Acute myocardial ischaemia and reperfusion (I–R) are major causes of ventricular arrhythmias in patients with a history of coronary artery disease. Ursodeoxycholic acid (UDCA) has previously been shown to be antiarrhythmic in fetal hearts. This study was performed to investigate if UDCA protects against ischaemia-induced and reperfusion-induced arrhythmias in the adult myocardium, and compares the effect of acute (perfusion only) versus prolonged (2 weeks pre-treatment plus perfusion) UDCA administration. Langendorff-perfused adult Sprague–Dawley rat hearts were subjected to acute regional ischaemia by ligation of the left anterior descending artery (10 min), followed by reperfusion (2 min), and arrhythmia incidence quantified. Prolonged UDCA administration reduced the incidence of acute ischaemia-induced arrhythmias (p = 0.028), with a reduction in number of ventricular ectopic beats during the ischaemic phase compared with acute treatment (10 ± 3 vs 58 ± 15, p = 0.036). No antiarrhythmic effect was observed in the acute UDCA administration group. Neither acute nor prolonged UDCA treatment altered the incidence of reperfusion arrhythmias. The antiarrhythmic effect of UDCA may be partially mediated by an increase in cardiac wavelength, due to the attenuation of conduction velocity slowing (p = 0.03), and the preservation of Connexin43 phosphorylation during acute ischaemia (p = 0.0027). The potential antiarrhythmic effects of prolonged UDCA administration merit further investigation.

1% (I период) до 27,8% (II период). Основные измене-ния у больных сочетанной инфекцией были ассоциированы с ВИЧ, удельный вес которых увеличился с 10,0% (I период) до 91,8% (III период). Летальность больных сочетанной инфек-цией возросла с 11,7 до 34,7% (в 3 раза).Ключевые слова: хронические вирусные гепатиты, туберкулез, ВИЧ-инфекция, сочетанные инфекции. 1998-2001 year (period I, 128 patients), 2008 year (period II, 334 patients) and in 2013-2014 11,7 to 34,7% (3 times). Аbstract With the aim of improving the system of epidemiological surveillance and monitoring of the most significant and socially determined co-infections, carried out the epidemiological analysis of viral hepatitis B and C, tuberculosis and HIV infection who were registered in the Clinical infectious hospital named. S. P. Botkin in the beginning of this century (17-year period). Examined 707 patients. The comparison carried out between the three groups of patients co-infected identified in

The epidemiological analysis of the recorded incidence of chronic forms of viral hepatitis (H) in Leningrad - St. Petersburg performed for 39 years, revealed the presence of a peculiar periodicity of the epidemic process, etiopathogenetic relationship between the incidence of acute and chronic forms of HB and HC in the megacity. The epidemic process of viral hepatitides, presented with chronic forms in dynamics, has undergone significant alterations, consisting in the change of the leading age groups in the formation of disease morbidity. In the first and second periods of observation (1962-1994) in the epidemic process mainly adults and children were involved. Under the influence of socio-economic conditions and changes in the moral and ethical foundations of society in the third period in the formation of chronic liver pathology the equity participation of adolescents, young adults increased, and the proportion of children and older groups of adults decreased. Increasing the percentage offemales in the structure of incidence of chronic viral hepatitis is an unfavorable sign. Gender and age-related changes in disease morbidity contributed to the decline in mortality from chronic viral hepatitides.

Резюме Цель: провести сравнительный эпидемиологический анализ и выявить эпидемиологические и клинические особенности клещевого энцефалита и боррелиоза как моно-, так и одновременного сочетания этих инфекций у больных в Санкт-Петербурге. Материалы и методы: ретроспективно изучено 718 случаев клещевого энцефалита, 4353 случая клещевого боррелиоза и 127 сочетанных заболеваний, зарегистрированных в отделе учета и регистрации инфекционных и паразитарных заболеваний Центра гигиены и эпидемиологии Санкт-Петербурга за 2006-2017 гг. Идентификация сочетанных заболеваний происходила с помощью специальной программы, позволяющей выявлять сочетанные заболевания из массива моноинфекций. Для выявления клинико-эпидемиологических особенностей изучено 144 истории болезни клещевым энцефалитом, 286-клещевым боррелиозом и 43 истории болезни в случаях сочетания этих инфекций. Проанализированы возрастно-половые характеристики, места заражения людей, вирусо-и борелиафорность клещей, клинические формы моно-и сочетанных заболеваний, изменения, происходящие во времени. Коэффициент серопозитивности IgM у больных оценивался в динамике обследования пациентов. Результаты: многолетняя динамика заболеваемости клещевым энцефалитом и клещевым боррелиозом не имела выраженных тенденций к росту или снижению и характеризовалась синхронными колебаниями. Выявлен приоритет заболеваемости мужчин над женщинами. Заражения клещевым энцефалитом и боррелиозами в 61-69% случаев происходили в Ленинградской облас

Сombination of tuberculosis and viral hepatitis have been registered 2525 newly identified patients in Saint-Petersburg for the period 2006–2017. Some of these patients have been infected with HIV. Fatal outcome in 625 (24,7%) was noted. Patients with tuberculosis and chronic viral hepatitis have had a combination of viral hepatitis B and C in 36% of cases. Patients with combination tuberculosis and chronic hepatitis of unknown etiology experienced a more frequent death (60%) than patients with combination tuberculosis and other chronic viral hepatitis. In patients with concurrent tuberculosis, chronic viral hepatitis and HIV infection, patients infected viral hepatitis B and C were 31,6%. In 160 patients with fatal outcomes had a combination of infections (tuberculosis, viral hepatitis and HIV infection), the mortality rate of persons with hepatitis of unknown etiology was the lowest (42%), compared with a group of individuals affected by viral hepatitis B and C simultaneously (83%). Among patients with tuberculosis, chronic hepatitis and HIV infection, the highest incidence of tuberculosis of the intrathoracic lymph nodes and disseminated pulmonary tuberculosis was registered. Lethal outcomes most often occur in individuals with advanced tuberculosis, in whom the secretion of mycobacteria tuberculosis into the external environment has not been established. Given the high level of mortality in patients with simultaneous defeat of tuberculosis, viral hepatitis and HIV infection, it is necessary to establish their centralized registration in order to study the epidemiological patterns and clinical features of co-infections.