[Influence of endovideosurgical operations on rate of purulent surgical complications].

Structure and rate of postoperative hospital complications after endovideosurgical operations are analyzed. Comparison of laparotomic and laparoscopic cholecystectomy and appendectomy were used as the model. Microbial contamination of unit environment and medical devices and correlation between purulent complications and laparoscopic procedures rate are analyzed.

[Current epidemiological surveillance of tuberculosis]. / Epidemologicheskii nadzor za tuberkulezom v sovremennykh usloviiakh.

Some present-day specific epidemiological, microbiological and clinical features of tuberculosis are presented. A variant of the epidemiological surveillance morbidity scheme, comprising 3 blocks, viz. information, analysis and management, is proposed. In the information block the basic data necessary for epidemic analysis is listed, while the diagnostic block contains the stage-by-stage analysis of the information block data. In the block of management decisions the main directions of the tuberculosis prophylaxis interventions are listed.

[Tick-borne borreliosis in the Iaroslavl region]. / Kleshchevoi borrelioz v Iaroslavskoi oblasti.

The present paper characterizes a natural focus of tick-borne borreliosis in the Yaroslavl Region, analyzes the incidence of this infection in the Region, and thus concludes that the density of the population living in the areas of the natural foci of tick-borne borreliosis has a significant impact on its epidemic process. The incidence of tick-borne borreliosis in the Yaroslavl Region has remained a challenge in the past 7 years. By the number of cases, this infection heads the list of naturally focal infections recorded in the Region. Examining long-term changes in the incidence and prevalence of tick-borne borreliosis in the Region revealed its high incidence in the population residing in the tidal marshlands and forest areas. At the same time the potential activity of natural foci of borreliosis due to the conditions that maintain the population of Ixodes ticks is high in the forest-field, southern, and meadow-forest-field regions.

[Reactive arthritis: terminology, etiology and pathogenesis]. / Reaktivnye artrity: terminologiia, etiologiia, patogenez.

Different serovars of Y. enterocolitica, Y. pseudotuberculosis, Acinetobacter calcoaceticus, and Pseudomonas pauimobilis were isolated from the synovial fluid of 23 out of 34 patients with Yersinia-triggered arthritis by a new bacteriological method based on the selection of the optimal conditions for microorganism culturing; in some cases the strains were isolated repeatedly. The authors discuss the necessity of correcting the previous notions on the aseptic nature of reactive arthritis.

[Bacteria of the genus Aeromonas as the causative agents of saprophytic infection]. / Bakterii roda Aeromonas kak vozbuditeli sapronoznoi infektsii.

The bacteriological study of feces from 458 patients with acute enteric diseases revealed that in 3.2% of cases (in summer in 8.1% of cases) the disease was caused by Aeromonas. In Aeromonas strains isolated from river water in the Volga delta, from fish and from raw meat the same pathogenicity factors occurred as in strains isolated from patients (hemolysin, DNA-ase, protease, lecithinase, amylase, adhesins, capacity of binding Congo red).

[The epidemiology of Yersinia infections in the central taiga subzone of the eastern European plain]. / Epidemiologiia iersiniozov v podzone srednei taigi Vostochno-Evropeiskoi ravniny.

The seroepidemiological survey of the population in four southern regions of the Komi Republic for the presence of pseudotuberculosis and enteric yersiniosis was carried out. The survey revealed a high level of seroconversions to with respect to enteric yersiniosis (26.2 +/- 2.7% with the average antibody titer being 2.6 +/- 0.2 log2) and rare contacts of the rural population with Y. pseudotuberculosis (0.4%). Moreover, the intensity of contacts of the population with the infective agent was found to be closely related to the type of cattle breeding farms: the highest level of the immune stratum (32.2%) was registered among those persons whose residence was situated near large cattle breeding complexes. The prevalence of Y. enterocolitica, serovar 0:5, has been noted: to this serovar 87% of all positive reactions were obtained. The study of medical histories revealed that is some cases the disease manifested itself in the form of acute gastroenteritis.

