Plague still poses a significant threat to human health and as a reemerging infection is unfamiliar to the majority of the modern medical doctors. In this chapter, the plague is described according to Dr. Nikiforov's experiences in the diagnosis and treatment of patients, and also a review of the relevant literature on this subject is provided. The main modern methods and criteria for laboratory diagnosis of plague are briefly described. The clinical presentations include the bubonic and pneumonic form, septicemia, rarely pharyngitis, and meningitis. Early diagnosis and the prompt initiation of treatment reduce the mortality rate associated with bubonic plague and septicemic plague to 5-50 %; although a delay of more than 24 h in the administration of antibiotics and antishock treatment can be fatal for plague patients. Most human cases can successfully be treated with antibiotics.
Relevance. Humanity has been confronted with the global spread of dangerous viral diseases for centuries. Today a new coronavirus, SARSCoV-2, has been added to the list of potentially pandemic pathogens.The purpose of the article is to highlight, as much as possible, the physical and chemical properties of coronavirus, its epidemiology, framework for the disease prevention and treatment in various population groups and healthcare workers. The article provides a list of regulatory documents, a detailed guidance for healthcare professionals on how to act in case of identifying a patient with suspected COVID-19 in healthcare facilities, and a description of the coronavirus disease outbreak situation in the world and in the Russian Federation.Conclusions. The sanitary protection of the territories of the countries represents the main way to shield a population from a dangerous infectious disease. Therefore, the collaboration of physicians from all over the world and constant exchange of information among them is of crucial importance. The COVID-19 pandemic requires decisive, coordinated, global quarantine measures; biological protection of the population, collaboration on the vaccine’s development and treatment methods, and joining efforts against the panic and misinformation.
Environmental change, climate warming, population density increase, high migration activity of the population and other factors provoke the emergence and spread of new infections around the world. The emergence in December 2019 of diseases caused by the new coronavirus («coronavirus disease 2019») has already gone down in history as an emergency of international importance. It is known that the most common clinical manifestation of a new infection is pneumonia, and also in a significant part of patients — respiratory distress syndrome. Our article provides a brief analytical review of these temporary guidelines Ministry of Health of the Russian Federation «Prevention, Diagnosis and Treatment of a New Coronavirus Infection (COVID-19)», version 3 (03.03.20) and other published sources. The team of authors expresses the hope that these data will be useful to doctors in providing medical care to patients with a new coronary virus infection, as well as to teachers in preparing students and residents. Source: Ministry of Health of the Russian Federation. Temporary guidelines «Prevention, diagnosis and treatment of new coronavirus infection (COVID-19)», version 4 (27.03.20). Available on: https://static-3.rosminzdrav.ru/system/attachments/attaches/000/049/881/original/COVID19_recomend_v4.pdf
Aim. To evaluate the efficacy and safety of Raphamin, containing technologically processed affinity-purified antibodies to interferon , CD4 receptor, 1 domain of the major histocompatibility complex class II and 2 microglobulin major histocompatibility complex class I in the treatment of acute respiratory viral infection (ARVI), including influenza, in adults. Materials and methods. 240 patients 1870 years old with ARVI were included in a phase III (20192020), randomized, double-blind, placebo-controlled trial. Pregnant women, patients with suspected bacterial infections were excluded from the study. Raphamin/placebo was prescribed for 5 days within 24 hours of the illness onset. Primary endpoint was a time to resolution of ARVI (Polymerase chain reaction PCR-confirmed). Additionally, the severity of ARVI, proportion of patients with ARVI resolution/worsening/complications, frequency of antipyretics prescription, and time to resolution of symptoms of ARVI (including PCR non confirmed) were assessed. Results. The average time to resolution of ARVI (PCR-confirmed) was 4.11.9 [4.01.9] and 5.02.5 [5.02.5] days in the Raphamin/placebo groups (ITT and [PP] analysis, р=0.0155 and [р=0.0114], respectively). The duration of ARVI decreased by 0.892.23 [0.932.25] days. Superiority of Raphamin was shown during therapy period according to the ARVI resolution criterion (р=0.0014 [р=0.0005]). There were no statistically significant difference in the severity of ARVI and frequency of antipyretics prescription. The proportion of patients with worsening/complications was 0 [0]% and 2.5 [2.8]% in the Raphamin and placebo groups, respectively. Favorable safety profile of Raphamin (including the incidence and severity of adverse events) and high compliance were shown. Conclusion. Raphamin promotes significant decrease, practically by a day, the duration of ARVI, including influenza.
