[Prenosological approach to assessing morbidity and mortality].

The paper deals with the morbidity- and mortality-associated problem arising from the processes occurring in the transition period of development of new Russia. It points to the leading role of health care service in this process. The authors show the real health status of the working population, the actual state of affairs with the rendering primary medical care at industrial institutions. Measures are proposed to apply specific science-based health-promoting technologies adopted from Russian space medicine and called prenosological monitoring.

[Concentration and antiviral activity of interferon-alpha in the sera of patient with hepatic pathology]. / Kontsentratsiia i protivovirusnaia aktivnost' interferona-alpha v syvorotke krovi bol'nykh s patologiei pecheni.

The normalization of the antiviral activity of interferon-alpha (IFN-alpha) in the process of the treatment of patients with acute viral hepatitis (VH), simultaneously with the results of other clinico-laboratory tests, reflects the positive dynamics of the process. The prolonged preservation of the elevated level of the antiviral activity of IFN-alpha (up to 6 months and longer) is a prognostically unfavorable sign. In patients with chronic VH the growth of both the average concentration of IFN-alpha in the blood serum and its average antiviral activity can be observed. With the progress of the disease and the formation of the cirrhosis of the liver, the concentration of IFN-alpha in the blood serum remains to be elevated, while its antiviral activity drops.

[Diagnostic and prognostic significance of characteristics of serum interferon antiviral activity in chronic and acute diffuse liver diseases]. / Diagnosticheskaia i prognosticheskaia znachimost' pokazatelei protivovirusnoi aktivnosti syvorotochnogo interferona pri khronicheskikh i ostrykh diffuznykh zabolevaniiakh pecheni.

The interferon (IFN-alpha) level and its antiviral activity were investigated in 236 patients, suffered from the chronic diffuse liver disease (CDLD), including 121 patient with chronic hepatitis (CH), 115 patients with hepatocirrhosis (HC) and 26 patients with acute viral hepatitis (AVH). This permitted to elaborate the pathogenetic and prognostic value of these indices in CH, AVH and HC. The analysis of the variations of IFN-alpha antiviral activity in patients with CDLD in dependence on the etiology, activity of the pathologic process, CH stages by CHild-Pugh graduation, the presence of the portal hypertension and its complications was carried out for the first time. The antiviral activity in the patients suffered from HC with progression of the disease, aggravation of the portal hypertension, development of the decompensation along with persisted elevated IFN-alpha concentration decreased. The main mechanisms modulating IFN-alpha antiviral activity in peripheral blood of the patients suffered from CDLD have been determined. The use of the suggested indices in the combination with other methods of the examining significantly extends the possibilities of the diagnostics, permits to evaluate the reserve possibilities of the organism and to detect the strategy of the immunomodulating treatment. The determination of the IFN-alpha antiviral activity in serum in dynamics is recommended for the control of the therapy of the patients with CDLD and AVH.

[Significance of social-hygienic monitoring in the control of environmental quality and population's health]. / Znachenie sotsial'no-gigienicheskogo monitoringa v upravlenii kachestvom okruzhaiushchei sredy i zdorov'ia naseleniia.

The paper deals with control of the population's environment and health. It shows the leading role of public health services in this activity. A standard approach to controlling environmental quality is presented. The first stage of this process is to determine the population's health status. To estimate the hazard of adverse environmental factors to human health may be a token of success in implementing health-promoting programmes.

[Organization of social-hygienic monitoring in Zelenograd]. / Organizatsiia sotsial'no-gigienicheskogo monitoringa v Zelenograde.

The paper deals with the experience of the Zelenograd Town Sanitary and Epidemiological Surveillance Center with sociohygienic monitoring. Its work on the recording and analysis of infectious and non-infectious diseases by using the present-day computers and local electronic networks is outlined. The paper shows it necessary to develop a unified approach to sociohygienic monitoring and standardization of databases in the corporative system of sanitary service.

[Hygienic significance of geohydrochemical features of the Moscow region]. / Gigienicheskoe znachenie geogidrokhimicheskikh osobennostei Moskovskogo regiona.

The biochemical features of the Moscow artesian pool and the influence of water on the population's health are shown. The paper present information on the sources of the water-supply system in the town of Zelenograd whose population uses river and artesian waters. The drinking water in Zelenograd and in the populated areas of the Moscow Region contains toxic elements, such lithium, born, strontium, fluorine, barium in the quantities greater than the adopted specifications. It is stated that the presents of the above agents in the waters of the Moscow artesian pool suggests regional geochemical anomaly. Mixing artesian and river waters in Zelenograd has a positive effect, by causing a reduction in the incidence of fluorosis.

[Cytokines in the immunorehabilitation of infectious patients]. / Tsitokiny v immunoreabilitatsii infektsionnykh bol'nykh.

For the first time in Russia the authors have defined an infectious process of Astrakhan rickettsiosis hemorrhagic fever attended by hyper- and hypoproduction of interferon g and its aftereffects. Reaferon and gammaferon therapy have proved to be very effective in fast normalisation of the immunology index. Enthalferon pills greatly reduced the morbidity rate in servicemen in rotaviral infections.

