ORGANIZATION OF MEDICAL AID DURING ANTHRAX OUTBREAK IN YAMALO-NENETS AUTONOMOUS DISTRICT IN 2016

The efficiency and timeliness of medical care of infectious patients are largely determined by the promptness of diagnosis and the rational organization of medical sorting of patients and contact persons. In 2016 there were 36 anthrax cases in the Yamal. In the immediate area of the epidemic were 327 people, including 135 children, in the endangered area – 539 people, including 217 children. Organization of medical care for patients and contact persons was accompanied by objective difficulties associated with the vastness of the territory under threat of infection spread, the presence of atypical and rare clinical forms of anthrax. Тhe article presents the analysis of actions for rendering of medical aid to patients with anthrax in the Yamal in 2016, and the proposed algorithms in medical triage and the organization of the emergency unit

CLINICAL FEATURES OF ANTHRAX MANIFESTATIONS IN YAMALO-NENETS AUTONOMOUS DISTRICT IN 2016

36 cases of human infection with anthrax, manifested in various clinical forms, were registered in the territory of Yamalo-Nenets Autonomous District in 2016. Cutaneous anthrax was characterized by emergence of carbuncle, however objective difficulties of clinical diagnostics, associated with atypicality of clinical manifestations (erysipeloid form of the disease, crusting) were outlined. Clinical manifestations of oropharyngeal anthrax were severe febrile reaction, intoxication, edema of subcutaneous fat on face and neck, and lesions of mucous membranes. Intestinal anthrax was diagnosed in one patient and characterized by the acute onset followed by faintness, loss of appetite, vomiting, and abdominal pain. Based on the results of carried out investigations, put forward were the measures on optimization of approaches to clinical diagnostics of anthrax

Текущие вопросы совершенствования сопоставлений на основе паритета покупательной способности валют: опыт ОЭСР - ЕС

The authors of this article formulate current issues of the 2014 round of international comparisons and the results of the 2011 round, on the basis of information relating to the Workshop on PPP-based GDP comparisons methodology (19-21 May 2014, Paris). Key topics included the following issues: experience of individual countries’ experience on automated prices collection through the Internet, new questionnaires and methodology for collecting prices from the selected industry, a new classification of primary groups adopted for ICP 2014 and ways to implement it, discussion of the final results of International Comparison Program in 2011 and the future development of the ICP.Авторами с использованием информации, касающейся работы Семинара по методологии международных сопоставлений ВВП на основе паритета покупательной способности валют (19-21 мая 2014 г., Париж), сформулированы текущие вопросы сопоставлений раунда международных сопоставлений 2014 г. и итоги раунда 2011 г. Ключевые темы включали в себя такие вопросы, как опыт отдельных стран по автоматизированному сбору данных о ценах в сети Интернет, новые вопросники и методологии сбора данных о ценах в отдельных отраслях, новая классификация первичных групп, принятая для раунда Программы международных сопоставлений 2014 г., и пути ее внедрения, обсуждение окончательных результатов Программы международных сопоставлений 2011 г. и будущего развития ПМС

New palynological data for Toarcian (Lower Jurassic) deep-marine sandstones of the Western Caucasus, southwestern Russia

Information on Jurassic palynomorphs from the Greater Caucasus is potentially of great importance, but its availability to the international research community is severely limited. New palynological data for Toarcian deposits of the Western Caucasus are recorded in the present paper. Particularly, dinoflagellate cysts are described for the first time from the Bagovskaja Formation; palynomorphs are found in sandstone levels within this unit. The most representative assemblage includes pollen (with predominant bisaccate pollen), spores (Cyathidites being commonest), and dinoflagellate cysts amongst which the predominant taxon is Nannoceratopsis spiculata. The dinocyst assemblage implies a late Toarcian age for the upper part of the Bagovskaja Formation. On the basis of these new palynostratigraphical results, the range of the formation is extended; previously, only the lower part had been dated on ammonite evidence

HBV-инфекция у детей при перинатальном инфицировании. Клинический случай семейного гепатита В

