Congenital and Acquired Interferonopathies: Differentiated Approaches to Interferon Therapy

This chapter reviews various interferon (IFN) system disturbances—interferonopathies. The authors describe clinical specifics of type I interferonopathy associated with overexpression of IFNα—which is a rare Mendelian genetic disease. Certain autoimmune diseases (systemic lupus erythematosus (SLE), vasculitis, immune dysregulation syndrome, etc.) are also characterized by overproduction of IFNα. Furthermore the most common interferonopathies are described—deficiencies of IFN, congenital or acquired IFNα/IFNβ and IFNγ deficiencies in children and adults. Deficiency of IFNα/IFNβ associated with severe recurrent viral infections and deficiency of IFNγ cause mycobacterial infection. Interferon-corrective therapy methods are described. The target therapy of type I interferonopathies (biologics) binds IFNα and normalizes the high level of IFNα. From the other side, patients with congenital IFNα deficiencies are needed in replacement IFN therapy. In case of acquired IFNα deficiency, the differentiated interferon-corrective therapy is performed. In both replacement and interferon-corrective therapies, recombinant human IFNα2b in complex with antioxidants (Viferon®) can be used, because their application is safe and has good clinical efficiency and no side effects

Remodeling of Phenotype CD16 + CD11b + Neutrophilic Granulocytes in Acute Viral and Acute Bacterial Infections

Neutrophilic granulocytes (NGs) are very important cells of innate immunity that can very quickly realize antibacterial and antiviral defense. Until the present time, the phenomenon of different levels of presentations of membrane receptors CD16 and CD11b NG in normal and pathological conditions wasn’t studied. We had studied the population of CD16+CD11b+NG in two groups of patients with acute viral and acute bacterial infections in the models of acute bacterial tonsillitis (ABT) and acute viral tonsillitis-EBV infection (AEBVI), having the same clinical symptoms in early stages of the disease. Comparative analysis of the redistribution of equipment intensity of CD16 and CD11b has detected three subpopulations of CD16+CD11b+NG population—CD16brightCD11bbright, CD16brightCD11bdim, and CD16dimCD11bbright—in normal and pathological conditions. It was found that subpopulation CD16brightCD11bdimNG dominates in healthy individuals; subpopulation CD16brightCD11bbrightNG dominates in patients with acute viral infection; subpopulation CD16dimCD11bbrightNG dominates in patients with acute bacterial infections. We had demonstrated that the study of CD16+CD11b+NG subpopulations allows in early stage of diseases to diagnose acute viral and acute bacterial infections. Our studies have demonstrated the positive effects of eukaryotic DNA sodium salt on the negatively altered phenotype subpopulation CD16+CD11b+NG, in particular, through the remodeling of the expression of CD11b on NG membrane

Electrodialysis Tartrate Stabilization of Wine Materials: Fouling and a New Approach to the Cleaning of Aliphatic Anion-Exchange Membranes

Electrodialysis (ED) is an attractive method of tartrate stabilization of wine due to its rapidity and reagentlessness. At the same time, fouling of ion-exchange membranes by the components of wine materials is still an unsolved problem. The effect of ethanol, polyphenols (mainly anthocyanins and proanthocyanidins) and saccharides (fructose) on the fouling of aliphatic ion-exchange membranes CJMA-6 and CJMC-5 (manufactured by Hefei Chemjoy Polymer Materials Co. Ltd., Hefei, China) was analyzed using model solutions. It was shown that the mechanism and consequences of fouling are different in the absence of an electric field and during electrodialysis. In particular, a layer of colloidal particles is deposited on the surface of the CJMA-6 anion-exchange membrane in underlimiting current modes. Its thickness increases with increasing current density, apparently due to the implementation of a trap mechanism involving tartaric acid anions, as well as protons, which are products of water splitting and “acid dissociation”. A successful attempt was made to clean CJMA-6 in operando by pumping a water-alcohol solution of KCl through the desalination compartment and changing electric field direction. It has been established that such a cleaning process suppresses the subsequent biofouling of ion-exchange membranes. In addition, selective recovery of polyphenols with high antioxidant activity is possible

Primary Observational Results on Children Who Have Been Exposed to COVID-19 in Moscow

