Rabies surveillance in the Russian Federation.

Rabies is endemic to the Russian Federation. The disease incidence ranges between 2,000 and 4,000 cases annually. Between two and six cases in humans are also reported each year. Wild animals are the basic reservoir and vector of the virus, and the incidence of rabies in foxes and raccoon dogs amounts to 50% of the total number of disease cases. When outbreaks occur, the disease is also reported in domestic animals. To prevent the further spread of rabies, vaccination of domestic animals and oral immunisation of wildlife are practised. Unfortunately, vaccine coverage and disease prevention measures have not been sufficient to achieve a notable improvement in the rabies situation in the country.

La rage est présente à l'état endémique dans la Fédération de Russie. Son incidence varie de 2 000 à 4 000 cas par an. Deux à six cas de rage humaine sont également enregistrés chaque année. Les animaux sauvages constituent le principal réservoir et vecteur du virus, l'incidence de la rage chez le renard et le chien viverrin représentant 50 % du nombre total de cas. En cas de foyer, la maladie affecte également les animaux domestiques. La vaccination des animaux domestiques et l'immunisation orale de la faune sauvage sont les deux mesures appliquées pour empêcher la rage de se propager davantage. Malheureusement, la couverture vaccinale obtenue et les mesures de prévention appliquées n'ont pas suffi à améliorer significativement la situation de la rage.

La rabia es endémica en la Federación de Rusia, con una incidencia que va de los 2 000 a los 4 000 casos anuales. Cada año se notifican entre dos y seis casos en el ser humano. Los animales silvestres son el principal reservorio y vector del virus: la incidencia de la rabia en zorros y mapaches supone el 50% de la totalidad de los casos. Cuando estallan brotes también se registran casos en animales domésticos. Para impedir que la enfermedad se siga propagando se procede a la vacunación de los animales domésticos y a la inmunización oral de la fauna silvestre. Lamentablemente, la cobertura de vacunación y las medidas de prevención no han bastado para lograr una mejora sustancial de la situación de la rabia.

[Combined use of local anesthetic with clonidine in cases of tooth extraction].

The technique of local anesthesia by lidocain in combination with clonidine (clofelinum) as vasoconstrictor in the dose of 1 microg/kg was compared with local anesthesia by novocain in combination with adrenaline (1:200 000) or by lidocain without vasoconstrictor or by articain in combination with adrenaline (0.012 mg/ml). Lidocain use led to expressed tachycardia and considerable increase of cardiac oufput in moderate hypertension reactions. Adrenaline addition in anesthetic solution increases general peripheral resistance and all parameters of arterial pressure with simultaneous rise of heart contractions. Adrenaline substitution as local vasoconstrictor for clofelinum decreases sympathetic tension during operation, prevents hypertensive reactions as the result of general peripheral resistance decrease, stabilizes heart rhythm and basic indices of central hemodynamics, that testifies to its (technique) adequacy.

[General status of patients before dental treatment]. / Obshchee sostoianie bol'nykh pered lecheniem u stomatologa.

Arterial pressure (AP), heart rate, and stress index (estimated by ECG) were measured in 20 patients several minutes before dental treatment. Systolic AP was normal in 56% patients (mainly elderly), diastolic was normal in 50.5% and increased in 36% (particularly so in elderly patients). Heart rats was normal in 33% patients, the rest had bradycardia (6%) or tachycardia (61%); the latter condition was more typical of young patients and was paralleled by high systolic AP. 10.5% patients had normal stress index and in 87.5% it was increased, indicating extreme stress of the sympathoadrenal system. All 4 parameters were normal in 3.5% patients, half of whom were youths aged under 20 years. 10.5% examinees had three normal parameters, 32.5% had two normal parameters, and 37.5% had one normal parameters; 16% examinees had all parameters beyond the threshold values. The authors point to the double hazard of such a state (possible complications and decreased pain sensitivity) and emphasize the need in preventive measures to correct the general status of patients.