Degradation of geosystems in the Belgorod region as a result of the economic activities

We determined the rates of anthropogenic degradation of vegetation cover, soils, the river network, the slope type of terrain, and of the geological framework of landscapes. A decrease of the anthropogenic transformation rate of the component composition of geosystems was revealed in the biogenic components bio-inert components - abiogenic components series was reveale

Photophoresis of topical steroids in the treatment of severe forms of lichen ruber planus of oral mucosa

The objective of the study is to search for new methods of treatment for lichen ruber planus with high efficacy, few complications and side effects, as well as providing a long-term therapeutic effect. The authors used the method of photophoresis (red LED radiation + topical steroid) in the combination treatment of 40 patients with severe forms of lichen ruber planu

Photophoresis of topical steroids in the treatment of severe forms of lichen ruber planus of oral mucosa

The objective of the study is to search for new methods of treatment for lichen ruber planus with high efficacy, few complications and side effects, as well as providing a long-term therapeutic effec

Ранний артрит как ревматологический хамелеон: описание клинического случая

The article discusses the difficulties of differential diagnosis of early arthritis and inflammatory bowel diseases with a predominant clinical picture of extraintestinal manifestations, in particular, articular syndrome. The clinical observation demonstrates features of the course of such conditions, a long diagnostic search and a wide list of diseases included in differential diagnostics range.В статье рассматриваются сложности дифференциальной диагностики раннего артрита и воспалительных заболеваний кишечника с преобладающей клинической картиной внекишечных проявлений, в частности суставного синдрома. Представлено клиническое наблюдение, демонстрирующее особенности течения таких состояний, длительный диагностический поиск и широкий перечень заболеваний, включенных в круг дифференциальной диагностики

Foreign bodies of ent organs, in children's practice

The article provides statistics on the incidence of foreign bodies of ENT organs in Yekaterinburg, a clinical example is considered. The key points that are worth paying attention to when making a diagnosis and diagnostic search when working in primary care are highlightedВ статье приведена статистика по встречаемости инородных тел ЛОР-органов в г. Екатеринбурге, рассмотрен клинический пример. Выделены ключевые моменты, на которые стоит обратить внимание при постановке диагноза и диагностическом поиске при работе в первичном звен

Molecular and genetic characterization of the hepatitis B virus full-length genome sequences identified in HBsAg-negative blood donors in Ural Federal District

Introduction. The World Health Organization estimates that as of 2019, more than 296 million people were living with chronic hepatitis B virus (HBV) infection. The prevalence of HBsAg-negative, occult form of the disease in blood donors varies depending on the region of the world and the sensitivity of the methods of analysis used. Considering that the genetic diversity of viruses demonstrates space and time variations and taking into account that the genetic profile of isolates in key groups, which may turn into a source of the pathogen spread, is important for forecasting of the epidemiological situation, the attention should be given to identification of HBV genotypes currently circulating among regular blood donors in regions of the Russian Federation. The aim of this work was molecular and genetic characterization of HBV genomes identified in HBsAg-negative blood donors in the Ural Federal District. Materials and methods. The study material was 1400 plasma samples obtained from HBsAg-negative blood donors in Ural Federal District. The study included the testing for HBsAg, anti-HBs IgG and anti-HBcore IgG antibodies, HBV DNA. For all identified HBV DNA containing samples, sequencing and analysis of the nucleotide sequences of the complete HBV genomes were performed. Results. The prevalence of HBV DNA was 4.93%, including 4 (0.28%) cases of false occult hepatitis B. Among anti-HBcore IgG-positive samples, HBV DNA was found in 18.08% of cases, while in persons with detected HBV DNA the anti-HBcore IgG positivity rate was 46.38%. In 8.69% of the isolates, anti-HBs IgG antibodies and viral DNA were detected simultaneously in the absence of anti-HBcore IgG. Based on phylogenetic analysis, HBV subgenotypes distribution in HBsAg-negative blood donors was as follows: D3 53.62%, D2 21.74%, D1 18.84%, C2 5.8%. The high variability in the S, C, P regions of the virus genome in the examined group was shown. In all cases of HBsAg-negative chronic HBV infection identified in blood donors, viral sequences contained at least one amino acid substitution in positions, mutations in which are associated with immune escape. In 3 (4.35%) cases mutations in reverse transcriptase region of P gene that are associated with resistance to the following drugs were identified: lamivudine, telbivudine, entecavir. Mutations in the preCore/Core regions that contribute to the progression of liver disease were also identified. Conclusion. Occult HBsAg-negative chronic HBV infection poses a threat of HBV transmission through transfusion of blood and its components due to the extremely low viral load, which does not allow the virus to be detected using routinely used diagnostic kits. The situation can be exacerbated by the abundance and diversity of virus amino acid substitutions that we have identified, including immune escape mutations, drug resistance mutations, and mutations that contribute to the progression of the disease