[Endogenous regulatory peptides, interferons and cytokines as adaptogens in exposure of the body to adverse environmental factors]. / Endogennye reguliatornye peptidy, interferony i tsitokiny kak adaptogeny pri vozdeistvii na organizm neblagopriiatnykh faktorov vneshnei sredy.

The authors summarize data on the efficacy of various prefabricated recombinant interferons against virus, bacterial, and chlamydial infections, and in unfavorable environments. The spaceflight factors were shown to have a negative influence on natural killers in the human body providing the immunological resistance and defence not only from foreign microorganisms but also the body cells transformed because of a virus infection or malignancy. Entalferon awakes a particular interest for its convenience in extreme conditions, space flight included. It is still an open issue whether the interferon sensitivity of natural killers is compromised by space flight. This trend of investigation seems to be of paramount importance and promise in the context of enhancing the antiviral, antimicrobic and antineoplastic immunity of cosmonauts.

[Study of antiinfectious potential of recombinant tumor necrosis factor-alpha]. / Izucheniie antiinfekstionnogo potentiala rekombinantnogo faktora nekroza opukholi alpha.

Tumor necrosis factor-alpha (TNF) was shown to have an antiinfectious effect on murine and rat models of viral, bacterial and parasitic infections. The effective antiinfectious dose of TNF was determined to be 10(2)-10(3) U/kg body weight. TNF, interferon, and antibiotics were demonstrated to potentiate the antibacterial effect of each. Clinical trials of TNF in the treatment of slowly progressive, latent, and chronic infections and in the emergency prevention of acute infections are advisable.

[Anti-Trichomonas activity of metronidazole in the presence of immunobiological preparations]. / Protivotrikhomonadnaia aktivnost' metronidazola v prisutstvii immunobiologicheskikh preparatov.

The minimal doses of metronidazole, capable of the irreversible immobilization of Trichomonas in the presence of one antiprotozoan preparation and after the addition of recombinant tumor necrosis factor (TNF), recombinant gamma-interferon and complex immunoglobulin preparation (CIP) into the culture medium, were determined on 4 T.vaginalis isolates, obtained on day 2 after the inoculation of material from the mucous membrane of the urogenital organs of patients (incubation at 37 degrees C). After 12-hour incubation of Trichomonas with immunobiological preparations their sensitivity to metronidazole increased 2-fold. After the simultaneous introduction of TNF, gamma-interferon and CIP into the culture medium, the sensitivity of Trichomonas to the action of metronidazole increased 5- to 7-fold. The introduction of an additional dose of TNF into the culture medium, but without CIP led to the preservation of the motility in a small number of these microorganisms. The use of human albumin instead of CIP at the same concentration (15 g/l) in the presence of TNF and gamma-interferon ensured the complete immobilization of Trichomonas in all isolates.

[Use of recombinant alpha2-interferon and a complex immunoglobulin preparation for the treatment of chlamydiosis in pregnancy women]. / Primenenie rekombinantnogo alpha2-interferona i kompleksnogo immunoglobulinovogo preparata pri lechenii khlamidioza u beremennykh.

The comparative study of the efficiency of using erythromycin and the combination of recombinant alpha 2-interferon with complex immunoglobulin preparation (CTP) for the treatment of chlamydiosis in pregnant women was made. 31 patients (group 1) received erythromycin orally in doses of 500 mg twice a day for 15-14 days. 30 other pregnant women were prescribed vaginal suppositories containing 300 mg. Of CTP, 2.0 x 10(6) I.U. of recombinant alpha 2-interferon and the intravaginal application of 15(2)-30 ml of solution containing the analogous amount of CTP and recombinant alpha 2-interferon. Immediately after treatment 7 patients with clinical signs of chlamydiosis were found in group 1 and 3 such patients, in group 2. In the pregnant women of group 1 the laboratory confirmation of chlamydial infection after treatment occurred 5.8 times more frequently than in the patients of group 2. In 7 women of group 1 vaginal candidiasis was diagnosed after treatment. In no case any side effects resulting from the proposed treatment were observed. Pathology caused by chlamydiae was shown to be absent in newborns and in parturient women who had received complex treatment for chlamydiosis.

[A comparative study of the information value of the immunofluorescence and immunochromatographic identification of Chlamydia trachomatis antigens in smear material from the cervical canal and of the cytological picture of a vaginal discharge in pregnant women]. / Sravnitel'noe izuchenie informativnosti immunofliuorestsentnoi i immunokhromatograficheskoi identifikatsii antigenov Chlamydia trachomatis v soskobnom materiale iz tservikal'nogo kanala i tsitologicheskoi kartiny vaginal'nogo otdeliaemogo u beremennykh.

