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The system of the environment and health monitoring system has been introduced into the work of the State Sanitary and Epidemiological Service of the Lipetsk region in 1995. During this period, there was created a database for the collection of regional information on the quality and safety of the environment and public health. Methodology of the analysis is based on an assessment of the habitat on the total rank sanitary and hygiene index of the risk assessment to public health. The established relationships between adverse impacts of environmental factors on health are supported by statistical methods and are visualized in the form of cartograms. The results of multivariate analysis of the environment and the state of public health are summarized in the annual reports and 4 atlases “Sanitary-epidemiological situation in the Lipetsk region” being a good tool for the coordination of managerial decision-making basis for the development of legislative, administrative and regulatory guidance documents on public health. In recent years, in the region there are noted stable trends in the improvement of the quality of the environment, the health of the population and the demographic situation.

Experiments indicated that the argasid ticks Alveonasus lahorensis were highly susceptible to West Nile virus when inoculated in the hemocoel. The virus concentration in the ticks reached high values when very low doses (0.01 PFU) of the pathogen were administered. The ticks kept at 3.0 +/- 1.0 degrees C retained the pathogen up to 116 days (a follow-up period). The infection rate of the ticks depending on the virus dose administered was in the range from 12 to 80%. The contaminated specimens successfully transmitted the virus to rabbits by blood suckling. The findings suggest that the argasid ticks may be involved in the preservation of West Nile virus in the interepidemic period and be responsible for the outbreak of this infection in summer and autumn months.

Therapeutic activity of Triazavirin against experimental influenza A was studied on albino mice intranazally infected with influenza virus A/Chicken/Kurgan/Russia/02/05 (H5N1) vs. reference drugs (Oseltamivir, Remantadin and Arbidol). The study showed that in a therapeutic dose of 1 mg/kg Triazavirin was efficient in protection of the animals from death. Its protective therapeutic efficacy (36.7+/-1.7%) was close to that of Oseltamivir (50.0+/-0.0%), comparable with that of Remantadin (38.3+/-1.7%) and higher than that of Arbidol (11.7+/-1.7%). During the whole observation period (up to the terminal phase) Triazavirin inhibited the influenza virus A accumulation in the lungs of the infected albino mice by more than 3 lg.

Foreign experience with empirical management of severe acute respiratory syndrome (SARS) due to coronavirus, genotype IV is described. It is indicated that the data on the efficacy of ribavirin with respect to SARS in the patients are contradictory. The efficacy of two chemotherapeutics, i. e. lopinavir and ritonavir used in the SARS foci is confirmed. The drugs are at present applicable all over the world in retrovirus therapy of HIV infected subjects. The search for efficient Russian unspecific medicines for control of SARS is actual.

The use of immunomodulators in the treatment of subjects with postvaccinal reactions to TEOVac was investigated. The most effective schemes were shown to be those with the use of viferon or combination of arbidol and licopide. The terms of the response signs cupping off were much shorter vs. the cases treated with polyoxidonium. The immunomodulating factors did not affect the intensity of the immunity to the vaccine virus.

The results of the in vitro studies on the efficacy of medical nonspecific protective agents from various pharmacological groups showed that some drugs, such as velferon, alferon, betaferon, ribavirin and lopinavir were active against TOPC virus, that permitted to recommend them for estimation of their activity on laboratory animals. The data on the in vivo activity of pharmacological drugs with respect to TOPC virus are rather scanty and it is difficult to predetermine their efficacy. The danger of TOPC virus latent circulation among wild animals in China requires research of new efficient medical agents for protection of the people from the pathogen in the Russian Federation.

Analysis of the efficacy of Grippferon vs. the reference drugs Realdiron and Reaferon-EC against the influenza virus A(H1N1)/2009 in susceptible static cell cultures showed that in the concentrations tested it was efficient in inhibition of the virus cytopathic activity and generation of specific hemagglutinin.

The experimental study of the Ingavirin efficacy against the influenza virus A (H5N1) on intranasally-infected albino mice vs. Tamiflue and Arbidol showed that when used for the prophylaxis, urgent prophylaxis and therapy it was effective in the protectiom of the animals from death. The efficient dose for the prophylaxis of the influenza infection was 5 mg/kg (protective efficacy of 46.7%) and for the urgent prophylaxis and therapy it was 15 mg/kg (protective efficacy of 40.0 and 35.0% respectively).

Clinical trials of tabletted pox vaccine revealed development of tonsillitis as a postvaccinal reaction in some volunteers: ulceronecrotic lesions in the tonsils, lymphadenitis, hyperthermia and asthenia. The main cause of the local inflammatory reactions was activation of the host opportunistic microflora including hemolytic streptococci and Staphylococcus aureus. For the treatment of the infectious complications systemic antimicrobials, such as benzylpenicillin, amoxicillin, ampicillin, cefazolin and fluoroquinolones (ciprofloxacin) in combination with the symptomatic therapy were used. The treatment course of 9 days provided complete elimination of the postvaccinal reactions, the specific antibody generation being not affected.

