WEST NILE FEVER IN THE SARATOV REGION IN 2013-2015.

West Nile virus (WNV) circulation in the territory of Saratov region and its role in the infectious pathology were investigated. For this purpose, in studies conducted in 2013-2015, suspensions of bloodsucking arthropods, organs of birds and small mammals were analyzed for the presence of WNV markers (antigens and/or RNA). The seroprevalence level in live-stock animals and population of the region was evaluated; clinical samples from patients with symptoms compatible with West Nile fever (WNF) were analyzed. As a result of the investigations, WNV markers were detected in field samples gathered in natural biotopes and in the city of Saratov. Immunity to WNV was detected in horses. A stable domain of persons with immunity to this agent was revealed among regional population. Patients with WNF have been annually registered in the region since 2012. The obtained results confirm active circulation of WNF in the Saratov region, as well as formation of stable natural and anthropourgic foci.

[On the groups of maternal support of breast feeding].

The article deals with the data related to the establishment in Russia of public associations of maternal support of breast feeding initiated by the WHO/UNISEF international initiative "Baby friendly hospital". The breast feeding is mostly a concern of medicine and medical institutions of obstetrics and pediatrics and corresponding specialists such as obstetrician-gynecologist, neonatologist and pediatrician. Hence the issue of appropriateness of existence of such groups, their competence and relationship with medical personnel and forms of activity has to be considered From historical point of view, in Soviet health care accumulated very rich experience of effective cooperation of public activists of Russian Red Cross with public health bodies in implementation of preventive and health improving activities, including health education of population groups. The conclusion is made that to provide effective activities of voluntary mothers? Associations to support breast feeding their interaction is needed with medical personnel, the development of scientific-grounded programs of training of mothers-consultants and informational methodical and health education materials.

[The ecology and prevalence of arboviruses on the territory of the Saratov Region].

The territorial spread of Tahyna, Batai, Sindbis, West Nile fever and Crimean-Congo hemorrhagic fever viruses throughout the Saratov region in 1998 - 2000 was analyzed. The characteristics of the epizootic activity of the natural foci of these arboviruses in different landscape zones (temperate forest-steppes, steppes and semi-deserts) were calculated. The species composition of small mammals, the natural reservoirs of the causative agents of arbovirus infections, was determined.

[Diabetic polyneuropathy in children and adolescents]. / Diabeticheskaia polinevropatiia u detei i podrostkov.

Clinical electroneuromyography (ENMG) was carried out in 63 children aged 2-17 years with polyneuropathy (PNP). Correlations were studied between the results of the laboratory studies and ENMG evidence, duration, severity of diabetes mellitus (DM). Diabetic PNP was characterised as demyelinating motor-sensory or sensory PNP. ENMG signs of axonopathy and of a sensory block of the conductivity through the nerves of lower extremities at early stages of DM were estimated as prognostically unfavourable ones in terms of trophic complications development. Duration of DM had some influence on the nervous conductivity, while axonal function was more stable. The factor that determined the severity of PNP course was the age of DM onset. It resulted in the necessity of more accurate control because of the risk of PNP development in children with DM onset at the age of 12-13 years. At early stages of DM conductivity through peripheral nerves correlated with the level of glycosylated hemoglobin and with the frequency of hypoglycemic states.

The clinical picture and diagnosis of diphtheritic carditis in children.

UNLABELLED: During 1992 1996 we observed 122 children with diphtheria, 49 with the toxic form, in the region of Nizhny Novgorod in Russia. Sixty-four patients suffered from diphtheric carditis, 9 died. The clinical picture was characterized by a rapid development of heart and circulatory failure. ECG showed QRS alterations with intraventricular conduction impairment, sinus node dysfunction, ectopic rhythm disturbances and repolarization disturbances in all patients with carditis. Infarction-like ECG changes were typical for the pseudocoronary form with the worst prognosis. Echocardiographically there was left ventricular (LV) dilatation and depressed LV function, whereas LV muscle mass was increased. Myoglobin, LDH and CPK levels were elevated in each patient demonstrating significant differences between the various courses of disease. CONCLUSION: In diphtheria, the extent of hypermyoglobinaemia (> 2000 ng/ml) and an increased LDH1/LDH2 (> 1) ratio are reliable markers for the development of carditis indicating a poor prognosis.

[Status of the hemostatic system in patients with chronic lung diseases]. / Sostoianie sistemy gemostaza u bol'nykh s khronicheskimi zabolevaniiami legkikh.

Blood rheologic properties and homeostasis system were comprehensively examined in 23 patients with fibrous-cavernous pulmonary tuberculosis and 58 patients with various chronic nonspecific pulmonary diseases complicated by respiratory failure. The patients were found to have signs of erythrocyte edema, their more rapid depletion, lower resistance and higher aggregation which was accompanied by increased hematocrit and normal erythrocyte count. The thromboelastograms showed that all all phases of blood coagulation were shortened and fibrinolysis was deeply depressed. There was an increase in activated partial thromboplastin and thrombin time, a reduction in the values of the prothrombin indices and antithrombin III activity and higher heparin levels. The fibrinogen level was either normal or reduced despite an increase in other acute phase reactants, followed by the appearance of large amounts of blocked fibrinogen in the blood. Analysis of the findings enabled one to regard a combination of the above changes as signs of the latent DIC syndrome. Determination of fibrin and fibrinogen degradation products in a deep and long-term inhibition of fibrinolysis loses its diagnostic significance.