Interferon-gamma (IFN-y) is a pleiotropic lymphokine that have multiple effects on the growth and differentiation of various types of cells associated with innate immunity. IFN-y induces differentiation ofmyeloid cells, stimulates the expression of major histocompatibility complex (MHC) class II and class I antigens, it is a potent activator of macrophages which destroy antigenic molecules penetrating the cell. IFN-y is widely used for the treatment of infectious diseases, cancer, autoimmune and allergic diseases. Studies conducted in Research Institute ofInfluenza indicate that drugs IFN-y can be successfully usedfor prevention of influenza and acute respiratory infection (ARI) during the rise of incidence, as well as for the treatment - the first few days/ hours of the onset. The concomitant use of drugs as IFN-a and IFN-y on influenza and ARI can greatly improve the prophylactic and therapeutic efficacy.
Relevance. Humanity has been confronted with the global spread of dangerous viral diseases for centuries. Today a new coronavirus, SARSCoV-2, has been added to the list of potentially pandemic pathogens.The purpose of the article is to highlight, as much as possible, the physical and chemical properties of coronavirus, its epidemiology, framework for the disease prevention and treatment in various population groups and healthcare workers. The article provides a list of regulatory documents, a detailed guidance for healthcare professionals on how to act in case of identifying a patient with suspected COVID-19 in healthcare facilities, and a description of the coronavirus disease outbreak situation in the world and in the Russian Federation.Conclusions. The sanitary protection of the territories of the countries represents the main way to shield a population from a dangerous infectious disease. Therefore, the collaboration of physicians from all over the world and constant exchange of information among them is of crucial importance. The COVID-19 pandemic requires decisive, coordinated, global quarantine measures; biological protection of the population, collaboration on the vaccine’s development and treatment methods, and joining efforts against the panic and misinformation.
Objective. To evaluate the efficacy and safety of Ergoferon in children and adults with acute respiratory viral infections (ARVIs). Material and methods. We have analyzed the results of 10 randomized controlled trials involving 1732 patients. The outcome measures included duration of fever, disease severity, frequency of deteriorations, number of adverse events (AEs), and assessment of drug interaction. We have conducted statistical analysis of pooled data and meta-analysis using logistic regression. Results. Patients receiving Ergoferon were 1.5 times more likely to have shorter period of fever than those receiving placebo (ОR = 1.499, р = 0.0002). Patients in the Ergoferon group had milder ARVI and influenza than patients in the placebo group (according to the AUC analysis: 32.83 ± 18.12 vs 36.94 ± 19.08 units in the placebo group, p = 0.0083). The frequency of deterioration in the Ergoferon group was 7 times lower than that in the placebo group (0.6% vs 4.4% of cases). Treatment safety was confirmed by fewer patients having AEs in the experimental group (0.6% vs 10.8%, p = 0.0006.) and no drug interactions. Conclusion. Our findings suggest that Ergoferon significantly reduced duration of fever in patients with ARVI and influenza compared to placebo. Ergoferon alleviated the disease and reduced the incidence of bacterial complications. Moreover, this drug demonstrated good tolerability and compatibility with other drugs. Key words: ARVI, influenza, meta-analysis, ARVI treatment, influenza treatment, Ergoferon
Acute respiratory viral infections (ARVI), including influenza, remain the most common infectious diseases. In the context of COVID‑19 pandemic, there is a need for differential diagnosis of respiratory syndrome. The clinic of ARVI, depending on the pathogen, may have its own characteristics. Influenza and COVID‑19 have common pathways of transmission of the pathogen and similar symptoms, so the optimal differential diagnosis is the use of test systems for both viruses. Against the background of influenza and other acute respiratory infections, complications from various organs and systems can develop. The article discusses in detail the issues of the clinical course of ARVI, differential diagnosis, modern approaches to therapyand prophylactic. Complications of influenza from the cardiovascular system are considered in detail. The data of our own observations on the risk of developing acute coronary syndrome in persons who have undergone COVID‑19 are presented. Prevention of the development of complications of influenza and other acute respiratory infections is the early appointment of antiviral therapy. Numerous studies confirm the effectiveness of interferon inducers in the treatment of influenza and other ARVI. The article presents the results of clinical studies confirming the effectiveness of therapy with the interferon inducer Kagocel. Against the background of its use, a decrease in the severity of clinical manifestations, a reduction in the duration of the disease, and the prevention of complications were noted. In studies, the drug has shown a high level of safety. The article discusses studies on the effectiveness of chemoprophylaxis of influenza and other acute respiratory infections.
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