The experimental study of the prophylactic efficacy of Triazaverin against the experimental form of the influenza virus A (H5N1) on albino mice intranasally infected with the influenza virus A/Chicken/Kurgan/Russia/02/05 vs. the reference drugs Tamiflu, Remantadin and Arbidol showed that in doses of 1 to 100 mg/kg it was efficient in the animal protection from death. The drug was also efficient in the urgent prophylaxis. Triazaverin effectively inhibited the influenza A virus multiplication in the lungs of the albino mice.

High in vitro and in vivo efficacy of Ingavirin against the Mexican pandemic influenza virus A/H1N1/2009, strains A/California/04/2009 (H1N1) and A/California/07/2009 (H1N1) vs. the reference drug Arbidol was studied and verified when used therapeutically and prophylactically.

The virucide activity of Monclavit-1 against the influenza virus A/Chicken/Kurgan/2/Russia/05 (H5N1) was investigated in the MDCK cell culture. It was shown that at a temperature of 14.0 +/- 1.0 degrees C Monclavit-1 in a 20-fold dilution within an hour inactivated the cytopathic activity of the virus and the specific hemagglutinin generation by 100 and 87.5% respectively. In a 40-fold dilution it inactivated at the average by 50% both the cytopathic activity and the specific hemagglutinin generation. In an 80-fold dilution it inactivated the cytopathic activity at the average by 20%. In a 160-fold dilution it did not inactivate the pathogen. At a temperature of 25.0 +/- 1.0 degrees C Monclavit-1 inactivated the influenza virus A/Chicken/Kurgan/2/Russia/05 (H5N1) by 90.0% only in the highest concentration.

Efficacy of arbidol and ridostin in cupping postvaccinal complications due to variolation was studied by the clinico-virological, hematological and biochemical indices and it was shown that arbidol was efficient in cupping development of dermal complications, lowered the severity of the postvaccinal reaction and stimulated the cellular and humoral immune response. Ridostin, a high molecular interferon inductor, was highly efficient in cupping all the forms of the postvaccinal complications, including the neurological and cutaneous ones.

Investigation of the efficacy of ribavirin against the West Nile virus in standard cell cultures showed that in high concentrations it inhibited the virus reproduction (the inhibition coefficient of 100%). In the experiments on albino mice infected with the West Nile virus in a dose of 10 LD50 ribavirin was used in the form of injections in a dose of 20 mg/kg for 7 days in the scheme of urgent prophylaxis and proved to be highly efficient in protection of the animals from death (85-percent survival).

Ingavirin was shown to be efficient in inhibition of the influenza virus strains A/California/04/2009 and A/California/07/2009 (H1N1) in the MDCK cell culture. The coefficient of the cytopathic activity inhibition amounted to 50 and 60%, and the inhibition coefficients of the specific hemagglutinin formation were 50 and 50%, and 79,1 and 75% before and after the enrichment in chick embryos respectively.

Cytotoxicity of chemotherapeutics (Ribavirin, Remantadin and Ingavirin), interferon (Realdiron) and interferon inductors (Larifan, Ridostin, Arbidol and Cytarabin) was investigated with the use of persistent and diploid cell cultures. Ingavirin and Ribavirin from the group of the chemotherapeutics and Razifan and Ridostin from the group of the interferon inducrors showed the lowest toxicity. Light microscopy revealed no visible cytopathic changes in the investigation cell cultures exposed to maximum concentrations (> or =10(6) IU) of Realdiron. In vivo acute toxicity investigation demonstrated that in a concentration of 10(6) IU per animal weight Realdiron was not toxic for the albino mice and chinchilla rabbits. The maximum tolerance doses for the albino mice were the following: > or =3000 mg/kg of Ingavirin, 401.25 mg/kg of Arbidol, 170 mg/kg of Ribavirin, > or =100 mg/kg of Larifan and > or =100 mg/kg of Ridostin.

The experimental investigation of Ingavirin activity against influenza B virus showed that in concentrations 100 and 200 mcg/ml it was efficient in inhibition of the virus reproduction: the cytopathic effect was lowered by 75%, the level of the pathogen accumulation in the MDCK cell culture was decreased by more than 2.0 lg and the formation of the virus specific hemagglutinin was inhibited by more than 90%.

The comparative analysis of the efficacy of Ingavirin and etiotropic chemotherapeutics, such as Arbidol and Remantadin, against the influenza virus A (H3N2) performed with the use of susceptible permanent cell cultures showed that in the used concentrations Ingavirin was efficient in inhibition of the virus cytopathic activity, formation of the specific hemagglutinin and reproduction of the virus (by the accumulation).

The experimental investigation of the Ingavirin antiviral effect showed that in concentrations of 200 and 100 mcg/ml it totally protected the cells from the cytopathic action of the virus, when added before the inoculation of the HeLa cell culture. After a tenfold decrease of the infective dose (up to 0.001 CPD50/cell), the inhibition of the virus cytopathic effect by Ingavirin amounted to 100% in all the tested concentrations (including the low ones) added either before or after the culture contamination. Ingavirin was efficient in inhibition of the adenovirus type 5 reproduction in the HeLa cell culture.