Profile of Hepatitis B Virus Mutations Associated with HBsAg-Negative Disease in Patients of Hemodialysis Centers

The aim of this study was to characterize mutations in the hepatitis B virus (HBV) genome associated with HBsAg-negative form of the disease in patients receiving hemodialysis replacement therapy. Materials and methods. We used blood plasma samples obtained from hemodialysis centers in St. Petersburg, Russia – 173 patients and 108 patients from Belgrade, Republic of Serbia. The samples were examined for the presence of serological (HBsAg, antibodies anti-HBs IgG, anti-HBcore IgG) and molecular-genetic (HBV DNA) markers of HBV followed by whole-genome sequencing and determination of clinically significant virus mutations. Results and discussion. Antibodies to hepatitis B were detected in 7.5 % and 11.1 % of patients from St. Petersburg and Belgrade, respectively. HBsAg was identified only in 1.1 % of cases in the group from Russia and in 0.9 % of cases in the group from Serbia. HBV DNA was determined in 2.8 % of the studied samples from both, patients from Saint-Petersburg and Belgrade. Phylogenetic analysis of 9 viral isolates showed that genotype D virus (88.9 %) prevailed as compared to genotype A (11.1 %) in the examined group. Among the samples obtained from patients from St. Petersburg, four belonged to the D2 sub-genotype, one to the D3 genotype. Four samples obtained from Belgrade patients belonged to different sub-genotypes – D1, D2, D3, A2, respectively. When analyzing the nucleotide sequences of the HBV genomes, mutations in the MHR region were detected in all cases, but only in HBsAg-negative isolates, mutations were revealed in the region of 124–147 amino acids, including mutations P120T, R122K, A128V, Q129R, M133I, G145R affecting the recognition of HBsAg by anti-HBs antibodies and associated with the resistance of the virus to the vaccine. The results of this study indicate that transmission of blood-borne viral hepatitis agent in the hemodialysis departments of the Russian Federation and the Republic of Serbia still exists. The prevalence of the latent chronic hepatitis B, coupled with the presence of vaccine escape mutations in all identified cases, indicates the need to pay close attention to the occurrence of the virus mutant variants in hemodialysis centers

Results of implementation of viral hepatitis B elimination program in the North-West Russia

Introduction. Vaccination contributed to reduce the incidence of acute hepatitis B in the territories of the North-West Russia. The urgency of this problem remains due to the high incidence of chronic hepatitis B. This accounted for the need to develop a hepatitis B elimination program in the district discussed that was approved in 2013 by the head of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing. Objective is to characterize the results of the program for the elimination of acute hepatitis B virus implemented in the North-Western Federal District. Materials and methods. The 2010–2020 incidence rate of acute and chronic hepatitis B virus (HBV) infection in the regions of the North-West Russia was carried out. To determine HBV genotypes and subgenotypes, 160 blood plasma samples from patients with acute hepatitis B were studied using molecular genetic methods (PCR, sequencing). The prevalence of latent hepatitis B in various population groups was assessed. The 2016–2020 hepatitis B vaccination coverage and relevant serological monitoring in adults was carried out. Results. While implementing the program, it was found that the incidence rate of acute hepatitis B in the district decreased by 4.5-fold, revealing in 2020 no cases of the disease in 5 regions, with incidence rate in the 6 subfederal units being lower than 1.0 per 100,000 population. Moreover, the incidence rate for chronic hepatitis B decreased by 2.6 times. The 2020 vaccination coverage of children under 17 and adults in all territories comprised more than 95% and 90%, respectively. In addition, it was shown the circulation of genotypes D and A of hepatitis B virus is dominated by genotype D (91.8%), subgenotype D2 (47.8%). The prevalence of latent hepatitis B among migrants was 6.5%, pregnant women — 4.9%, hemodialysis patients — 1.7%. Conclusion. Implementation of the program on elimination of acute viral hepatitis B in the territory of the North-West Russia contributed to raise in the vaccination coverage in adult population and lowered incidence rate of acute and chronic HBV infection

COVID-19 Pandemic and IBS. Results of the All-Russian Observational Non-interventional Program to Study the Effectiveness of the Drug Kolofort® in Real Clinical Practice in Patients with Irritable Bowel Syndrome After a New Coronavirus Infection (VESNA)

