Biomedical subjects
Publications and source records attributed to V S Perepelkin.
Difficulties in the clinical diagnosis of rickettsiosis and related illnesses made it necessary to develop and improve its methods (immunoferment analysis, nondirect methods of fluorescent antibodies and polimerase chain reaction). Detailed recommendations for diagnosis of Q-fever by the level and growth of antibodies of IgG and IgA subclasses.
In article is spoken about influence of quality of diagnostics of diseases on contents of anti-epidemiological measures in the epidemic centers of infections and efficiency of treatment on characteristic of the epidemiological conditions in the troops. A role of anti-epidemiological regimen in the infectious departments of the military hospitals is shown.
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As a result of long-standing screening of chemopreparations of anti-rickettsiosis action in-vitro and in-vivo experiments and their clinical evaluation in the treatment of R. of any etiology, it is established that the most effective ones are those of the 4 groups: tetracyclines (doxicycline, minocyclines), ansamicines (rifampicine), ftorchinolones (cyprofloxacine, ofloxacine, pefloxacine) and the new generation of macrolides (asitromicine, klaritromicine). Since all the studied preparations have only rickettsiosis-static effect, a promising way to finding a rickettsiocidic preparation capable of preventing a possible persistence of a relevant agent in a human body is a combined application of highly effective chemopreparations (doxicycline, in particular) or pefloxacine with lysosomal alkalinizing drugs (chlorochin, ammonium chloride or amantadine). Antibiotics of prolonged anti-rickettsiosis action give a real chance for prevention even with a one-time dose.
Peculiarities of modern influenza and other acute respiratory diseases in the units make medical service to execute epidemiologic supervision of these infections, especially in relation of newly formed collectives and troop contingency during there moving to other regions of the country. The medical service should apply agents of specific prophylaxis of influenza in groups of increased risk during threat of occurrence of an epidemic of influenza. It is necessary to contain a sufficient reserve of influenza vaccines for this purpose. At occurrence of pandemic strain of virus of influenza tactics and measures of prophylaxis should be revised with account of new epidemiologic situation.
In article the methodical approaches to study of regularity of occurrence and distribution of shigellosis are revealed from positions of the theory of etiologic selectivity of main ways of transfers, its unequivalentness at the various nosologic forms of dysentery. A complex of antiepidemiologic measures under conditions of means of prophylaxis is proved. On the basis of analysis of etiologic structure of shigellosis a main problem of the Armed Forces, causing dysentery is designated.
Microbe of taxonomical families Rickettsiaceae aceal and Bartonellaceae of Rickettsiales order have caused not less than 14 nosological forms of disease among people in different parts of the world. About 8 of them--in Russia and in the former Soviet Republics. These diseases are not unequivocal from epidemiological point of view. Trench, Marseilles and other forms of fever, murine typhus, vesicules rickettsia, etc. have been liquidated and never recurred for 30-40 years. Prowazek's [correction of Provachek's] rickettsia in its two forms has lost its epidemiological meaning in Russia and is next to full disappearance. However, some types of fever still represent a definite threat to public health. Some diseases, like ehrlichiosis, Bartonella, tsutsugamushi fever have not yet been studied to the end in Russia.
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As possible alternative to a complex of sanitary-hygienic measures, directed on the infectious diseases prevention, not specific prophylaxis with the aid of immunomodulative preparations is offered. Prospects of the immunomodulative preparations application is defined by transition to popularized epidemiological thinking planned in modern conditions. Strategy of total and selective not specific prophylaxis, results of own researches on estimation of preventive efficiency of dibazolum and prodigiosanum during acute respiratory disease and virus hepatitis A are described.
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The article summarizes the experience of antiepidemic support of combat operations of the Soviet troops in Afghanistan. The basic antiepidemic principles which were worked out during the Great Patriotic war are still actual and must be used in organization of antiepidemic measures in local wars and military conflicts. The following aspects are of most practical significance in this matter: sanitary-epidemic reconnaissance, pre-operational readiness of troops, preventive measures to interdict the spreading of the infection to the cantonment areas when the units return from combat operations.
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Russian Armed Forces Medical Service has worked out the basic trends of anti-epidemiological measures to be conducted in troops. To battle shigellosis and other acute intestinal infections of non-dysentery etiology a number of factors were taken into account, such as: methods of proliferation of these diseases, dynamics and morbidity rate, etc. The article shows the tasks of medical service during organization and execution of sanitary-epidemiological control over morbidity rate, disclosure of the causes which originate the appearance of acute intestinal infections, elaboration of proposals on the improvement of sanitary-epidemiological situation in troops, strict adherence to the rules of hygiene.
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On the basis of the experience gained during the Great Patriotic war (1941-1945) on antiepidemic support of minimally wounded, and analysing the work of the military field hospitals for minimally wounded (HMW) the authors describe the role played by the "mixing" factor and the "local population transmission" factor upon the spreading of infectious diseases. A special attention is paid to disclosure of infectious patients during their admission to the HMW, measures towards the enhancement of their immune resistance, and strict control over sterilization of medical instruments. A proposal was made to introduce a post of sanitation physician in the organic structure of HMW.
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