Hepatitis B, despite of being a controlled infection today, is one of the most common form of hepatitis in the world. According to the experts' evaluation there are about 3 million patients with chronic hepatitis B in our country. The global strategy of the World Health Organization includes the elimination of viral hepatitis by 2030.The program used in the North-West Federal District to eliminate acute hepatitis B has reduced the incidence rate due to the widespread vaccination coverage of children and the annual increase in adult immunization coverage.However, the relevance of HBV-infection in children still remains high which is associated with a high infection by hepatitis B virus in women of childbearing age and the possibility of the transmission of the infection from mother to her child. In case of perinatal infection the formation of chronic hepatitis B in children reaches up to 90%. The natural course of chronic hepatitis B is characterized by a change in pathogenetically determined phases, and HBsAg-negative infection, which is a latent (occult) form of hepatitis, was added to them in 2009. Occult hepatitis B is an epidemiological danger, for the child as well, if the mother suffers from this form of chronic hepatitis B. Monitoring of pregnant women is often limited to identifying only HBsAg, which is not enough to detect occult hepatitis B. Lately diagnosed occult HBV-infection can become a source of the infection for the baby, especially in cases when due to some reasons there are disorders in hepatitis B vaccination schedule after birth. The article presents an interesting clinical case of family hepatitis B.Гепатит В, несмотря на то, что сегодня он относится к управляемым инфекциям, является одним из самых распространенных гепатитов в мире. Согласно экспертным оценкам, в нашей стране насчитывается около 3 млн больных хроническим гепатитом В. Глобальная стратегия Всемирной организации здравоохранения подразумевает элиминацию вирусных гепатитов к 2030 г.Принятая программа элиминации острого гепатита В на территории Северо-Западного федерального округа привела к снижению заболеваемости благодаря широкому охвату вакцинацией детей и ежегодному увеличению охвата иммунизацией взрослого населения. Однако актуальность HBV-инфекции у детей сохраняется, что связано с высокой инфицированностью вирусным гепатитом В женщин детородного возраста и возможностью передачи инфекции от матери к ребенку. При перинатальном инфицировании формирование хронического гепатита В у детей достигает. 90%. Естественное течение хронического гепатита В характеризуется сменой патогенетически обусловленных фаз, к которым в 2009 г. была добавлена HBsAg-негативная, являющаяся скрытым (оккультным) гепатитом. Оккультный гепатит В представляет эпидемиологическую опасность, в том числе и для ребенка, в случае если мать переносит эту форму хронического гепатита В. Мониторирование беременных женщин часто ограничивается определением только HBsAg, что недостаточно для выявления оккультного гепатита В. Вовремя не диагностированная оккультная HBV-инфекция может стать источником инфекции для ребенка, особенно в тех случаях, когда по тем или иным причинам имеются нарушения схемы вакцинации против гепатита В после рождения. В статье представлен интересный клинический случай семейного гепатита В

Delivery and reveal of localization of upconversion luminescent microparticles and quantum dots in the skin in vivo by fractional laser microablation, multimodal imaging, and optical clearing

Delivery and spatial localization of upconversion luminescent microparticles [Y 2 O 3 ;Yb, Er] (mean size ~1.6 μm) and quantum dots (QDs) (CuInS 2 ZnS nanoparticles coated with polyethylene glycol-based amphiphilic polymer, mean size ~20 nm) inside rat skin was studied in vivo using a multimodal optical imaging approach. The particles were embedded into the skin dermis to the depth from 300 to 500 μm through microchannels performed by fractional laser microablation. Low-frequency ultrasound was applied to enhance penetration of the particles into the skin. Visualization of the particles was revealed using a combination of luminescent spectroscopy, optical coherence tomography, confocal microscopy, and histochemical analysis. Optical clearing was used to enhance the image contrast of the luminescent signal from the particles. It was demonstrated that the penetration depth of particles depends on their size, resulting in a different detection time interval (days) of the luminescent signal from microparticles and QDs inside the rat skin in vivo. We show that luminescent signal from the upconversion microparticles and QDs was detected after the particle delivery into the rat skin in vivo during eighth and fourth days, respectively. We hypothesize that the upconversion microparticles have created a long-time depot localized in the laser-created channels, as the QDs spread over the surrounding tissues

