C virus genotype should be taken into account as in the forecast of the disease and in determination of the indications for antiviral therapy. The main socio-age group actively involved in the epidemic process and need for causal treatment, are young persons of working age.
Epidemiology and Infectious Diseases. 2013;18(6):8-16
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Clinical and epidemiological aspects of the incidence of nonpolio enteroviral infections in Primorsky Krai

Kolpakov S.L., Popov A.F., Mirgorodskaya N.V.


There are considered problems of epidemiology and clinical presentation of enteroviral infections in the territory of Primorsky Krai. Among the hospitalized adult patients during the period from 2006 to 2012 persons aged from 18 to 39 years (49,3%) prevailed. The main clinicalforms of enteroviral infection (EVI) are a "minor" illness (55.6 %) and serous meningitis (21.7 %). In the study of a series of cytokines the differences in patients with the "minor" illness and serous viral meningitis have been identified. From 2009 to 2012 the incidence of EVI has a sporadic seasonal character (previously there was epidemic seasonal incidence). Adults are mainly affected. The epidemic process is formed owing to corporate and school-university types, with a dominated contact-community-acquired pathway of transmission. The dramatic shift in the nature of EVI rate in recent years, likely due to the exchange of the leading modes of transmission pathway, nutritional, which determined the carrying non-typical for the Primorsky Krai pathogen variants (ECHO - 30), by the contact-community-acquired pathway of transmission.
Epidemiology and Infectious Diseases. 2013;18(6):16-21
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Current trends of the changes of the etiological structure and clinical and laboratory characteristics of hepatocellular carcinoma

Yakovlev A.A., Komarova A.Y., Musatov V.B., Fedunyak I.P., Tsinzerling V.A., Karnaukhov E.V., Semenova N.Y.


The etiological structure of chronic viral hepatitides with the outcome in hepatocellular carcinoma (HCC) was studied among deceased patients for the periods of 1986-1998 and 2002-2012 in total and in comparison. HCC developed as the outcome of CHB in 45.0% of patients, CHC - in 20.7 % , CHB+C - 18,6%, CVHN- in 12.9%, CHB + D - 1.4%, CHB+C+D - also in 1.4% of patients. When comparing the data for 1986-1998 (13 years), and 2002-2012 (11 years) there was noticed an increase in the number of deaths from HCC (2-fold), there was significantly increased the incidence of HCC, associated with CHC (from 2.0% to 30.8 %), nonverified chronic hepatitis as a cause of HCC occurred 6.5 times less often (28.6 % - 4.4%), the number of cases of HCC, caused by CHB, became lower (49.0 % - 42.9 %), CHB+C - almost unchanged (20.4% - 17.6 % ). A presumptive middle time of the development of HCC since infection with hepatitis viruses is 27,6 ± 9,8 years. In assessing the cofactors ofprogression of HCC there was found that alcohol abuse occurred in 38.5 % ofpatients, diabetes - in 18,7%, HIV- infection -in 3.3%.
Epidemiology and Infectious Diseases. 2013;18(6):21-27
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Perspectives on tuberculosis control in the Russian Federation

Makarov V.K., Krylov V.V., Lebedev V.M., Grishkina N.A., Starikov S.V.


In the conditions of the current tuberculosis epidemic situation there are required consolidated efforts of all branches of government, phthisiatricians, general health services net, family medicine, the proper population, public and other organizations and the mass media for the prevention of the spread of this terrible social disease in Russia.
Epidemiology and Infectious Diseases. 2013;18(6):27-31
pages 27-31 views

Preventive and pharmacoeconomic efficacy of the use of herbal drug preparations in streptococcal infections in an organized military collectives

Marin G.G., Akimkin V.G., Salmina T.A., Sukhova V.A.


