General dynamics of the URT microbiome and microbial signs of recovery in COVID-19 patients.

COVID-19 is caused by an airborne virus, SARS-CoV-2. The upper respiratory tract (URT) is, therefore, the first system to endure the attack. Inhabited by an assemblage of microbial communities, a healthy URT wards off the invasion. However, once invaded, it becomes destabilised, which could be crucial to the establishment and progression of the infection. We examined 696 URT samples collected from 285 COVID-19 patients at three time-points throughout their hospital stay and 100 URT samples from 100 healthy controls. We used 16S ribosomal RNA sequencing to evaluate the abundance of various bacterial taxa, α-diversity, and ß-diversity of the URT microbiome. Ordinary least squares regression was used to establish associations between the variables, with age, sex, and antibiotics as covariates. The URT microbiome in the COVID-19 patients was distinctively different from that of healthy controls. In COVID-19 patients, the abundance of 16 genera was significantly reduced. A total of 47 genera were specific to patients, whereas only 2 were unique to controls. The URT samples collected at admission differed more from the control than from the samples collected at later stages of treatment. The following four genera originally depleted in the patients grew significantly by the end of treatment: Fusobacterium, Haemophilus, Neisseria, and Stenotrophomonas. Our findings strongly suggest that SARS-CoV-2 caused significant changes in the URT microbiome, including the emergence of numerous atypical taxa. These findings may indicate increased instability of the URT microbiome in COVID-19 patients. In the course of the treatment, the microbial composition of the URT of COVID-19 patients tended toward that of controls. These microbial changes may be interpreted as markers of recovery.

[Immunopatological and genetic aspects of pathogenesis of CNS lesions in VZV infection]. / Immunopatologicheskie i geneticheskie aspekty patogeneza porazhenii TsNS pri VZV-infektsii.

The review article provides information about the features of the Varicella-zoster virus (VZV), about the clinical manifestations of CNS damage in acute and chronic VZV infection in children and adults, about the mechanisms of interaction of the pathogen with the immune system during the development of the disease. The question of whether to consider neurological disorders in VZV infection as a complication or manifestation of the disease caused by a defective virus or the presence of subclinical immunodeficiency is discussed, which is confirmed by modern scientific studies. The critical mechanisms of immune defense against VZV, which are the main reason for the penetration of the virus into the CNS and the development of neurological disorders, as well as the relationship between VZV genotypes, the presence of mutations in the gE gene and the nature of the course, the identification of rare variants of the POLR3A, POLR3C, POLR3E and POLR3F genes associated with violation of IFNs induction, and the development of severe VZV infection, in which vasculopathy also occurs, which is the basis for the use of vascular drugs of complex action, such as Cytoflavin, the effectiveness of which has been proven by the authors. A special place is given to the analysis of intrathecal immunopathogenesis, which is likely to be associated with the presence and severity of neurological manifestations, their relapses. The issue of the causes of the development of a severe course of the disease in patients vaccinated against chickenpox, as well as the issue of resistance to specific antiviral drugs, probably associated with the presence of mutations responsible for the resistance of the virus to therapy, is discussed.

[Economic aspects of occupationally conditioned diseases risk (exemplified by potassium salts extraction enterprises].

Economic evaluation of workers' health disorders risk could include cost equivalent not of health itself, but a prevented risk for worker's health. The authors evaluated a potential underproduced output during disablement period and changes of tax proceeds (except gross domestic product losses). This approach was tested in evaluating risk for.health of workers engaged into underground mining on potassium salts extraction enterprise. Mathematic models of unfavorable effects development enabled to follow dynamics of these effects and forecast possible development of diseases in the studied workers group.

[THE MEDICAL SOCIAL STUDY OF QUALITY OF NURSING CARE].

The article considers medical social aspects of quality of nursing care. The questionnaire survey of nursing personnel of oblast and municipal medical organizations of Omsk was carried out. The results permitted evaluating qualification of nursing medical personnel, organization of personnel training at workplace and internal control of knowledge and skills in medical organizations. The results of analysis can be applied in development of measures concerning optimization of organizational actions in the area of management of nurse business quality.

[THE AVERAGE DURATION OF TREATMENT OF THE INJURED WITH DIFFERENT FORMS OF ACUTE INTOXICATIONS OF CHEMICAL ETIOLOGY].