Background. The number of people infected with SARS-CoV-2 causing COVID-19 is growing worldwide. It is necessary to study features of prevalence and clinical signs in pediatric population considering the fact that this disease is rather new.The aim of the study is to analyze the features of prevalence and clinical signs of pathologic process of COVID-19 in pediatric patients according to the results of practical experience of primary care medical facility (Children’s City Outpatients Clinic № 133) under the conditions of pandemia.Methods. Pediatricians of Children’s City Outpatient’s Clinic № 133 have examined certain categories of pediatric patients (especially who came from abroad or contacted with infection) for the presence of a new coronaviral infection in February 2020. Doctors have been examining children with catarrhal symptoms and hyperthermia since March 2020. The survey of children in February and March was carried out in accordance with algorithms (uniform for adults and children) approved by the Moscow City Health Department. Later, the survey was carried out in accordance with the guidelines for children prepared by the Ministry of Health of the Russian Federation. The throat and nose swabs on SARS-CoV-2 were performed for all patients on the 1st, 11th and 13th day of the disease.Results. 1,900 children (or 3.1% of total attached pediatric population) have been examined in our outpatient’s clinic with the polymerase chain reaction (PCR) method on the presence of the new coronavirus RNA since the beginning of the COVID-19 pandemic in Russia. The course of disease was analyzed in first 100 patients with the confirmed COVID-19 diagnosis: 58 (58%) boys and 42 (42%) girls. In 81% of cases we revealed the source of infection, in 19% – we did not. The disease was asymptomatic in 11 (11%) children examined after the contact with ill relatives; 89% had mild COVID-19 disease with light catarrhal signs. The most numerous group of patients who had COVID-19 consisted of children over 10 years of age (42%); in 20% of cases it was pupils from 7 to 10 years old. Smell disorders were reported in children over the age of 10 in 50% of all cases.Conclusion. New coronaviral infection COVID-19 in children is taking mild course, without complications, under the «mask» of common viral infection. Thus, it is unknown either those who have undergone COVID-19 asymptomatically remain healthy or they need special rehabilitation. The timely development of clear algorithm with step-by-step instructions for various situations for every health professional is crucial during these difficult times

Анализ трудоспособности сотрудников ГБУЗ ДГП № 133 ДЗМ после перенесенной COVID-19

The issues of long-lasting violations of physical and mental health among employees of Children’s City Outpatient’s Clinic №133 of Moscow City Health Department after COVID-19, as well as they effect on work quality and efficacy, and in some cases loss of any interest to work got us thinking about the features of post-COVID-19 syndrome and and forced us to analyze the prevalence and duration of various symptoms in employees. The protocol for this observational study was approved by the Moscow City Independent Ethics Committee. Developed questionnaires with questions both on the course of COVID-19 and on the postcovid period have fully revealed the picture of psychological, cognitive and asthenovegetative disorders in employees. Healthcare professionals of our clinic were interested in studying this issue as many symptoms of the disease have significantly affected the working capacity of several people. The study involved 68 volunteers. Interesting data and correlations were obtained and they have confirmed the fact of cognitive and memory decline in some employees of Children’s City Outpatient’s Clinic №133 who underwent COVID-19 and the effect of these disorders on working capacity. Study results have shown that 47.5% of doctors and 50% of nurses feel disability of varying degrees after COVID-19. The major task of the head of the facility in such situation is to implement long, comprehensive and effective rehabilitation for employees in order to maintain the capacity of medical workers.Проблема длительно сохраняющихся нарушений физического и психического здоровья сотрудников Городского бюджетного учреждения здравоохранения «Детская городская поликлиника № 133 Департамента здравоохранения Москвы» (ГБУЗ ДГП № 133 ДЗМ) после COVID-19, влияющих на качество и оперативность выполнения функциональных обязанностей, а иногда и потеря интереса к работе заставили задуматься об особенностях постковидного синдрома и проанализировать частоту и длительность различных симптомов у работников. Протокол планируемого наблюдательного исследования был утвержден Московским городским этическим независимым комитетом. Разработанные анкеты с вопросами как по течению COVID-19, так и по постковидному периоду полностью раскрыли картину психологических, когнитивных и астеновегетативных нарушений у сотрудников. Медицинские работники поликлиники заинтересованно отнеслись к изучению этого вопроса, так как многие симптомы после болезни значительно повлияли на трудоспособность конкретных людей. В исследовании участвовало 68 добровольцев. Получены интересные данные и корреляционные связи, подтверждающие факт снижения когнитивных функций и свойств памяти у части сотрудников ГБУЗ ДГП № 133 ДЗМ, перенесших COVID-19, влияния этих нарушений на трудоспособность. По результатам исследования выяснилось, что 47,5% врачей и 50% медицинских сестер после COVID-19 ощущают потерю трудоспособности в различной степени. Приоритетной задачей руководителя в данной ситуации становится обеспечение длительной, комплексной и эффективной реабилитации сотрудников для сохранения потенциала медицинских работников

