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    Клинико-эпидСмиологичСская характСристика Π³Π΅ΠΏΠ°Ρ‚ΠΈΡ‚ΠΎΠ² Π’ ΠΈ Π΄Π΅Π»ΡŒΡ‚Π° Π² РСспубликС ДагСстан

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    Aim: The analysis of the incidence of hepatitis B in the Republic of Dagestan (RD) and clinical and epidemiological characteristics of HBV/HDV coinfection in the region.Materials and Methods. The dynamics of the hepatitis B incidence rates and the coverage of vaccination against this infection in the RD in 2008-2022 were analyzed based on the data from of the statistical forms of Rospotrebnadzor. The clinical and epidemiological characteristics of delta hepatitis were analyzed in 371 patients under dispensary observation at the Republican Center for Infectious Diseases named after S.-А.М. Magomedov.Results. Over the past 10 years, the incidence of CHB in the RD has increased more than 4.5 times, from 1.4 per 100 thousand population in 2008 to 6.7 per 100 thousand population in 2022. A decrease in the rates of hepatitis B child immunization in the RD is observed since 2009. Hepatitis B vaccination coverage rates in adult population fell sharply after 2010, both in the RD and in the Russian FederationΒ  on average. The frequency of HDV co-infection in persons infected with HBV in the RD is 13.8%, but reaches 15% in some regions of the republic, indicating the moderate levelΒ Β  of endemicity. Patients with HBV/HDV coinfection are predominantly males aged 25–45 years with advanced fibrosis or cirrhosis. All cases of HDV infection in the RD are caused by viral genotype 1.Conclusions. The obtained results testify to the significance of the problem of hepatitis B and delta in the RD. The number of identified patients and, accordingly, the rate of co-infection, apparently, will increase with the expansion of screening for markers of HDV infection, when patients who were registered as HBsAg carriers will be examined according to the patient routing guidelines. The late diagnosis of delta hepatitis in RD and the limited possibilities of antiviral therapy are another significant issues.ЦСль: Π°Π½Π°Π»ΠΈΠ· заболСваСмости Π³Π΅ΠΏΠ°Ρ‚ΠΈΡ‚ΠΎΠΌ Π’ Π² РСспубликС ДагСстан ΠΈ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-эпидСмиологичСская характСристика ΠΊΠΎ-ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ HBV/HDV Π² Ρ€Π΅Π³ΠΈΠΎΠ½Π΅.ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Ρ‹ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹: ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½ Π°Π½Π°Π»ΠΈΠ· Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠΈ заболСваСмости Π³Π΅ΠΏΠ°Ρ‚ΠΈΡ‚ΠΎΠΌ Π’ ΠΈ ΠΎΡ…Π²Π°Ρ‚Π° Π²Π°ΠΊΡ†ΠΈΠ½Π°Ρ†ΠΈΠ΅ΠΉ ΠΏΡ€ΠΎΡ‚ΠΈΠ² этой ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ Π² РСспубликС ДагСстан Π² 2008–2022 Π³Π³. ΠΏΠΎ ΠΌΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Π°ΠΌ Ρ„ΠΎΡ€ΠΌ статистичСского ΡƒΡ‡Π΅Ρ‚Π° РоспотрСбнадзора. ΠŸΡ€ΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Π½Ρ‹ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΎ-эпидСмиологичСскиС  характСристики  Π³Π΅ΠΏΠ°Ρ‚ΠΈΡ‚Π°Β Β  Π΄Π΅Π»ΡŒΡ‚Π°Β  Ρƒ 371 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π°, находящихся Π½Π° диспансСрном наблюдСнии Π² РСспубликанском Ρ†Π΅Π½Ρ‚Ρ€Π΅ ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΎΠ½Π½Ρ‹Ρ… Π±ΠΎΠ»Π΅Π·Π½Π΅ΠΉ ΠΈΠΌ. Π‘.