EVALUATION OF CHANGES IN TUBERCULOSIS EPIDEMIOLOGICAL RATES AMONG PRISONERS IN THE PENITENTIARY SYSTEM OF RUSSIA AND SMOLENSK REGION

The article presents the results of retrospective analysis of tuberculosis epidemic situation among prisoners in Smolensk Region and its comparison with the same rates in the Russian Federation for 2007-2013. During those years positive changes had been observed in tuberculosis incidence, mortality and prevalence rates. The rates for the region were significantly lower compared to the rates in the penitentiary system for the whole country. Tuberculosis incidence in remand prisons of Smolensk Region was higher compared to the same in penal colonies and overall rate in the penitentiary system of Smolensk Region. Those in the age from 21 to 40 years prevailed among tuberculosis patients in Smolensk Region during the period being analyzed

ОЦЕНКА ДИНАМИКИ ЭПИДЕМИОЛОГИЧЕСКИХ ПОКАЗАТЕЛЕЙ ПО ТУБЕРКУЛЕЗУ СРЕДИ СПЕЦКОНТИНГЕНТА УГОЛОВНО-ИСПОЛНИТЕЛЬНОЙ СИСТЕМЫ РОССИЙСКОЙ ФЕДЕРАЦИИ И СМОЛЕНСКОЙ ОБЛАСТИ

The article presents the results of retrospective analysis of tuberculosis epidemic situation among prisoners in Smolensk Region and its comparison with the same rates in the Russian Federation for 2007-2013. During those years positive changes had been observed in tuberculosis incidence, mortality and prevalence rates. The rates for the region were significantly lower compared to the rates in the penitentiary system for the whole country. Tuberculosis incidence in remand prisons of Smolensk Region was higher compared to the same in penal colonies and overall rate in the penitentiary system of Smolensk Region. Those in the age from 21 to 40 years prevailed among tuberculosis patients in Smolensk Region during the period being analyzed.Представлены результаты ретроспективного анализа эпидемической ситуации по туберкулезу среди спецконтингента Смоленской области в сравнении с таковыми данными по Российской Федерации за 2007-2013 гг. Установлена наблюдавшаяся положительная динамика в изменении показателей заболеваемости, смертности и распространенности. Данные по региону были значимо ниже показателей по пенитенциарному сектору страны. Заболеваемость туберкулезом в следственных изоляторах Смоленской области выше таковой в исправительных колониях и общего значения индикатора в пенитенциарной системе региона. Среди заболевших в Смоленской области в анализируемом периоде преобладали лица в возрасте 21-40 лет

Нозокомиальная пневмония у взрослых: практические рекомендации по диагностике, лечению и профилактике. Пособие для врачей

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Liraglutide and Renal Outcomes in Type 2 Diabetes.

BACKGROUND: In a randomized, controlled trial that compared liraglutide, a glucagon-like peptide 1 analogue, with placebo in patients with type 2 diabetes and high cardiovascular risk who were receiving usual care, we found that liraglutide resulted in lower risks of the primary end point (nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes) and death. However, the long-term effects of liraglutide on renal outcomes in patients with type 2 diabetes are unknown. METHODS: We report the prespecified secondary renal outcomes of that randomized, controlled trial in which patients were assigned to receive liraglutide or placebo. The secondary renal outcome was a composite of new-onset persistent macroalbuminuria, persistent doubling of the serum creatinine level, end-stage renal disease, or death due to renal disease. The risk of renal outcomes was determined with the use of time-to-event analyses with an intention-to-treat approach. Changes in the estimated glomerular filtration rate and albuminuria were also analyzed. RESULTS: A total of 9340 patients underwent randomization, and the median follow-up of the patients was 3.84 years. The renal outcome occurred in fewer participants in the liraglutide group than in the placebo group (268 of 4668 patients vs. 337 of 4672; hazard ratio, 0.78; 95% confidence interval [CI], 0.67 to 0.92; P=0.003). This result was driven primarily by the new onset of persistent macroalbuminuria, which occurred in fewer participants in the liraglutide group than in the placebo group (161 vs. 215 patients; hazard ratio, 0.74; 95% CI, 0.60 to 0.91; P=0.004). The rates of renal adverse events were similar in the liraglutide group and the placebo group (15.1 events and 16.5 events per 1000 patient-years), including the rate of acute kidney injury (7.1 and 6.2 events per 1000 patient-years, respectively). CONCLUSIONS: This prespecified secondary analysis shows that, when added to usual care, liraglutide resulted in lower rates of the development and progression of diabetic kidney disease than placebo. (Funded by Novo Nordisk and the National Institutes of Health; LEADER ClinicalTrials.gov number, NCT01179048 .)