Antiviral efficacy of Ingavirin was studied on albino mice infected intranasally by the grippe A virus (H3N2) vs. Tamiflu, Remantadin and Arbidol. Ingavirin used prophylactically in doses of 5 to 10 mg/kg was shown to be effective in protecting the animals from death and inhibiting the specific hemagglutinin formation and the virus reproduction in the lungs (by the accumulation).

Investigation of the therapeutic efficacy of Ingavirin (Valenta Farmacevtica, Russia) against influenza virus A (H3N2) vs. Tamiflu, Remantadin and Arbidol showed that in daily doses of 15 and 20 mg/kg (equal by the efficacy to the human doses of 90 and 120 mg) Ingavirin was effective in protection of the albino mice infected by the virus in a dose of 10 to 15 LD50. The protective efficacy was 38.3-39.2% and the increase of the average lifespan amounted to 4.2-4.4 days. The Ingavirin efficacy was comparable with that of Remantadine, markedly exceeded that of Arbidol and was lower than that of Tamiflu. Investigation of the Ingavirin influence in doses of 15 and 20 mg/kg on the dynamics and level of the influenza virus A/Aichi/2/68 reproduction in the lungs of the infected albino mice weighing 10-12 g revealed that during the whole observation period in the doses tested Ingavirin was effective in inhibition of the influenza virus reproduction. During the whole period of the observation (5 days) Ingavirin was effective in inhibiting the formation of the virus specific hemagglutinin in the target organ.

Ways for increasing the anthrax treatment efficacy by combined use of antibiotics, toxin neutralizing, immunomodulating, symptomatic and pathogenetic agents are considered. The dynamics of the infection development was studied on rabbits by the microbiological, cytochemical, biochemical and cytomorphologic criteria. The efficacy of monoantibacterial and complex schemes of the etiopathogenetic therapy of the disease at the early and late stages (phases) of the infection generalization was estimated.

Comparative in vitro and in vivo efficacy of new fluoroquinolones with respect to pathogens of tularemia, glanders, melioidosis and anthrax was estimated. It was shown that the strains of the tularemia, glanders, melioidosis and anthrax pathogens were in vitro highly susceptible to the new agents. The experiments on laboratory animals demonstrated that pefloxacin and sparfloxacin had extremely broad spectra and were of special value in emergency prophylaxis of tularemia, glanders, melioidosis and anthrax.

Analysis of triazavirin efficacy with respect to influenza A virus (H5N1) in sensitive cell culture MDSK vs. effective antigrippe drugs, such as tamiflu, remantadin and arbidol showed that triazavirin in a wide range of the concentrations was efficient in inhibition of the virus cytopathic activity and formation of the specific hemagglutinin.

The paper characterizes the sanitary and epidemiological situation in Lipetsk in 1997-1998. It emphasizes the topical problems in the control of tuberculosis and particularly life-threatening infections at the present stage and the importance of prevention of nosocomial diseases. The paper also shows how actions in final disinfection are made in the foci of infectious diseases in the Lipetsk Regional Center of Disinfection and Sterilization.

Under analysis there were 14 patients operated upon for fibrous periarteritis. In 10 patients there was a retroperitoneal localization of the pathological process, and 4 patients had the mediastinal localization. The both localizations have similar features of etiology, pathogenesis, clinical course and lead to the formation of a stenosing scarry housing around the arteries with an issue into the occlusion. The operation volume for the retroperitoneal and mediastinal localization of the fibrous periarteritis depends on the stage of the disease: decompression and arteriolysis at first stages for stenosis and reconstructive operations for occlusions of the arteries.

An analysis of the results of the examination and treatment of 379 patients undergoing transthoracic interventions showed that the use of the target-aimed selective immunomodulation, short-term antibacterial prophylaxis, inhibitors of arachidonic acid metabolites, active elimination of the circulating immune complexes and medium-weight molecular peptides and adequate local analgesia after the interventions providing normalization of the laryngeal reflex and early activation of the patients permitted the incidence of the pulmonary complications to be decreased by 2.5 times, pleural complications by 1.7 times, suppuration of the postoperative wound by 1.8 times and the total expenses by 25.6 per cent.

The method of extracorporal connection of the swine spleen (ECSS) was used in the complex treatment of 32 patients with acute pancreatitis. Three patients died. It was established that ECSS effectively reduced hyperfermentemia and increased the phagocyte activity of blood leukocytes which was an important component of complex treatment of patients with acute destructive pancreatitis.

On the basis of the analysis of 217 records of acute diffuse peritonitis peculiarities of the postoperative process of that complication in persons treated with 2 antibiotics (161) and 4 antibacterial drugs (56) were discussed. 4 risk levels were defined with an account of the inflammation process severity. The use of poly-antibiotic therapy was validated. The technique of its application is described in detail. The technique allowed to lower the frequency of postoperative complications and lethality 5-fold.