The article presents materials relate to analysis of average duration of the injured of Omsk under different forms of acute chemical intoxications during 2001-2013. It was established that during analyzed period as a result of implementation of new organizational technologies occurred reliable. decreasing of duration of treatment of patients with light, medium and severe forms of acute chemical intoxications. Under severe complicated forms with lethal outcome no reliable dynamics of average duration of treatment of patients were established.

[The analysis of infant mortality in Omsk oblast' in 2002-2012].

In Omsk oblast during 2002-2012 a stable increase of birth rate is noted. Against the background of birth rate increase up to 2011 a positive dynamics of decrease of infant mortality was noted. In 2012, indicator of infant mortality increased up to 38.9% as compared with 2011. This occurrence can be explained by the change over to the new criteria of viviparity from January 1 2012. No significant alterations occurred in the structure of infant mortality in 2002-2012.

[The hospitalized morbidity of children population of Omsk as a result of acute intoxication of chemical etiology in 2003-2012].

The article analyzes the rate of hospitalization of children with acute intoxications of chemical etiology in Omsk during 2003-2012. It is established that during the mentioned period decrease of hospitalized morbidity of acute intoxication of chemical etiology occurred among children population of Omsk. The basis of hospitalization constitute acute medicinal intoxication. The level of hospitalization because of alcohol intoxication decreased too. At the same time the rate of hospitalization in the result of intoxication with poisons of vegetable origin significantly increased.

[The actual incidence of the population in the RF subject: assessment of economic effect (losses)].

In the paper there is presented an analysis and evaluation of the economic losses associated with the actual incidence of the population of the Altai Region on disease classes "Poisoning by drugs, medicaments and biological substances" (T36-T50) and "Toxic effect of substances, mainly non-medical purpose" (T51-T65), including the assessment of the underproduced product in economy of the region in monetary terms, assessment changes in cash flows on the budgets of the Russian Federation (tax receipts). The time period of analysis on disease classes is 5 years (2007-2011).

[The dynamics of population mortality due to acute alcoholic intoxications in the Russian Federation].

The article deals with the study of dynamics of population mortality in the Russian Federation as a result of acute intoxications in 2001-2010. In the Russian Federation, during the examined period, population mortality due to casual acute alcoholic intoxications decreased up to 2.1 times. The most rapid race of mortality decrease occurred in the Central Federal Okrug and the slowest race was established in the Siberian Okrug. The highest population mortality rate as a result of alcoholic intoxications is in the Siberian Okrug and the lowest ones--in the South Okrug. The analysis of mortality rates as a result of chemical intoxications and their dynamics will allow to assess the toxicological situation and to determine the strategic directions of preventive activities in the area of chemical security on the regional level.

[The dynamics of the indicators of population mortality in Omskaya oblast as a result of acute chemical intoxications in 2001-2010].

The study was organized to investigate the dynamics of indicators of population mortality in Omskaya oblast due to acute chemical intoxications in 2001-2010. The dynamics of indicators of population mortality under acute exogenous intoxications is a chief medical demographic characteristic of premature social losses. The analysis of the mortality indicators structure favors to reveal the major causes of development of unfavorable situations and to develop the concept of organization of chemical security of population in Omskaya oblast.

[Medico-social studies of reproductive behaviour in first-term female students of vocational schools].

This questionnaire study was designed to analyse reproductive behaviour of 702 first-term female students of vocational schools located in the city of Omsk. It provided data on the sources and level of awareness of sex life hygiene. Recommendations are proposed for the development of prophylactic measures.

[The morbidity of persons dwelling in the gerontological centers].

The article deals with the results of comprehensive medical social study of medical social characteristics of morbidity and disability among persons dwelling in the gerontological centers. It is established that persons dwelling permanently in the gerontological centers need a special attention of the medical stuff and highly require the long-term supportive care and rehabilitation and social support measures.

[The medical social aspects of acute intoxications of chemical etiology].

The purpose of the study was to investigate the medical social aspects of morbidity of adult population in case of such forms of traumatism as acute chemical intoxications. The comprehensive medical social study of the issues of chemical pathology was executed applying the factorial analysis technique. This particular method of statistical analysis gave an opportunity to establish the major causes and risk factors of development of acute intoxications of chemical etiology in adult population of large industrial center. This is a mandatory condition for optimizing the organizational managerial conditions within the framework of this kind of traumatism.

[On the results of the medical social study of the female infertility].

