Коморбидность и мультиморбидность у пациентов с хроническим гепатитом С

The aim of the study was to analyze comorbidity in patients who underwent a course of antiviral therapy for chronic hepatitis C with direct antiviral drugs.Materials and methods: 288 patients diagnosed with chronic hepatitis C with stages of liver fibrosis from F1 to F4 according to the METAVIR scale, various genotypes, who underwent antiviral therapy with direct antiviral drugs in the period from 2018 to 2021, were under observation, with an analysis of comorbid and multimorbid diseases.Results of the study: most often in these patients, regardless of gender and antiviral therapy regimen, lesions of the gastrointestinal tract were registered in the form of various inflammatory diseases, as well as non-alcoholic fatty liver disease. In second place in terms of frequency of occurrence, diseases of the endocrine system were diagnosed, primarily due to the development of metabolic syndrome, as well as damage to the thyroid gland, as an extrahepatic manifestation of chronic HCV infection. Slightly less marked diseases of the cardiovascular system. A relationship was found between the number of comorbid diseases and the body mass index, with an increase in which the stage of liver fibrosis progresses.Conclusions: The frequency of comorbidity and multimorbidity in patients with chronic HCV infection is significantly higher than in uninfected patients. Patients with chronic hepatitis C with advanced stages of liver fibrosis (F3 and F4 according to the MEVIR scale) with overweight and obesity of varying severity are characterized by the highest incidence of comorbidities. A variety of extrahepatic manifestations of chronic hepatitis C determine the polymorbid profile of the patient.Цель: анализ сопутствующей патологии у пациентов, прошедших курс противовирусной терапии хронического гепатита С препаратами прямого противовирусного действия.Материалы и методы: под наблюдением находилось 288 пациентов с диагнозом хронический гепатит С со стадиями фиброза печени от F1 до F4 по шкале METAVIR, различными генотипами, прошедших курс противовирусной терапии препаратами прямого противовирусного действия в период с 2018 по 2021 г.Результаты: наиболее часто у данных пациентов независимо от гендера и схемы противовирусной терапии было зарегистрировано поражение желудочно-кишечного тракта в виде различных воспалительных заболеваний, а также неалкогольной жировой болезни печени. На втором месте по частоте встречаемости диагностированы заболевания эндокринной системы, в первую очередь за счет развития метаболического синдрома, а также поражения щитовидной железы как внепеченочного проявления хронической HCV-инфекции. Чуть реже отмечены заболевания сердечно-сосудистой системы. Выявлена взаимосвязь между числом коморбидных заболеваний и индексом массы тела, с увеличением которого прогрессирует стадия фиброза печени.Заключение: частота коморбидности и мультиморбидности у пациентов с хронической HCV-инфекцией значительно выше, чем у неинфицированных пациентов. Для пациентов с хроническим гепатитом С с продвинутыми стадиями фиброза печени (F3 и F4 по шкале METAVIR) c избыточной массой тела и ожирением различной степени выраженности характерна наибольшая частота встречаемости сопутствующих заболеваний. Разнообразные внепеченочные проявления хронического гепатита С обусловливают полиморбидный профиль пациента

Analysis of the Epizootiological Situation in the Amur Region in Autumn, 2013 Formed under the Influence of High Water over the Small Mammals

Objective of the work was to estimate the number and state of the small mammal populations after the summer flood, 2013 in the territory of the Amur Region and make short-term forecasting of the epidemiological situation development. Carried out was small animals capturing using Gero traps with bread as a bait. Epizootiological surveillance in August-September 2013 indicated that the numbers of small mammals did not differ from the average annual rates, but the process of active reproduction in the populations was being underway. In October-November a sharp increase in the animal abundance rate was registered, reproduction process terminated. Large-scale flooding resulted in the formation of local settlements with a high animal density. Stress, aggressiveness and food ration change along with seasonal migration of rodents into human buildings predetermined epizootiological and epidemiological premises for onset of natural-focal infections. Therewith the conclusion was made up that it was necessary to perform epizootiological monitoring of the small mammal populations and realization of measures aimed at the rodent extermination in human settlements in 2014

A Joint Study of Seismicity and SAR Interferometry Observations for Assessing the Possibility of an Eruption of the Dormant Bolshaya Udina Volcano

International audienceSeismicity began to be recorded in October 2017 around the dormant Bolshaya Udina Volcano (B. Udina in what follows) situated 10 km southeast of Plosky Tolbachik Volcano. Seismic tomography showed the existence of a long-lived magma chamber south of B. Udina in the area of the Tolud River. The chamber has its top at a depth of about 15 km, and may probably be connected to the Plosky Tolbachik plumbing system (Koulakov et al., 2017). Saltykov et al. (2018) and Koulakov et al. (2019) related the observed resumption of seismic activity to a hypothetical emplacement of magma beneath the Udina volcanoes, pointing out a high likelihood of the resumption of volcanic activity. The present study examines data from permanent seismic stations showing a systematic displacement of the center of seismic energy southward from B. Udina from October 2017 through August 2019. The center characterizes the location of the volume that generates the bulk of seismicity. We used images of the Sentinel-1A satellite (wavelength 5.6 cm) taken from a descending orbit of track 60 during the period from June 7, 2017 through September 23, 2017 (10 images) and during the period from May 21, 2018 to September 30, 2018 (12 images) to determine time series and average velocities of displacement on the slopes of B. Udina. Persistent scatterers could only be identified at the foot of B. Udina. An analysis of displacement time series for the surface of the volcano showed that the character of displacements in 2017 and 2018 on the southwestern and eastern slopes remained nearly the same, while the average rate of displacement on the northwestern slope decreased in 2018. We used three images of the ALOS-2 PALSAR-2 satellite (wavelength 23.5 cm) taken on October 4, 2016, June 13, 2016, and October 2, 2018 from an ascending orbit to construct paired interferograms, which characterize displacements for the time period between images. The displacements on both interferograms did not exceed a few centimeters, except for narrow zones confined to local relief forms. The deformations thus detected were most likely due to surface processes. The deformed volumes related to pressure changes in the magma chamber at a depth of 5 km must have linear dimensions of 10-15 km, while the displacement areas detected in the satellite images are considerably smaller. These results suggested an alternative model that postulates the resumption of seismic activity to accompany the retreat and sinking of magma melt from B. Udina into the chamber in the Tolud R. area as identified by tomographic techniques

Antibiotic therapy for acute respiratory viral infections in children:what do parents know about antibiotics and antibiotic resistance?

One of the causes of antibiotic resistance (AR) is irrational use of antibiotics (ABs) that are commonly administered to patients with acute respiratory viral infections (ARVIs). Rational AB use largely depends on the awareness of people. Objective. To analyze the awareness of people about AR and AB use, as well as to assess the attitude to AB therapy among parents of preschool children. Materials and methods. We conducted anonymous survey among 513 parents of preschool children in Tomsk. Results. Almost two-thirds (61.6%) of respondents admitted that their children received AB during cold/flu/ARVI. The most commonly used ABs were amoxicillin (62.3%), azithromycin (19.7%), and amoxicillin with clavulanic acid (11.1%). The majority of patients administered ABs to their children only after doctor's prescription (80.4%) and adhered to treatment regimen (79.7%). A total of 65.8% respondents stated that doctors had explained why AB therapy was necessary. Nearly two out of three parents (62.4%) believed that ABs may have a negative impact on health. More than half of the respondents were aware of AR. Conclusion. The majority of parents use antibiotics to treat ARVI in their children only with doctor's prescription. However, we observed insufficient awareness about AR, AB use, and possible side effects, which necessitates the development of educational programs for the population