COVID-19: etiology, clinical picture, treatment

Whereas the XX century marked the history of acute respiratory disease investigation as a period for generating in-depth system of combating influenza viruses (Articulavirales: Orthomyxoviridae, Alpha-/Betainfluenzavirus) (based on environmental and virological monitoring of influenza A virus in its natural reservoir — aquatic and semi-aquatic birds — to supervising epidemic influenza), a similar system is necessary to build up in the XXI century with regard to especially dangerous betacoronaviruses (Nidovirales: Coronaviridae, Betacoronavirus): Severe acute respiratory syndrome-related coronavirus (SARS-CoV) (subgenus Sarbecovirus), Severe acute respiratory syndrome-related coronavirus 2 (SARSCoV-2) (Sarbecovirus), Middle East respiratory syndrome-related coronavirus (MERS-CoV) (Merbecovirus). This became particularly evident after pandemic potential has been revealed in 2020 by the SARS-CoV-2. This review provides an insight into the historic timeline of discovering this virus, its current taxonomy, ecology, virion morphology, life cycle, molecular biology, pathogenesis and clinical picture of the etiologically related COVID-19 (Coronavirus disease 2019) as well as data available in the scientific literature on the anti-SARS-CoV-2-effectiveness of passive immunotherapy and most debated drugs used to treat COVID-19: Chloroquine, Hydroxychloroquine, Nitazoxanide, Ivermectin, Lopinavir and Ritonavir, Camostat mesilate, Remdesivir, Ribavirin, Tocilizumab, Anakinra, corticosteroids, and type I interferons. The pathogenesis of SARS-CoV-2 infection implicates decreased efficacy of artificial respiration, which, in this case might be replaced by more efficient extracorporeal membrane blood oxygenation supplemented with nitrogen oxide and/or Heliox inhalations

The importance of pathogenicity factors of some Streptococcus spp. and Klebsiella spp. in determining their etiological role in the inflammatory processes of the respiratory tract

Together with the known pathogens of inflammatory processes of the respiratory tract in clinical practice are often found representatives of Streptococcus and Klebsiella, previously considered commensals of the mucous membranes of the upper respiratory tract. The exchange of genetic information facilitates the transfer of virulence factors between strains not only within the species but also within the genus. In such cases, the acquisition of virulence genes by nonpathogenic species from representatives of pathogenic species contributes to the manifestation of previously not typical properties. Therefore, the aim of the research was to study the virulence of opportunistic Streptococcus spp. and Klebsiella spp. in inflammatory processes of the respiratory tract and substantiate their etiological role in the development of the disease. We studied 220 strains of Streptococcus spp. and 97 strains of Klebsiella spp., isolated from patients with inflammatory processes in the respiratory tract and from healthy individuals. Strains of Streptococcus spp. were investigated for the presence of virulence genes: sagA, lmb, fapl, ply, lytA. Strains of Klebsiella spp. were examined for the presence of virulence genes: MrkD, magA, kfu. The phenotypic marker of lmb gene expression in Streptococcus and MrkD gene in Klebsiella was the indicator of adhesion of isolated strains to buccal epithelial cells. Expression of the fapl gene was evaluated in a phenotypic biofilm formation test. In individuals with upper respiratory tract inflammation, the most common types of strepto -cocci were: S. mitis, S. anginosus, and S. oralis. Strains of these species isolated from inflammatory processes in the upper respiratory tract had 2—4 times greater adhesiveness than strains isolated from healthy individuals. Phenotypic determination of the ability to biofilm formation showed that strains of Streptococcus containing the fapl gene formed a dense biofilm in contrast to strains without the fapl gene. K. oxytoca strains isolated from people with sinusitis had mrkd, magA, and kfu virulence genes that are characteristic of K. pneumoniae strains. In phenotypic tests, it was found that the value of the adhesion index in K. oxytoca strains isolated from patients is 4 times higher than in strains of this species isolated from healthy individuals. Thus, to confirm the etiological role of an opportunistic microorganism in the development of the infectious process, it is necessary to be guided by data on the genetic and phenotypic markers of virulence of the isolated strain

Forecasting of Brucellosis Morbidity Rates in the Russian Federation Using Wald Method

Objective of the study is to conduct epidemiological analysis of official statistical data on brucellosis morbidity rates over the period of 2005–2014 in different constituent entities of the Russian Federation, using Wald method. Materials and methods. Utilized were recording and reporting documents of the Federal Service for Surveillance in the Sphere of Consumers Rights Protection and Human Welfare, FBHI “Federal Center of Hygiene and Epidemiology” of the Rospotrebnadzor, and WHO information resources.Results and conclusions. Studies of peculiarities of epidemic process development over the long-term period have allowed for identification of entities that are the most affected by the diseases. The results obtained on the morbidity rates in the Russian Federation over the period of 2005–2014 testify to the fact that first comes North Caucasian Federal District (NCFD) (62 %), next go Siberian (SbFD) (16 %) and Southern (SFD) (13 %) Federal Districts, second and third lines of the list respectively. Other regions account for 9 % of the load. The largest share of morbidity in NCFD entities belongs to the Republic of Dagestan – 62 %. Thereat, annual increment rate is 5.54 cases, which points to stabilization and some downward trend. Application of this morbidity rate prediction tool provides for in-time planning of clinical-diagnostic, prophylactic, and anti-epidemic measures in brucellosis foci. Wald method for forecasting of morbidity can be used for other infectious diseases too