Theory of differential inclusions and its application in mechanics

The following chapter deals with systems of differential equations with discontinuous right-hand sides. The key question is how to define the solutions of such systems. The most adequate approach is to treat discontinuous systems as systems with multivalued right-hand sides (differential inclusions). In this work three well-known definitions of solution of discontinuous system are considered. We will demonstrate the difference between these definitions and their application to different mechanical problems. Mathematical models of drilling systems with discontinuous friction torque characteristics are considered. Here, opposite to classical Coulomb symmetric friction law, the friction torque characteristic is asymmetrical. Problem of sudden load change is studied. Analytical methods of investigation of systems with such asymmetrical friction based on the use of Lyapunov functions are demonstrated. The Watt governor and Chua system are considered to show different aspects of computer modeling of discontinuous systems

Синдром избыточного бактериального роста у детей подросткового возраста на фоне хронического вирусного гепатита С

There is a close relationship between intestine and liver, so-called ‘gut liver’ axis, especially in patients suffered from chronic liver diseases with significant degree of fibrosis. Small intestinal bacterial overgrowth and disturbance in the microbiota composition lead to an increase in the permeability of the intestinal epithelium, the development of endotoxinemia, the activation of pro-inflammatory cytokines and, as a consequence, an additional damage to hepatocytes.Objective. To estimate the incidence of bacterial overgrowth syndrome (BOS) in the small intestine in adolescents with chronic hepatitis C (CHC), to identify the interaction between this syndrome and cytolytic activity, the degree of fibrosis.Materials and methods. There is a group of 33 patients aged 12—17 years old with CHC. All children underwent a hydrogen breath test with lactulose. The degree of fibrosis was assessed by the results of liver elastography (Fibroscan), cytolytic activity was determined by the level of alanine transaminase in serum.Results. The frequency of BOS was 81.8% in the study group. As a result of the correlation analysis, no relationship was found between the development of BOS and the degree of cytolytic activity of chronic hepatitis C (criterion χ2= 0.914, p > 0.05). Also, there was no correlation between excessive bacterial contamination and the degree of fibrosis in the liver tissue (criterion χ2= 0.914,p> 0.05).Conclusion. BOS in children with CHC occurs much more often than in adults. However, no relationship was found between this syndrome and the severity of cytolytic activity, the degree of fibrotic changes in the liver.При хронических заболеваниях печени, в особенности сопровождающихся значительной степенью фиброза, прослеживается тесная взаимосвязь по так называемой оси «печень-кишечник». Избыточный бактериальный рост и нарушение состава микро-биоты приводят к повышению проницаемости кишечного эпителия, развитию эндотоксинемии, активации провоспалительных цитокинов и, как следствие, дополнительному повреждению гепатоцитов.Цель исследования. Оценить частоту развития синдрома избыточного бактериального роста (СИБР) в тонком кишечнике у детей подросткового возраста с диагнозом хронический гепатит С (ХГС), выявить взаимосвязь между наличием данного синдрома и цитолитической активностью, степенью фиброза.Методы исследования: В исследуемую группу вошли 33 пациента в возрасте 12—17 лет с установленным диагнозом ХГС. Всем детям был проведен водородный дыхательный тест с лактулозой. Степень фиброза оценивалась по результатам эластографии печени (Fibroscan), цитолитическая активность определялась по уровню АЛТ сыворотки.Результаты. Частота встречаемости СИБР в исследуемой группе составила 81,8%. В результате корреляционного анализа данных, связи между развитием СИБР и степенью цитолитической активности хронического гепатита С выявлено не было (критерий χ2= 0,914, р> 0,05). Также не была отмечена взаимосвязь избыточного бактериального обсеменения и степени фиброза в ткани печени (критерий χ2= 0,914, р> 0,05).Выводы. СИБР в детском возрасте при наличии ХГС встречается значительно чаще, чем у взрослых. Однако, связи между наличием данного синдрома и выраженностью цитолитической активности, а также степенью фибротических изменений в печени выявлено не было