[Approach to evaluation of the indicators of Yersinia infections in reactive and rheumatoid arthritis]. / Podkhody k otsenke pokazatelei iersinioznoi infektsii pri reaktivnom i revmatoidnom artrite.

A total of 140 patients with reactive arthritis due to Yersinia infection were under observation for 2-10 years. A group of 104 patients with erosive rheumatoid arthritis served as control for analysis of the results of bacteriological and serological studies. The bacteriological analysis of the feces, urine, smears of the feces and blood were made repeatedly. As established the articular syndrome in reactive arthrosis has its specific features depending on the nature of the pathological process: primary, recurrent and chronic. Patients with primary reactive arthritis exhibited recovery without residual phenomena and relapses in 35.8% of the cases; in 86% the disease relapsed; in 36% it was chronic, persisting for a number of years as a non-erosive seronegative arthritis; in 25.3% arthralgia persisted; in 6.2% the clinical picture of secondary osteoarthrosis developed; in 17.3% the disease changed into spondyloarthritis and in 1.2% of the cases it changed into RA. Since in reactive arthritis Yersinia infection was confirmed in 48.5% of the cases and in RA in 14-21%, laboratory diagnosis cannot serve as an absolute criterion for reactive arthritis. It is necessary to take into consideration the anamnesis and the peculiarities of the clinical picture and the course of the articular syndrome.

[The results of the dynamic observation of patients with reactive Yersinia arthritis]. / Rezul'taty dinamicheskogo nabliudeniia bol'nykh reaktivnym iersinioznym artritom.

As many as 50 patients with reactive Yersinia arthritis were followed up. There were 4 men and 46 women. The mean age of the patients was 31.1 yr. The mean follow-up period was 30.8 months. In 72% of the cases, the disease was preceded by diarrhea. During the first examination, mono-oligoarthritis was detected in 78% of the patients. Extra-articular alterations (damage of muscles, ligaments, heart, skin changes, etc) were also recorded. The results of bacteriological analyses were positive in 22 out of the 50 patients. In 16 persons, Yersinia might be cultivated from the different biological media: blood, feces, urine, fauces, and synovial fluid. In 47 persons, arthritis took a chronic course. Persistence of antibodies of the types 03 and 09 seen for many years merits attention. Monoclonal anti-Yersinia antibodies were also detectable repeatedly. In 8 patients, in whom Yersinia were cultivated from a lot of the biological media, the disease ran an especially grave course. The role of circulating specific antibodies in patients with Yersinia arthritis and the trigger role they may play in the development of RA and ankylosing spondylarthritis requires further discussion.

[Yersinia arthritis in children]. / Iersinioznyi artrit u detei.

Clinical and laboratory evaluation of arthritis in 36 children with diagnosed enteric yersiniosis is presented on seven-years' follow-up data. Twenty-eight patients were found to have an active course of the disease developing in cycles with a favourable outcome and no residual effects. In eight cases arthritis took a protracted (up to 8-10 months) or chronic (over 12 months) course which ended in clinical and laboratory remission; in three of the eight cases the clinical picture was similar to that of rheumatoid arthritis, in two of which the diagnosis was not excluded by the morphological study of the synovial biopsy sample.

[Immunological structure of the populations of the upper and middle Volga River regions in relation to the causative agent of yersiniosis and its determining factors]. / Immunologicheskaia struktura naseleniia Verkhnego i Srednego Povolzh'ia k vozbuditeliu iersiniozov i opredeliaiushchie ee faktory.

The study of the immunological structure of the population in respect of intestinal yersiniosis at territories with different hydrothermal conditions has revealed the presence of a greater immune stratum (23.9% with the average agglutination titer being 1.8 +/- 0.09 log D) in humid areas, such as the region of the Upper Volga, in comparison with dry areas, such as the region of the Middle Volga, where the level of the immune stratum has proved to be twice as low (10.6% with the average agglutination titer being 0.8 +/- 0.1 log D). At both territories no essential differences in the risk of infection between the inhabitants of rural and urban areas, as well as between different professional and age groups have been revealed, with the exception of persons over 51 years of age, among whom the occurrence of seroconversions has proved to be lower.