Первые результаты наблюдения за детьми, переболевшими COVID-19 в Москве

Background. The number of people infected with SARS-CoV-2 causing COVID-19 is growing worldwide. It is necessary to study features of prevalence and clinical signs in pediatric population considering the fact that this disease is rather new.The aim of the study is to analyze the features of prevalence and clinical signs of pathologic process of COVID-19 in pediatric patients according to the results of practical experience of primary care medical facility (Children’s City Outpatients Clinic № 133) under the conditions of pandemia.Methods. Pediatricians of Children’s City Outpatient’s Clinic № 133 have examined certain categories of pediatric patients (especially who came from abroad or contacted with infection) for the presence of a new coronaviral infection in February 2020. Doctors have been examining children with catarrhal symptoms and hyperthermia since March 2020. The survey of children in February and March was carried out in accordance with algorithms (uniform for adults and children) approved by the Moscow City Health Department. Later, the survey was carried out in accordance with the guidelines for children prepared by the Ministry of Health of the Russian Federation. The throat and nose swabs on SARS-CoV-2 were performed for all patients on the 1st, 11th and 13th day of the disease.Results. 1,900 children (or 3.1% of total attached pediatric population) have been examined in our outpatient’s clinic with the polymerase chain reaction (PCR) method on the presence of the new coronavirus RNA since the beginning of the COVID-19 pandemic in Russia. The course of disease was analyzed in first 100 patients with the confirmed COVID-19 diagnosis: 58 (58%) boys and 42 (42%) girls. In 81% of cases we revealed the source of infection, in 19% – we did not. The disease was asymptomatic in 11 (11%) children examined after the contact with ill relatives; 89% had mild COVID-19 disease with light catarrhal signs. The most numerous group of patients who had COVID-19 consisted of children over 10 years of age (42%); in 20% of cases it was pupils from 7 to 10 years old. Smell disorders were reported in children over the age of 10 in 50% of all cases.Conclusion. New coronaviral infection COVID-19 in children is taking mild course, without complications, under the «mask» of common viral infection. Thus, it is unknown either those who have undergone COVID-19 asymptomatically remain healthy or they need special rehabilitation. The timely development of clear algorithm with step-by-step instructions for various situations for every health professional is crucial during these difficult times.Актуальность. В мире растет число людей, инфицированных коронавирусом SARS-CoV-2, вызывающим COVID-19. Учитывая тот факт, что болезнь новая, необходимо изучение особенностей распространения и клинической картины, в частности в детской популяции.Цель — на основании результатов практической работы медицинской организации первичного медико-санитарного звена (поликлиники; ГБУЗ «ДГП № 133 ДЗМ») в условиях пандемии проанализировать особенности распространения и клинической картины патологического процесса COVID-19 у пациентов детского возраста.Методы. В феврале 2020 г. педиатры ГБУЗ «ДГП № 133 ДЗМ» обследовали на наличие новой коронавирусной инфекции определенные категории пациентов детского возраста, а именно приехавших из-за рубежа, контактных с больным, прежде всего в семейных очагах; с марта 2020 г. врачи обследовали детей с катаральными явлениями и гипертермией. Обследование детей в феврале и марте проводилось в соответствии с утвержденными Департаментом здравоохранения города Москвы алгоритмами, едиными для взрослых и детей; в последующем обследование осуществлялось согласно методическим рекомендациям, подготовленным Министерством здравоохранения Российской Федерации для детей. Тест биоматериала на SARS-CoV-2 из зева и носа проводился пациентам в 1-й, 11-й и 13-й день болезни.Результаты. С начала пандемии COVID-19 в России в нашей поликлинике до 20 апреля 2020 г. методом полимеразной цепной реакции (ПЦР) обследовано 1900 детей (3,1% всего прикрепленного детского населения) на наличие РНК нового коронавируса. Проанализировано течение болезни у первых 100 пациентов с подтвержденным COVID-19: 58 (58%) мальчиков и 42 (42%) девочки. У 81% детей был установлен источник заражения, у 19% детей выявить источник заражения не удалось. У 11 (11%) детей, обследованных по контакту с больным родственником, болезнь протекала бессимптомно; у 89% отмечалось легкое течение COVID-19 с незначительными катаральными явлениями. Самую многочисленную группу пациентов, перенесших COVID-19, составили дети старше 10 лет (42%): в 20% случаев заболевшими были школьники от 7 до 10 лет. Нарушение обоняния, по данным наблюдения, зарегистрировано у детей в возрасте старше 10 лет в 50% случаев.Заключение. Новая коронавирусная инфекция COVID-19 у детей протекает в легкой форме, без осложнений, под «маской» обычной вирусной инфекции, однако не известно, остаются ли здоровыми те, кто перенес COVID-19 бессимптомно, или для них нужна специальная реабилитация. Критически важным является своевременная разработка четкого алгоритма с пошаговой инструкцией для каждого сотрудника при различных ситуациях в период повышенной готовности