[THE COMPARATIVE STRUCTURE OF ACUTE POISONINGS IN TWO CAPITAL CITIES OF THE SOUTH CAUCASUS REGION].

Objective - according to WHO, acute poisoning is one of the important public health global problems. At the same time, each geographic region is characterized by a unique epidemiological situation on acute poisoning. The aim of this study was to investigate and compare the main toxic-epidemiological parameters of the two largest cities of the South Caucasus - Baku and Tbilisi, and on the basis of the obtained data to develop a program on chemical safety and prevention of acute poisoning among population of the region. Data on all acute poisoned patients undergoing in-patient treatment in the hospitals of Baku and Tbilisi in 2009-2016 were placed in the standard forms and subjected to a comparative analysis. Diagnoses of toxicological patients were unified in accordance with ICD-10 (T36-T65). The total number of patients in this study was 13,292 in Baku and 14,229 in Tbilisi. The results of the study showed that in the both cities among toxicological hospitalizations dominated by cases of toxic effects of substances chiefly nonmedicinal as to source (62.13% in Tbilisi and 53.75% in Baku). However, with a detailed analysis of individual nosological units, we found significant and fundamental differences in the toxic-epidemiological profile of non-medicinal chemical poisoning in two capitals. For example, acute alcohol poisoning in Tbilisi was accounted for 24.26% of all intoxications, or 39,865 cases per 100,000 population. At the same time, alcohol intoxications in Baku were significantly less frequent, amounting to 4,454 hospitalizations per 100,000 population or 5.73% of all poisoning cases. Corrosive substances poisoning in Baku amounted 10.77% of all intoxication, while in Tbilisi it was significantly less - 3.86%. In Baku, the hospitalizations rate of acetic acid poisoning was 5.724 cases per 100.000 population, while in Tbilisi it was only 0.023 cases per 100.000 inhabitants. Toxic effects of carbon monoxide in Baku occupied 24.36% and in Tbilisi - 4.53% of all poisoning cases, which was 18.951 and 7.449 hospitalizations per 100.000 population, respectively. According to pesticide poisoning, hospitalization rates in Baku was 2,710 and in Tbilisi 6,906 cases per 100,000 population. Hospitalization of patients with envenomation in Tbilisi amounted to 5,901; and in Baku - 2,622 cases per 100,000 residents, respectively. In general, the hospitalization rate of intoxication with substances chiefly nonmedicinal as to source use in Tbilisi was 102,088 cases per 100,000 population, and in Baku - 41,817 cases per 100,000 residents respectively. This prospective toxic-epidemiological study revealed a significant incidence of acute intoxication in the two largest cities in the South Caucasus. However, there are considerable differences in the comparative profile and frequency of hospitalizations in patients with acute poisoning in Baku and Tbilisi over the period 2009-2016. The observed cases of mass and unusual intoxication during the study period make it necessary to create the unified network for the monitoring toxic-epidemiological situation and rapid information exchange on emerging toxicological risks in the South Caucasus region.

[Characteristics of etiotropic therapy of plaque infection induced by atypical strains of F1- phenotype plaque microbe]. / Osobennosti étiotropnoi terapii chumnoi infektsii, vyzvannoi atipichnymi shtammami vozbuditelia s F1- fenotipom.

The efficacy of various group antibacterial drugs: aminoglycosides, quinolones, 3rd generation cephalosporins, doxycycline, rifampicin, ampicillin and azthreonam was estimated in the treatment of experimental plague of albino mice induced by antigen complete and atypical strains of the F1- phenotype plague microbe. The in vitro experiments showed that all the strains of the plague microbe irrespective of the phenotype (F1+ or F1-) were highly susceptible to the drugs. The animal experiments demonstrated that aminoglycosides (streptomycin, kanamycin, tobramycin, gentamicin and amikacin) and cephalosporins (ceftriaxone and ceftazidim) were highly efficient in the prophylaxis and treatment of plague due to F1+ and F1- strains. In experimental plague due to F1- phenotype plague microbe the prophylactic effects of cefotaxime, cefoperazone, sulbactam/ampicillin, azthreonam, ciprofloxacin and rifampicin were lower. However, increase of the daily doses of the drugs and prolongation of the treatment course up to 7 days made it possible to increase the protective effects up to 80-100 per cent. Doxycycline and ampicillin were not sufficiently efficient even when used for 10 days in the prophylaxis of plague due to F1- strains.

[A comparative study of fluoroquinolones and 3rd-generation cephalosporins in the prevention and treatment of experimental plague caused by Yersinia pestis strains typical and serologically atypical with respect to F1]. / Sravnitel'noe izuchenie ftorkhinolonov i tsefalosporinov III pokoleniia v profilaktike i lechenii éksperimental'noi chumy, obuslovlennoi tipichnym i serologicheski atipichnym po F1 shtammami chumnogo mikroba.

Fluoroquinolones (ciprofloxacin and pefloxacin) and 3rd generation cephalosporins (cefoperazone, cefotaxime, ceftazidime and ceftriaxone) were comparatively studied in the prevention and treatment of experimental plague in albino mice caused by F1+ and F1- strains of the plague microbe. Despite the phenotype of the strain which caused the infection, the drugs were highly efficient in the etiotropic therapy. However, in the experimental plague due to F1- strains it was needed to use the maximum mean daily doses of the fluoroquinolones, cefoperazone and cefotaxime. For the prevention of the infection such doses should be used for not less than 7 days. By the efficacy ceftriaxon was superior to the other cephalosporins and should be considered as a drug of choice.