The cytological picture of the vaginal discharge and scrape material, obtained from 30 pregnant women of the control group (not infected with C.trachomatis) and 61 pregnant women with chlamydiosis; of these, in 42 women the comparative identification of chlamydiae by the methods of direct immunofluorescence and immunochromatography was carried out. Direct immunofluorescence was carried out with the use of a set of reagents "MicroTrak" (USA) and immunochromatographic identification was made with the use of a set of reagents "Clearview Chlamydia" (Britain). The comparison of the results of immunochromatography and direct immunofluorescence revealed that the sensitivity of the set "Clearview Chlamydia" was 100.0% in comparison with the data obtained in the examination of women with the use of the set "MicroTrak". The negative results coincided in 90.1% of cases. The common features of the cytological picture of vaginal samples taken from pregnant women were established. The optimum system of the examination of pregnant women suspected for chlamydiosis, as well as for the evaluation of the effectiveness of its treatment, was proposed.

[Interferon efficacy in treating patients with Astrakhan fever]. / Effektivnost' interferonov pri lechenii bol'nykh astrakhanskoi likhoradkoi.

Astrakhan fever is a new endemic rickettsiosis belonging to the group of tick-borne spotted fevers. Adjuvant use of interferons in basic treatment of Astrakhan fever elevates its efficacy. The maximal contribution of interferons can be reached at administration of alpha-2 and gamma-interferons in daily doses 15,000-25,000 and 1500-2500 IU/kg, respectively. The response is higher at early administration of the medication. Interferons induce side effects early in the course: intensification of hyperthermia and pains.

[The effect of recombinant tumor necrosis factor on antibody formation in mice immunized with a preparation of the outer membranes from Francisella tularensis]. / Vliianie rekombinantnogo faktora nekroza opukholi na antitelogenez u myshei, immunizirovannykh preparatom vneshnikh membran Francisella tularensis.

The influence of exogenic human recombinant tumor necrosis factor (TNF-alpha) on antibody production in mice immunized with the preparation of F.tularensis outer membranes (OM) was studied. TNF-alpha was injected into mice in doses of 0.001-10 I.U. before and simultaneously with the injection of the preparation of F.tularensis OM. The levels of tularemia antibodies, determined by ELISA techniques, and the number of antibody-producing cells (APC) were studied. The study revealed that recombinant TNF-alpha in the range of doses used in this investigation stimulated the formation of humoral immunity. The injection of TNF-alpha in a dose of 0.001 I.U. was found to produce the most pronounced effect on the level of tularemia antibodies and the number of antibody-producing cells. The use TNF-alpha as immunomodulator made it possible to decrease the dose of the preparation of F.tularensis OM introduced as immunogenic agent without essential changes in the number of splenic APC and in the level of tularemia antibodies.

[The activity of natural killers and K cells and their interferon sensitivity in subjects inoculated against diphtheria and meningococcal infection]. / Izuchenie aktivnosti estestvennykh killerov, K-kletok, ikh chuvstvitel'nosti k interferonu u liudei, privitykh protiv difteriinoi i meningokokkovoi infektsii.

The work deals with the time course of changes in the activity of natural killers, K-cells, their sensitivity to interferon, which reflects, in our opinion, the reserve possibilities of this killer system simultaneously with the development of the specific sensitization of lymphocytes. Significant changes in the cytotoxicity of natural killers, K-cells, have been detected in persons immunized against meningococcal infection, especially in those immunized with meningococcal vaccine introduced in combination with diphtheria toxoid. In this latter group of volunteers even more pronounced sensitization of peripheral blood lymphocytes has been observed than in persons immunized with monopreparations. The results obtained in this investigation indicate that the determination of these cell reactions may be of importance in the evaluation of the effectiveness of immunization.

[Interactions of interferon with other immunomodulators in the regulation of human natural killer cell activity]. / Vzaimodeistvie interferona s drugimi immunomoduliatorami reguliatsii aktivnosti estestvennykh killerov cheloveka.

The cytotoxic activity of natural killer (NK) cells isolated from peripheral blood of 20 healthy donors and 34 patients with multiple sclerosis (MS) against labelled with H3-uridine target cells K-562 before and after their 1 hr treatment with reaferon (RF), T-activin (TA), myelopid (MP), opioid preparation dalargin (DL) as well as with combinations of TA, MP and DL with RF was studied in 14 hrs cytotoxic test. It has been shown that combination of RF with TA, MP and DL changed the regulatory action of these peptides on NK cell activity in healthy donors in vitro. The same combination of the preparations in patients with MS caused another changes in regulation of NK activity by them because NK cells in MS patients had had initially changed sensitivity to action of these regulatory polypeptides.

[The treatment of apical periodontitis by using combined exposure to focal measured vacuum and local d'Arsonval treatment]. / Lechenie verkhushechnogo periodontita s primeneniem sochetannogo vozdeistviia ochagovogo dozirovannogo vakuuma i mestnoi darsonvalizatsii.

Vacuum d'Arsonval treatment was employed in the treatment of 95 patients with various forms of chronic periodontitis. After tooth filling local vacuum d'Arsonval treatment was dosed for time (3 min on the vestibular and oral surface), strength of current (1-15 microA), length of discharge interval (3-4 mm), vacuum intensity (400-500 mm Hg), number of sessions (3-4 every 3 days). A 2-year follow-up has shown that vacuum d'Arsonval treatment prevented exacerbations after filling in 63 percent of cases and that in was conducive to accelerating regeneration of periodontal tissue (in 60 percent) as against the controls (14 percent).