Малярия: современное состояние диагностики и лечения

Status and modern ways in malaria diagnostics and treatment are reviewed. It's noticed that malaria severity and treatment efficacy, specifically for falciparum-malaria, depend on diagnostics terms as well as on timely and adequate ethyotropic and pathogenic therapy. Clinical characteristics of malaria in children based on the obtained data in endemic region in Tajikistan and approaches to optimization of treatment are described.Рассмотрены состояние и современные возможности диагностики и лечения малярии. Отмечено, что тяжесть течения и эффективность лечения малярии, особенно тропической, зависят от сроков диагностики, своевременной и адекватной этиотропной и патогенетической терапии. Отражены особенности течения малярии у детей по материалам наблюдения в эндемичном районе Таджикистана и подходы к оптимизации лечения

Optimizing the intensive care treatment of severe and complicated plasmodium falciparum malaria in nonimmune patients

This study analyses the intensive care treatment of 48 patients admitted to the Intensive Care Unit (ICU) at the Infectious Diseases Clinical Hospital No. 2, Moscow, Russia, between 2007 and 2019, with a severe and complicated form of P. falciparum malaria (B50.8 ICD 10). Objective. The aim of this study was to improve the intensive care treatment for severe and complicated P. falciparum malaria. The treatment strategy implemented was aimed at preventing ischaemia-reperfusion injury to organs, as well as haemorrhagic complications. The ICU Case Management Protocol set up indications for transferring patients to the ICU which provide preventive (prior to the development of renal failure) application of extracorporeal hemocorrection methods (continuous venous-venous hemodiafiltration and plasmapheresis in a plasma exchange mode) and mechanical ventilation under a medically induced coma, given impaired consciousness as the initial symptom of patients. Results. Successful treatment outcome in a majority of the patients (93.8%), shorter ICU length of stay (6.67 ± 1.9 days as compared to 94 ± 1.6 before introduction of the protocol), a median parasite clearance time of 37.50 hours (95% CI 36.21-38.18), and a reduced mortality rate from 29.1% to 6.25% support the efficacy of the ICU protocol in managing severe and complicated P. falciparum malaria. © 2020 V. B. Chentsov et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Сравнительная оценка эффективности методов заместительной почечной терапии при тяжелом течении геморрагической лихорадки с почечным синдромом

A comparative assessment of the effectiveness of renal replacement therapy methods is presented in the article with examples of clinical cases: prolonged venovenous hemodiafiltration and hemodialysis in patients with severe hemorrhagic fever and renal syndrome complicated by acute renal failure.В статье на примере клинических случаев, представлена сравнительная оценка эффективности методов заместительной почечной терапии: продленной вено-венозной гемодиафильтрации и гемодиализа у больных с тяжелым течением геморрагической лихорадки с почечным синдромом, осложненной острой почечной недостаточностью

Problems of clinical diagnosis and treatment of P. Falciparum malaria in Russian Federation

Aim. To study the causes of falciparum malaria deaths in Russian Federation and to optimize therapy for severe forms of the disease. Materials and methods. The analysis of falciparum malaria cases with deaths recorded in Russian Federation from 2013 to 2017 was conducted. The results of optimization of pathogenetic therapy of severe forms of falciparum malaria for the prevention of adverse outcomes in the intensive care unit of the Infectious Clinical Hospital №2 of Moscow in 44 patients with severe course are presented. Treatment, clinical laboratory and instrumental investigations were carried out in accordance with our intensive care protocol, which took into account the current WHO recommendations. Results. From 2013 to 2017 there were nine deaths from falciparum malaria reported in patients from African countries (6) and India (3). In Russia, due to the lack of effective drugs of artemisinin group, quinine with tetracycline or doxycycline is used for etiotropic therapy of patients with complicated form of falciparum malaria. In the management of such patients, the basis for treatment was the prevention of is-chemic, reperfusion injuries of organs and hemorrhagic complications. In the infectious clinical hospital №2 of Moscow, since 2007, the intensive care unit has developed and tested a protocol for intensive therapy in patients with severe and complicated forms of falciparum malaria, including preventive methods of extracorporeal hemocorrection with prolonged veno-venous hemodiafiltration therapy and plasmapheresis, as a result of which the mortality rate decreased from 84 to 6.8% Conclusion. The country's lack of anti-malarial drugs, the insufficient awareness of the population about the risk of infection and measures to prevent malaria, late referral of cases for medical care and errors of clinical diagnosis and treatment annually lead to fatal outcomes. In such situation, the experience of optimizing the treatment of severe falciparum malaria is particularly useful, allowing decreasing the mortality. © 2018 Media Sphera Publishing Group.All Rights Reserved

Сравнительная оценка эффективности методов заместительной почечной терапии при тяжелом течении геморрагической лихорадки с почечным синдромом

A comparative assessment of the effectiveness of renal replacement therapy methods is presented in the article with examples of clinical cases: prolonged venovenous hemodiafiltration and hemodialysis in patients with severe hemorrhagic fever and renal syndrome complicated by acute renal failure.В статье на примере клинических случаев, представлена сравнительная оценка эффективности методов заместительной почечной терапии: продленной вено-венозной гемодиафильтрации и гемодиализа у больных с тяжелым течением геморрагической лихорадки с почечным синдромом, осложненной острой почечной недостаточностью

Human babesiosis: Clinical cases in the european part of the Russian Federation

The article describes four clinical observations of patients with babesiosis detected in the European part of the Russian Federation, two of whom were under the direct supervision of the authors. The analysis of epidemiological data, clinical picture, results of laboratory studies in the dynamics of the disease. Differential diagnosis and treatment are discussed. © 2019 Consilium Medikum. All rights reserved