Vol 24, No 2 (2019)

Data on identification and verification of the etiologically diagnosis of a acute respiratory viral infections are presented in article at sharp upper respiratory tract infections of the multiple and not specified localization and at local diseases of respiratory organs in Vladivostok. The highest average value of detectability from 2011 for 2017 was at a rinoviral infection - 22,8 cases %ооо. The detectability of flu A (H3N2) was 19,6%ooo; flu A (H1N1) - 15,1%ooo; flu B - 9,8%ooo. Detection of the acute respiratory viral infections verified on an etiology had natural seasonality. The incidence of flu, caused by representatives of the Orthomyxoviridae family, was formed in the winter and in the spring. During the summer-autumnal period rise in incidence of Paramyxoviridae family viruses was formed (paraflu, RS-viral infection, a metapneumoviral infection). The Coronaviral infection had winter seasonality. The Rinoviral infection, adenoviral and bakaviral infections were characterized by summer-autumnal seasonality. According to the nature of seasonality and structure of the verified cases on months of year the probability of confirmation of the diagnosis of a rinoviral infection from May to October was from 56,8+5,1% to 62,1+7,5%. Similar situation develops with paraflu. From May to November the specific weight of the verified paraflu was from 11,6+4,9% to 19,5+4,9% of all confirmed SARS cases. For flu A (H1N1) the probability of confirmation of the diagnosis from December to March is from 15,4+3,9% to 54,8+5,3%. And at flu A (H3N2) in data of month - from 5,2+2,4% to 47,6+4,0%. At flu B high probability of confirmation of the diagnosis in spring months, in March and April, 30,0+3,6% and 26,4+5,2%.

The aim of the work is to create a sensitive, fast and easy-to-use immunochemical assay for the detection of orthopoxviruses in the “point of care” format. The objectives of the study included: the fine-tuning of technology of preparation and use of the developer for colloidal gold conjugates in autonomous diagnostic systems based on flat protein matrices, as well as testing of this technology for detecting vaccinia virus. The quality of available reagents (metol, citric acid and silver nitrate) for the manufacture of the developing system was assessed: the most suitable reagents were selected. A technology has been fine-tuned for the preparation of a developer. The developer includes the dry component in the form of tablets (3.5-4 mg) containing metol and citric acid in a ratio of 2:3, and the liquid component - 0.4% silver nitrate solution. To increase the contrast and stability of optical signals, it was proposed to use the processing of the developed protein matrix with an alkaline solution of thiourea. The use of a two-component developer allows the detection of vaccinia virus in non-laboratory conditions with a sensitivity of 5.4 × 104 PFU/ml.

In 2018 key changes were made to the recommended treatment for multi-drug resistant tuberculosis, the priority of oral medications over injectables was indicated. For the first time in history, a new, completely oral 20-month treatment regimen was proposed. The regimen recommends bedaquiline and linezolid together with levofloxacin / moxifloxacin, cycloserine / clofazimine. This treatment regimen differs from the standard 4 MDR-TB chemotherapy regimens adopted in Russia. Until recently, bedaquiline and linezolid were relatively unobtainable in the conditions of tuberculosis dispensaries, patients who needed such treatment were referred to specialized Federal tuberculosis facilities. The aim of the study was to study the long-term results of treatment of patients with drug-resistant pulmonary tuberculosis in cases of the ineffectiveness of previous therapy in an antituberculosis dispensary and referral to a specialized Federal tuberculosis institution. In 2010-2014, 143 people of both sexes in the age group from 20 to 60 years old were treated in the Tver Regional Clinical Antituberculosis Dispensary. Individual conversations, organizing communication with other patients who received effective anti-tuberculosis treatment, watching the training video “Tuberculosis: Questions and Answers”, studying the materials of the brochure “School of the Patient. A brochure for patients suffering from tuberculosis” developed by the charitable organization “Partners in the name of health” was used in the process of increasing adherence to treatment. When carrying out measures to increase adherence to treatment among patients with pulmonary tuberculosis, a positive result was obtained in 143 people. These patients agreed to possible surgical intervention in the Federal Tuberculosis Institution. Immediately after the surgical stage of treatment, cavity closure and/or abacillation were achieved in 132 (92.3%) people. In the postoperative period anti-tuberculosis therapy was continued in accordance with the drug-resistant pathogen, the discipline of patients in receiving anti-tuberculosis drugs increased significantly.