Aim: to study the effectiveness and safety of using the drug Kolofort® in outpatients with irritable bowel syndrome (IBS) after a new coronavirus infection.Materials and methods. An observational non-interventional program was conducted in patients with exacerbation of IBS symptoms after a new coronavirus infection. One hundred forty-one patients took part in the study. The final efficacy analysis included data from 127 study participants. All patients complained of increased/appearing gastrointestinal symptoms that appeared within 1–6 months after the infection (all patients had a history of COVID-19 infection). To assess the presence and severity of symptoms of the disease, the “7 × 7” questionnaire was used before the start of treatment and three months after the start of treatment.Results. At the stage of inclusion in the program, the average total score on the “7 × 7” questionnaire was 17.36, which corresponded to a moderately severe disorder. During the treatment period, the average total score decreased to 6.14, which corresponded to borderline disorder. In addition, significant improvement was observed for each symptom separately. After three months of therapy, doctors rated the overall impression of the treatment on a 5-point Likert scale from “very effective” to “ineffective”. The average score was 4.24. In addition, no serious adverse events were identified while taking the drug.Conclusion. In real clinical practice, the drug Kolofort® demonstrated high clinical efficacy in the treatment of patients with IBS after COVID-19 infection

Энтеральные вирусные гепатиты в южном регионе Социалистической Республики Вьетнам

Aim: To study the hepatitis A (HAV) and hepatitis Е (HEV) prevalence in the Southern region of Vietnam based on the frequency analysis of the antibodies to hepatitis A and E viruses detection in the local population and groups at increased risk of infection.Materials and methods. Serological markers of enteral viral hepatitis were determined in blood serum samples from adults aged 18 to 65 years of three groups: conditionally healthy individuals (n = 397), HIV-infected (n = 316), and patients with chronic viral hepatitis (n = 268). The ELISA method was used for the qualitative detection of anti-HAV IgG, anti-HAV IgM, anti-HEV IgG, anti-HEV IgM.Results. When analyzing the prevalence of anti-HAV IgG in samples obtained from conditionally healthy, HIV-infected, and patients with chronic viral hepatitis, no differences were found between the groups. The incidence of anti-HAV IgG in the general group (n = 981) was 80.1%, in the absence of anti-HAV IgM. There were no gender-age differences in the frequency of anti-HAV IgG in the examined groups. Antibodies anti-HEV IgG in the groups of conditionally healthy, patients with chronic viral hepatitis, and HIV-infected were present in the samples in 36,2%, 33,2%, and 39,8% of cases, respectively. The prevalence of anti-HEV IgM in these groups was 3,27%, 4,1%, and 3,79%, respectively. In the general group (n = 981), anti-HEV IgG was detected in 36,6% of cases, anti-HEV IgM in 3,66%, which corresponds to the prevalence of antibodies to HEV in endemic regions.Conclusion. A high incidence of enteral viral hepatitis markers was shown in residents of South Vietnam, including the groups of conditionally healthy, patients with chronic viral hepatitis, and HIV-infected. There is an obvious need for further studies of the spread extent of hepatitis A and hepatitis E in the Socialist Republic of Vietnam using currently available highly sensitive diagnostic methods, including sequencing of the virus›s nucleotide sequences.Цель: изучить распространенность гепатита А (ГА) и гепатита Е (ГЕ) в Южном регионе Вьетнама на основании анализа частоты выявления антител к вирусам гепатитов А и Е у местного населения и группах повышенного риска инфицирования.Материалы и методы. Серологические маркеры энтеральных вирусных гепатитов определяли в образцах сыворотки крови взрослых от 18 до 65 лет 3 групп: условно-здоровых лиц (n=397), ВИЧ-инфицированных (n=316), пациентов с хроническим вирусным гепатитом (n=268). Использован метод ИФА для качественного выявления анти-ВГА IgG, анти-ВГА IgM, анти-ВГЕ IgG, анти-ВГE IgM.Результаты. При анализе распространенности анти-ВГА IgG в образцах, полученных от условно-здоровых, ВИЧ-инфицированных и пациентов с хроническими вирусными гепатитами, различий между груп пами не выявлено. Встречаемость анти-ВГА IgG в общей группе (n=981) составила 80,1% при отсутствии анти-ВГА IgM. Гендерно-возрастных различий по частоте антиВГА IgG в обследованных группах не выявлено. Анти-ВГЕ IgG в группах условно здоровых, больных хроническими вирусными гепатитами, ВИЧ-инфицированных присутствовали в образцах в 36,2%, 33,2% и 39,8% случаев соответственно. Распространенность анти-ВГЕ IgM в указанных группах составила 3,27%, 4,1% и 3,79% соответственно. В общей группе (n=981) анти-ВГЕ IgG выявили в 36,6% случаев, анти-ВГЕ IgM в 3,66% что соответствует распространенности антител к ВГЕ в эндемичных регионах.Заключение. Показана высокая встречаемость маркеров энтеральных вирусных гепатитов у жителей Южного Вьетнама, включая группы условно-здоровых, пациентов с хроническим вирусным гепатитом и ВИЧинфицированных. Очевидна необходимость дальнейших исследований масштабов распространения гепатита А и гепатита Е в Социалистической Республике Вьетнам с использованием доступных в настоящее время высокочувствительных диагностических методов, включая секвенирование нуклеотидных последовательностей вирусов.