№2, 2013, volume 9

Objective: To analyze the clinical and epidemiological characteristics in the post-pandemic influenza seasons in 2010/11/12/13 years. Material and methods: The analysis of the incidence of acute respiratory viral infections and flu in the Saratov region from 2009 to 2013. A clinical and laboratory examination of 252 patients with a diagnosis of «flu»: 152 pregnant women at different stages of pregnancy at the age of 18 years to 41 years and 100 children aged from 5 months to 14 years. The work was carried out to assess the epidemiological pattern and clinical course of influenza, and the effective operation of antiviral therapy. Results: In the post-pandemic period 2010-2013 simultaneously circulating influenza A viruses (N1N1/09) pd, influenza A (H3N2) and influenza B. In most cases, influenza in adults and children is of moderate form. All serious forms of influenza have been caused by influenza A with the development of viral-bacterial pneumonia, respiratory failure and neurotoxic syndrome. Late hospitalization and absence of antiviral therapy in the prehospital are at risk of severe and complicated forms. Conclusion: Early initiation of antiviral therapy is one of the main factors for the effectiveness of treatment and reduce the risk of influenza complications.

The purpose is to reveal functional violations of various organs and systems at persons who have suffered from diphtheria and to develop algorithm of medical examination. Material and methods: 10 years» observation of over 722 patients who have had diphtheria has been made. Nuclear heating plants, ALT, glucose, urea, creatinine, troponin, blood myoglobin, creatinine of urine, SKF, LPI, anti-toxic antibodies, organ authoantibodies, interferons, AKTG, a corti-sol, TTG, ТЗ, T4, insulin and S-peptide, authoantibodies to thyroglobulin have been determined, an electrocardiogram, Doppler — and an echocardiography have been carried out. Results: It is revealed that at 59% of the persons who have had diphtheria, in the first three years catamnesis included the pathology of cardiovascular, nervous and urinary systems caused by existence of complications and a form of diphtheria in the acute period was created. It was accompanied by violation of functions of immune and hormonal systems: there was no protective anti-toxic immunity, autoimmune process was started, activity of the central and vegetative endocrine glands decreased. Depending on extent of these violations various options of disturbance of adaptation have been developed. At 5% of patients disturbance of adaptation resulted in lethal outcome. Conclusion: Functional violations of various organs and systems in catamnesis in persons who have had diphtheria have been revealed. The algorithm of medical examination for the purpose of regulation and correction of process of their adaptation has been offered.

Aim: to define clinical and etiological, radiation and neurophysiological parameters determining the transformation of disseminated leukoencephalitis to multiple sclerosis in children. Materials and methods: clinical and etiological analysis of leukoencephalitis in 229 children aged 1-17 years old and their catamnesis for 5,5±1,8 years were performed. Morphostructural characteristic was made by brain and spinal cord MRI and multimodal provoked potentials. Results: The development of multiple sclerosis in children was observed in the outcome of leukoencephalitis chronic course in 44,4% of the cases and in 73,3% of the cases of mixed herpes viral infection (Epstein-Barr virus and 6 type herpes virus). Morphostructural features in the cases of leukoencephalitis in children depending on the disease course characterized by the prevalence of edematous and inflammatory character of CNS changes in the cases of an acute course, by demyelinating changes in the cases of a prolonged course, and by degenerative and demyelinating ones in the cases of a chronic course were determined. Administration of etiopathogenetic therapy for leukoencephalitis allows to achieve either a complete recovery or with the deficiency up to 2,5 points by EDSS in 96,6% in the cases of acute and prolonged course, and clinical and radiation remission in 50,1% and recovery in 5,5% in the cases of chronic course.

The aim of the study is to improve the treatment of patients with male reproductive organs pathology, formed by chronic brucellosis infection. Material and methods: We have analyzed the dynamics of the clinical manifestations of diseases of the scrotal organs, data of physical and ultrasound studies, semen parameters, the quality of life in 22 patients with chronic brucellosis and the presence of orchitis / orchiepididymitis against conventional therapy (10 patients), and combined treatment with the inclusion of cycloferon (i/m, 2 injection rate from 5 (0.25g) with a break 10 days) — 12. Results: We have proved ability of cycloferon to reduce the severity of the inflammatory process in the testis and epididymis, with improving of spermatogenesis and the quality of life for patients. We have marked the reduction in the number of exacerbations of chronic orchitis / orchiepididymitis 2.4 times after the course of cycloferon, its good tolerability of patients, no side effects. Conclusion: Using these results, the presence of anti-inflammatory and immunomodulatory potencies, cycloferon can be recommended in treatment of inflammatory lesions of the scrotal organs in patients with chronic brucellosis.

The article presents biographic data of professor N. R. Ivanov and reflectshis contribution to the development of the national department of infectious service and the department of children infectious diseases at Saratov Medical University.