Современные подходы к ведению пациентов с острой печеночной недостаточностью

The paper considers data on the etiopathogenesis and clinical manifestations of acute liver failure (ARF), as well as current approaches to managing patients with this condition. Despite success in intensive care, ARF is a clinical syndrome with a high mortality rate that amounts to as much as 50%. The clinical picture is most frequently represented by the development of coagulopathy, encephalopathy, and multiple organ dysfunction. The severity of the course, the likelihood of irreversibility of RF, and the etiological heterogeneity of the syndrome necessitate further elaboration of therapeutic strategies.Рассмотрены данные об этиопатогенезе и клинических проявлениях острой печеночной недостаточности (ОПН), а также современные подходы к ведению таких пациентов. Синдром ОПН, несмотря на успехи интенсивной терапии, представляет собой клинический синдром с высоким уровнем летальности, которая достигает 50%. Клиническая картина наиболее часто представлена развитием коагулопатии, энцефалопатии и полиорганной недостаточности. Тяжесть течения, вероятность необратимости ОПН, этиологическая неоднородность синдрома диктуют необходимость дальнейшей разработки терапевтических стратегий

Assessment of the role of microorganisms of respiratory tract in patients with progressive acute respiratory viral infections

The article presents the review of literature for the period from 1987 till 2012. It has been shown that the spread of acute respiratory viral infections (ARI) and the incidence of complications is of great social and economic importance worldwide. Therefore, the identification of etiological factors and associated development of ARI is an urgent task for practical health care. It is of great importance to determine both the type of pathogen and the presence of its pathogenic factors. The etiological agent of bacterial complications of ARI becomes Moraxella catarrhalis, featuring a large set of markers of virulence. In the development of the pathological process in the respiratory tract, adhesins, a number of enzymes and toxins produced by M.catarrhalis are important. It allows to persist and multiply in the body of the patient. Dangerous strains of M.catarrhalis, resistant to (3-lactam antibiotics and characterized by multiresistance greatly reduce the effectiveness of the therapy. Lack of laboratory studies in acute inflammatory diseases of the respiratory tract leads to the reduction of the etiological interpretation of these diseases, inadequate etiotropic treatment and as a consequence — the development of complications that reduces the effectiveness of therapy. In conclusion it is necessary to improve the system of microbiological diagnostics and tactics of treatment of ARI patients

The medical and social significance of schistosomiasis at the present stage. Schistosomiasis in the Republic of Guinea

Schistosomiasis are registered in more than 70 countries of the world in which more than 250 million people are infected, about 800 million people are at high risk of infection, and the number of deaths associated with the disease reaches 200,000 people per year. The African region accounts for about 90% of all cases. Due to the low results of many years of struggle in many endemic foci, schistosomiasis gradually passed into the category of "neglected tropical diseases". However, according to the modern WHO roadmap, the fight against schistosomiasis has again become one of the priorities, which is directly related to new diagnostic capabilities. Due to the low sensitivity of traditional microscopy, the often long asymptomatic course of the disease, the absence of pathognomonic symptoms and the high risk of developing severe complications (malignant neoplasms, liver cirrhosis, secondary infertility, increased risk of HIV infection), there is an urgent need for a new "gold standard" of diagnostics, based on modern immuno-serological and molecular genetic methods, which would meet the ASSURED criteria (Affordable, Sensitive, Specific, User friendly, Rapid and robust, Equipment free and Deliverable). Increasing the diagnostic capabilities of medical centers in endemic zones, especially in the Republic of Guinea, and extensive population studies using sensitive methods will allow timely detection of schistosomiasis among the population, especially in children, who are the most vulnerable contingent, and obtain reliable statistical data, which will become the basis for optimizing the strategy fight against dangerous helminthiasis. Praziquantel remains the treatment of choice for all types of schistosomiasis. © 2021, Dynasty Publishing House. All rights reserved

CONSOLIDATION OF THE PROFESSIONAL COMMUNITY OF TEACHERS OF GEOGRAPHY AS AN INNOVATIVE VECTOR OF GEOGRAPHIC EDUCATION IN THE NIZHNY NOVGOROD REGION

The article explores the role of geographical education at the present stage, it examines the main problems. The causes underestimation of geography as a school subject and as a science. The role of the All-Russian public organization "Russian geographical society", activity which is aimed at the revival of geographical education at all levels. On the basis of analysis of the professional associations of teachers of geography in the regions of Russia, the conclusion about the need for the Association of Geography Teachers Nizhny Novgorod region. The purpose of the Association is to consolidate the forces of geography teachers to enhance the prestige of the teaching profession, professional development and deepening of inter-regional and international relations, improve geographic education of students in the direction of its humanization, humanization, education of youth in the spirit of the priority of human values, patriotism and citizenship. The Association aims to raise the status and quality of geography education in the Nizhny Novgorod region. Disclosed are the main directions of its activities as an educational and informational, scientific and methodological and research