Infections of the respiratory tract (acute respiratory infection (ARI), acute bronchitis, pneumonia, etc.), skin and subcutaneous tissue (pyodermas) are the most urgent for the conscripts in training units of the Armed Forces of the Russian Federation. The most common complication of ARI is community acquired pneumonia, severe course of which leads to an unfavorable outcome. In the first period of military service in a number of military units up to the one-third of the military personnel gets pyoderma. Factors of military service and a significant reduction in body immunoresistance of recruits contribute to the high incidence. The use of herbal drug preparation "Karmolis drop" with a prophylactic purpose permits to significantly reduce the incidence of ARI in military units - in 2,0-3,3 times. Also, there was noticed a decrease in the incidence of pneumonias - 2.33.0 times, tonsillitides - in 3,2-6,8 times, pyodermas - in 1,8-2,9 times. The use of the drug "Karmolis drop" has a pronounced non-specific protective effect and resistance to diseases of the respiratory system and pyoderma due to the increase of general non-specific resistance of the organism, allows to prevent substantial economic damage. The preparation can be recommended for the prevention of ARI and pyodermas in groups of troops prior to their seasonal breaks.
Epidemiology and Infectious Diseases. 2013;18(6):32-38
pages 32-38 views

The results of the monitoring of vibrio cholerae in the Taganrog Bay of the Azov sea in 2011-2012

Mazrukho A.B., Kruglikov V.D., Monakhova E.V., Moskvitina E.A., Shestialtynova L.S., Podoynitsyna O.A., Vodopyanov A.S., Vodopyanov S.O., Pisanov R.V., Zubkova D.A., Kudryakova T.A., Ezhova M.I., Uskova N.N., Skachko M.V.


The complication of cholera epidemic situation in Ukraine (2011) caused the reinforcement measures on monitoring Vibrio cholerae in seawater in Taganrog Bay in the framework of measures for prevention of the spread of infection over the territory of the Rostov region and the country. Phenotypic and genotypic features of 3 selected atoxigenic strains of Vibrio cholerae eltor O1 and 1 toxigenic strain of V. cholerae eltor Inaba № 301, containing the hybrid prophage were characterized. With great probability there was established the absence of association of this strain with the outbreak of infection within the territory of the neighboring country, but there was revealed his relationship with to imported strains (1999, 2005). Atoxigenic strains were similar to strains previously detected in water bodies of the Rostov region. The implementation of the set of measures for the strengthening of epidemiological control permitted to prevent the importation of infection into the territory of the Russian Federation in 2011 - 2012.
Epidemiology and Infectious Diseases. 2013;18(6):39-42
pages 39-42 views

C. difficile toxins A and B from the clinician's viewpoint

Gyulazyan N.M., Belaya O.F., Malov V.A., Pak S.G.


To date, C. difficile is considered as an etiological factor in pseudomembranous colitis and antibiotic-associated diarrhea as well as the main cause of nosocomial diarrhea spread mainly in economically developed countries. The complexity of laboratory and experimental studies of infection is what the microbe cannot be genetically manipulated. At the same time, the most of hospital and municipal laboratories have no the possibility to carry out research on detection C. difficile toxins, that limits the resource of real estimation of the spread of the disease in the Russian Federation.
Epidemiology and Infectious Diseases. 2013;18(6):42-48
pages 42-48 views

The case of severe botulism: artificial ventilation of lungs for 127 days

Nikiforov V.V., Tomilin Y.N., Davydov A.V., Zimin P.E., Aleynikova O.I.


Botulism is a rare but extremely severe disease being difficult to treat and often leading to the death. In this context, undoubted interest is the detailed analysis of the course of disease in a patient with severe botulism, who in the course of therapy in total (from first admission to hospital discharge) spent totally on hospital beds (considering staying in various hospital) 152 days, including in intensive care units - 145 days, out of which 127 days - on a ventilator (the first 93 days of treatment there was carried out in the mode of mechanical ventilation IPPV, the next 34 days there was carried out intermittent mechanical ventilation in mode of BiPaP).
Epidemiology and Infectious Diseases. 2013;18(6):49-57
pages 49-57 views

A life devoted to the fight against the plague and tularemia (on the occasion of the 130th anniversary of the birth of N. A. Gayskiy)

Knopov M.S., Taranukha V.K.


In the article there is presented the life and the creative work way of a prominent national epidemiologist, a microbiologist and immunologist, a talented organizer of medical science, USSR State Prize winner, Nikolay Akimovich Gayskiy.
Epidemiology and Infectious Diseases. 2013;18(6):58-60
pages 58-60 views

Calendar of historical anniversaries of epidemiology and infectious diseases for 2014

Voskresenskaya N.P.
Epidemiology and Infectious Diseases. 2013;18(6):61-63
pages 61-63 views

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