-А.М. МагомСдова.Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹: Π·Π° послСдниС 14 Π»Π΅Ρ‚ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡ‚ΡŒ хроничСским Π³Π΅ΠΏΠ°Ρ‚ΠΈΡ‚ΠΎΠΌ Π’ Π² РСспубликС ДагСстан ΡƒΠ²Π΅Π»ΠΈΡ‡ΠΈΠ»Π°ΡΡŒ Π±ΠΎΠ»Π΅Π΅ Ρ‡Π΅ΠΌ Π² 4,5 Ρ€Π°Π·Π°, с 1,4 Π½Π° 100 тыс. насСлСния Π² 2008 Π³. Π΄ΠΎ 6,7 Π½Π° 100 тыс. насСлСния Π² 2022 Π³. Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹ Π°Π½Π°Π»ΠΈΠ·Π° ΠΎΡ…Π²Π°Ρ‚Π° Π²Π°ΠΊΡ†ΠΈΠ½Π°Ρ†ΠΈΠ΅ΠΉ ΠΏΡ€ΠΎΡ‚ΠΈΠ² Π³Π΅ΠΏΠ°Ρ‚ΠΈΡ‚Π° Π’ ΡΠ²ΠΈΠ΄Π΅Ρ‚Π΅Π»ΡŒΡΡ‚Π²ΡƒΡŽΡ‚ ΠΎ сниТСнии уровня ΠΈΠΌΠΌΡƒΠ½ΠΈΠ·Π°Ρ†ΠΈΠΈ дСтского насСлСния Π² РСспубликС ДагСстан послС 2009 Π³. ΠŸΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ ΠΎΡ…Π²Π°Ρ‚Π° Π²Π°ΠΊΡ†ΠΈΠ½Π°Ρ†ΠΈΠ΅ΠΉ ΠΏΡ€ΠΎΡ‚ΠΈΠ² Π³Π΅ΠΏΠ°Ρ‚ΠΈΡ‚Π° Π’ взрослого насСлСния Ρ€Π΅Π·ΠΊΠΎ ΡƒΠΏΠ°Π»ΠΈ послС 2010 Π³., ΠΊΠ°ΠΊ Π² РСспубликС ДагСстан, Ρ‚Π°ΠΊ ΠΈ Π² Российской Π€Π΅Π΄Π΅Ρ€Π°Ρ†ΠΈΠΈ Π² срСднСм. Частота ΠΊΠΎ-ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ HDV Ρƒ Π»ΠΈΡ†, ΠΈΠ½Ρ„ΠΈΡ†ΠΈΡ€ΠΎΠ²Π°Π½Π½Ρ‹Ρ… HBV, Π² РСспубликС ДагСстан составляСт 13,8%, Π½ΠΎ достигаСт 15% Π² ΠΎΡ‚Π΄Π΅Π»ΡŒΠ½Ρ‹Ρ… Ρ€Π°ΠΉΠΎΠ½Π°Ρ… рСспублики, Ρ‡Ρ‚ΠΎ позволяСт отнСсти Π΅Π΅ ΠΊ Ρ€Π΅Π³ΠΈΠΎΠ½Π°ΠΌ с ΡƒΠΌΠ΅Ρ€Π΅Π½Π½ΠΎΠΉ ΡΠ½Π΄Π΅ΠΌΠΈΡ‡Π½ΠΎΡΡ‚ΡŒΡŽ. Π‘Ρ€Π΅Π΄ΠΈ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с ΠΊΠΎ-ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠ΅ΠΉ HBV/HDV ΠΏΡ€Π΅ΠΎΠ±Π»Π°Π΄Π°ΡŽΡ‚ ΠΌΡƒΠΆΡ‡ΠΈΠ½Ρ‹ Π² возрастС 25–45 Π»Π΅Ρ‚, с ΠΏΡ€ΠΎΠ΄Π²ΠΈΠ½ΡƒΡ‚Ρ‹ΠΌΠΈ стадиями Ρ„ΠΈΠ±Ρ€ΠΎΠ·Π° ΠΈΠ»ΠΈ Ρ†ΠΈΡ€Ρ€ΠΎΠ·ΠΎΠΌ. Π’ΠΎ всСх случаях HDV-инфСкция Π±Ρ‹Π»Π° Π²Ρ‹Π·Π²Π°Π½Π° 1 Π³Π΅Π½ΠΎΡ‚ΠΈΠΏΠΎΠΌ вируса.Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅:Β  ΠΏΠΎΠ»ΡƒΡ‡Π΅Π½Π½Ρ‹Π΅Β  Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹Β  ΡΠ²ΠΈΠ΄Π΅Ρ‚Π΅Π»ΡŒΡΡ‚Π²ΡƒΡŽΡ‚ ΠΎ значимости ΠΏΡ€ΠΎΠ±Π»Π΅ΠΌΡ‹ Π³Π΅ΠΏΠ°Ρ‚ΠΈΡ‚ΠΎΠ² Π’ ΠΈ Π΄Π΅Π»ΡŒΡ‚Π° Π² РСспубликС ДагСстан. ΠšΠΎΠ»ΠΈΡ‡Π΅ΡΡ‚Π²ΠΎ выявлСнных Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… ΠΈ, соотвСтствСнно, ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΡŒ частоты ΠΊΠΎ-ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ, ΠΏΠΎΠ²ΠΈΠ΄ΠΈΠΌΠΎΠΌΡƒ, Π±ΡƒΠ΄ΡƒΡ‚ ΡƒΠ²Π΅Π»ΠΈΡ‡ΠΈΠ²Π°Ρ‚ΡŒΡΡ ΠΏΡ€ΠΈ Ρ€Π°ΡΡˆΠΈΡ€Π΅Π½ΠΈΠΈ скрининга Π½Π° ΠΌΠ°Ρ€ΠΊΠ΅Ρ€Ρ‹ HDV-ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ, ΠΊΠΎΠ³Π΄Π° ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Ρ‹, Π½Π°Ρ…ΠΎΠ΄ΠΈΠ²ΡˆΠΈΠ΅ΡΡ Π½Π° диспансСрном ΡƒΡ‡Π΅Ρ‚Π΅ ΠΊΠ°ΠΊ носитСли HΠ’sAg, Π±ΡƒΠ΄ΡƒΡ‚ обслСдованы ΠΏΠΎ Π°Π»Π³ΠΎΡ€ΠΈΡ‚ΠΌΡƒ согласно ΠΏΡ€ΠΈΠΊΠ°Π·Ρƒ ΠΎ ΠΌΠ°Ρ€ΡˆΡ€ΡƒΡ‚ΠΈΠ·Π°Ρ†ΠΈΠΈ. НС мСньшСй ΠΏΡ€ΠΎΠ±Π»Π΅ΠΌΠΎΠΉ являСтся поздняя диагностика Π³Π΅ΠΏΠ°Ρ‚ΠΈΡ‚Π° Π΄Π΅Π»ΡŒΡ‚Π° Π² РСспубликС ДагСстан ΠΈ ΠΎΠ³Ρ€Π°Π½ΠΈΡ‡Π΅Π½Π½Ρ‹Π΅ возмоТности противовирусной Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ

    Immune-mediated epilepsies in children

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    The paper reviews the current literature on immune-mediated pediatric epilepsies. It describes the clinical picture, laboratory diagnosis, and treatment of autoimmune encephalitides (limbic encephalitis and anti-NMDA-receptor antibody encephalitis), Hashimoto's encephalopathy, opsoclonus-myoclonus-syndrome, and Rasmussen's syndrome, as well as groups of acute encephalopathies with immune-mediated status epilepticus (FIRES-, DESK-, HHE- syndrome). A clinical case of Hashimoto's encephalopathy is described. Emphasis is laid on a close relationship between epilepsy and inflammation, including the development of an autoimmune process due to recurrent epileptic seizures

    Clinical significance of FLG gene mutations in children with atopic dermatitis

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    Skin barrier dysfunction due to deficiency of the skin protein filaggrin is one of the factors involved in the pathogenesis of atopicΒ dermatitis. Objective: to determine the clinical significance of 2282 del CAGT, R501X, R2447X, and S3247X mutations in the FLGΒ gene in children with atopic dermatitis. The investigation included 58 children with atopic dermatitis. A molecular genetic analysis ofΒ the four mutations in the FLG gene was done in all the children. In the patients with FLG gene mutations, there was a tendency towardsΒ a higher frequency of sensitization to house dust allergens, significantly more often sensitization to cat epidermal allergen, andΒ significantly higher levels of specific IgE to the cat epidermis. Conclusion. Mutations in the FLG gene encoding the protein filaggrinΒ raise the risk for sensitization to domestic and epidermal allergens and, in case of already existing sensitization to the cat epidermis,Β the patients are found with a high degree of probability to have the high concentration of specific IgE to this allergen. The above factΒ justifies the need to place special emphasis on measures to eliminate house dust allergens, and cat epidermis allergen in particular,Β and to personalize approaches to therapy and prevention of atopic dermatitis in children
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