The results of the medical social study of the female infertility in the Omskaya Oblast from 1995 to 2005 is presented. According the data of the family planning and reproduction center, the portion of the females being observed on the occasion of the infertility, consists 28.6% of general number being registered on the books. The study data permitted to pick out the factors enhancing the development of both primary and secondary infertility among females.

[The state of health of the inmates of children's homes].

The basic results of the study of the general disease incidence and the pathological affectedness of the inmates of children's homes of Omsk oblast during 2000-2005. The respiratory diseases, the diseases of digestive system, the ophthalmic and accessory apparatus diseases, the infectious and parasitogenic diseases, the diseases of nervous system predominate in the structure of morbidity of the children-orphans. According the medical examination data, the percent of the healthy children does not exceed 9% and the percent of the children with chronic diseases makes up to more than 40%. The assessment of the subjective status of the school-age orphans revealed the discrepancy of their appraisal of state of health, physical activity and emotional conditions which is caused by the social immaturity and the fatigue.

[Development of chronic diseases in adolescents].

Complex impact of various factors on development of chronic diseases among adolescents aged of 15-17 years and dwelling in districts of Omskaya oblast is analyzed. It is noted that out of twelve factors four of them are of educational pedagogic category. Besides, one of these (the twelfth) takes second rank place emphasizing that making necessary hygienic conditions of education is of highly significance for maintenance of adolescent health. The most pronounced effect on development of chronic pathology among adolescents is produced by habitation conditions, timeliness and quality of applied health-improving medical activities during childhood. All educational pedagogic and some other factors can be controlled setting up thereby reserve for decreasing adolescent morbidity.

[A virological description of serous meningitis in children immunized with vaccine against epidemic parotitis]. / Virusologicheskaia kharakteristika seroznykh meningitov u detei, immunizirovannykh vaktsinoi protiv épidemicheskogo parotita.

The morbidity structure was analyzed in children vaccinated against epidemic parotitis in 1993-2002. Eight children (4 with serous meningitis and 4 with lesions of the salivary glands) underwent virologic and immunologic examinations. The molecular typing of the SH-gene fragment of the parotitis virus showed the process in 7 cases to be provoked by the vaccination strain. Presumedly, progressing vaccine-associated meningitis inhibits antibody formation. The total incidence of vaccine-associated meningitis was shown, according to Saint Petersburg data, to be not high, which testifies to a low reactogenicity of the Russian vaccine strain.

[Health of rural population under active migratory processes]. / Zdorov'e sel'skogo naseleniia v usloviiakh aktivnykh migratsionnykh protsessov.

Human health changes occurring in the presence of active migratory processes were analyzed in a rural area of the Orenburg region in 1995 to 2000. There were increases in morbidity and mortality rates. The rates of deaths caused by accidents, injuries and intoxication were noted to rise in the structure of mortality in the able-bodied population. The total mortality rate in the adult population in the area exceeds the average one of Russia. There is an evident tendency for an increase in the incidence of some most important non-epidemic diseases in the population. This all provides evidence for that its necessary to work out a system of preventive measures and, first of all, among socially disadapted strata of society.

[Four levels (types) of immune reponse in children with viral parotitis infections]. / Chetyre urovnia (tipa) immunnogo otveta u detei, perenosiashchikh parotitno-virusnuiu infektsiiu.

Four levels (types) of immune response, differing by expression of cytokines (TNF-alpha, IL-1 beta, IL-4, and gamma-IFN) and immunoglobulins IgG2, IgG3, IgG4, and IgE) and by expression and time course of specific cell-mediated and humoral immune response, were detected in children with different clinical forms of mumps. Types 1 and 3 immune response are predominantly cell-mediated, while types 2 and 4 predominantly humoral during the acute phase of the disease. The cytokine and antigen-specific profiles of each type of immune response correlate with the severity of clinical course of mumps.

[Disability in chronic nonspecific diseases of the lungs]. / Invalidnost' pri khronicheskikh nespetsificheskikh zabolevaniiakh legkikh.

The author presents the data of medical social study of disability caused by chronic nonspecific diseases of the lungs (CNDL) in Omsk and the Omsk region and analyzes the level, structure, and time course of primary disability in relation to sex, age, place of residence, and disability group. Working loss caused by CNDL in cities and in the country is evaluated. Factors promoting the formation of disability in CNDL are evaluated. One of important factors is the quality of check-ups of patients. The majority of risk factors can be controlled, which creates a certain reserve for decreasing disability in CNDL.