[Use of a regional registry of chronic hepatitis patients to optimize antiviral therapy]. / Ispol'zovanie regional'nogo registra patsientov s khronicheskimi gepatitami v tselyakh optimizatsii protivovirusnoi terapii.

AIM: To determine the general characteristics of patients with chronic viral hepatitis C (CVHC) from the data of a registry of patients with viral hepatitis (VH) in the Stavropol Territory and to estimate possible predictors for the inefficiency of antiviral therapy (AVT) for treatment optimization. SUBJECTS AND METHODS: The results of examining and treating patients with CVHC were retrospectively analyzed from the data of the registry of HV patients in the Stavropol Territory in 2008-2013. RESULTS: The chronic hepatitis registry includes 1811 patients with CVHC; out of them there are 64% who have its virus genotype 1. According to the registry, there is cirrhosis in 244 (13.5%) patients, fibrosis (METAVIR F2-F3 in 724 (39.97%), and fibrosis (METAVIR F0-F1) in the remaining 843. Carbohydrate and fat metabolic disturbances (obesity, insulin resistance (IR), and diabetes mellitus (DM)) have been found in 615 (34%) patients; every three patients have gastrointestinal diseases and comorbidity is absent in 24% of the patients. The results of AVT were analyzed in 493 patients with CHC virus genotype 1. The analysis showed the most important predictors for the inefficiency of AVT; these included HOMA-IR >2, the presence of IR (HOMA-IR >2.77), and type 2 DM, as well as patient age over 45 years, male sex, a viral load of ≥6 log10 IU/ml, and liver fibrosis (METAVIR ≥F3). CONCLUSION: The analysis of VH morbidity in the Stavropol Territory, the making of a registry of patients with chronic VH, its columns of IR, body mass index, virologic response changes during therapy could clarify the actual need in AVT and improve activities in the prophylactic medical examination and treatment optimization in this patient group in the areas of this region.

[Brucellosis in the Stavropol Territory: Results of 15-year follow-up of epidemiological and clinical features].

AIM: To analyze the epidemiological situation of brucellosis in the Stavropol Territory and to determine the specific features of its acute form. MATERIALS AND METHODS: The epidemiological situation of brucellosis in the Stavropol Region was retrospectively analyzed using the 2000-2014 official statistics of the Russian Federation and Stavropol Territory for brucellosis cases, individual documents of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Welfare Directorate in the Stavropol Territory and Russian Federation, and medical records of the Brucellosis Department, Stavropol Hospital Two. RESULTS: Brucellosis is a social problem in a group of focal zoonotic infections in the Russian Federation. In the North Caucasian Federal District, the largest number of new human brucellosis cases was notified in the Republic of Dagestan (59.3%) and Stavropol Territory (27.4%). The incidence of brucellosis in the Stavropol Territory was 5-10-fold higher than that in the Russian Federation as a whole. The true prevalence of brucellosis was 25% greater than the statistical data in terms of its clinical forms that were not included in official registration. Infection occurred in humans by contact with large and small cattle in 49.7% of cases. The disease mainly affected men (78.3%) and able-bodied people (67.7%); 78.5% of the patients seeking medical advice and as high as 79.9% of those being covered by serological examination of groups at risk for brucellosis were detected. There was a declining trend for the number of occupational brucellosis cases. At the same time, brucellosis accounted for 75% of the territory's total number of occupational diseases. In the past decade, brucellosis has exhibited a relatively benign course (91.3% for its moderate form), by predominantly involving the osteoarticular system (63%). Non-compliance with outpatient antibacterial therapy is one of the factors for brucellosis chronization. 28.2% of the patients who had undergone a complete therapy cycle developed chronic brucellosis less frequently (p < 0.005) than those who had stopped treatment for different reasons. CONCLUSION: Registration of brucellosis among humans is a result of the unfavorable epizootic situation of animal brucellosis. The highest incidence of brucellosis is observed in the northeastern areas of the Stavropol Territory, which border the Republic of Dagestan. The true prevalence of brucellosis greatly exceeds the official statistical data. Active detection of infection and timely diagnosis will be able to determine the real epidemic situation of brucellosis. Continuity of management and follow-up will provide a reduction in medical and social losses associated with this infection.

[Respiratory lesions in Congo-Crimean hemorrhagic fever].

AIM: To characterize pathogenesis, clinical, laboratory and x-ray features of respiratory disease in Congo-Crimean hemorrhagic fever (CCHF). MATERIAL AND METHODS: CCHF diagnosis was made in 283 patients basing on the detection in blood of specific antibodies by enzyme immunoassay (EIA) and virus RNA by polymerase chain reaction (PCR). Serum cytokines were measured with EIA. RESULTS: Pulmonary lesion in CCHF had characteristics of acute respiratory distress syndrome (ARDS). It manifested in the hemorrhagic period with blood spitting, pulmonary hemorrhage and bleeding into the pleural cavity. A high level of proinflammatory cytokines in the blood correlated with the disease severity. CONCLUSION: Respiratory affection in CCHF was seen at all the stages of the infectious process. ARDS occurs during hemorrhagic manifestations and is accompanied with systemic inflammatory reaction.

[Clinico-epidemiological characterization of Crimean haemorrhagic fever in Stavropol' region]. / Kliniko-épidemiologicheskaia kharakteristika krymskoi gemorragicheskoi likhoradki v Stavropol'skom krae.

The clinico-epidemiological analysis of morbidity in Crimean haemorrhagic fever in the Stavropol Territory is presented. Information on the clinical features, epidemiological characteristics and diagnostic criteria of the disease, as well as trends in its treatment, is given.