The influenza epidemic in 2015–2016 in Russia is characterized by a sharp increase of influenza cases (beginning from the second week of 2016) with increased fatalities. Influenza was confirmed in 20 fatal cases registered among children (0–10 years), in 5 cases among pregnant women, and in 173 cases among elderly people (60 years and older). Two hundred and ninety nine people died from influenza were patients with some chronic problems. The overwhelming majority among the deceased (more than 98%) were not vaccinated against influenza. We isolated 109 influenza A(H1N1)pdm09 and one A(H3N2) virus strains from 501 autopsy material samples. The antigenic features of the strains were similar to the vaccine strains. A phylogenic analysis of hemagglutinin revealed that influenza A(H1N1)pdm09 virus strains belonged to 6B genetic group that had two main dominant subgroups during the 2015–2016 season. In Russia strains of the first group predominated. We registered an increased proportion of strains with D222G mutation in receptor-binding site. A herd immunity analysis carried out immediately prior to the epidemic showed that 34.4% blood sera samples collected in different regions of Russia were positive to A/California/07/09(H1N1)pdm09. We came to a conclusion that public awareness enhancement is necessary to reduce unreasonable refusals of vaccination.

Aim. To analyze the results of the application and to study the effectiveness of ultrasound shear wave elastography and elastometry in the endometrial pathology diagnosis in secondary infertility.Methods. Multiparameter ultrasound with shear wave elastography and elastometry modes (Shear Wave Elastography) was performed in 146 women of reproductive age (Aixplorer scanner, Supersonic Imagine, France). The main group (N1) included 101 women with secondary infertility: 43 patients with tuberculous lesions of the uterus, 58 - with chronic endometritis without concomitant tuberculosis. The control group (N2) included 45 healthy women: 22 nulliparous women, 23 - parous women. Age of examined women ranged from 24 to 48 years, mean age in N1 group was 34.4±2.6 years, in N2 group - 33.9±2.9 years.Results.. Depending on the nature of the pathology elastographic cards of examined women in the main group differed in color. Elastographic cards of blue-green range of low intensity dominated in patients with chronic endometritis. In patients with tuberculous lesions of the uterus unevenly colored, non-homogeneous, high intensity, from green to yellow and red in color-grade elastographic cards were determined. Endometrial stiffness values in patients with chronic endometritis and in tuberculous lesions of the endometrium (31.7±4.3 and 89.7±5.7 kPa, respectively) were significantly higher than that in healthy women (16.5±1.0 kPa, pConclusion. The presented analysis indicates the feasibility of the shear wave elastography and elastometry application in multiparameter ultrasound study of the uterus and adnexa in the diagnostic algorithm of patients with secondary infertility.

Цель. Показать на клиническом примере из кардиохирургической практики необходимость проведения исследований для определения генетической резистентности к антиагрегантным препаратам.

Aim. Evaluation of seroprevalence of antibodies to influenza A and В viruses and analysis of specimens from severe or fatal influenza cases in Russia in 2015 - 2016 and 2016 - 2017 flu seasons. Materials and methods. Determination of antibody titer in human serum samples in hemagglutination inhibition assay with reference antigens. Isolation of influenza viruses from nasopharyngeal swabs and autopsy material in cell culture. Characterization ofisolated strains. Results. In 2016, compared to 2015, the proportion of serum samples, containing antibodies to influenza viruses A(H 1N1 pdm09) and A(H3N2), increased. During the 2015-2016 season, elevated number of severe and fatal cases of influenza were registered. The majority of circulated strains belonged to the new clade 6B.1 of A(HlNippdm09 viruses. 1% of analyzed isolates carried H275Y amino acid substitution in neuraminidase and were resistant to oseltamivir. In the 2016 - 2017 season, there were less severe cases of influenza. The most prevalent were influenza viruses A(H3N2) and B/Victoria. Isolated H3N2 viruses belonged to the 3C.2a subclade and B/Victoria isolates were from the 1A genetic group. All tested strains were susceptible to neuraminidase inhibitors. Conclusions. Flu seasons 2015 - 2016 and 2016 - 2017 differed in intensity of influenza activity and in the dominant influenza A virus subtype. Immunization with vaccine, comprising new HlNlpdm09-component, is crucial for prophylaxis of influenza infection with viruses from 6B. 1 subclade in the next season. Neuraminidase inhibitors are recommended for influenza treatment.

We performed an estimation of body fat using ultrasound, magnetic resonance imaging (MRI) and anthropometry in 60 patients with different types of body weight (BW). Correlation of waist circumference (WC), thickness of subcutaneous fat and visceral fat with components of the metabolic syndrome was studied comparatively between ultrasound and MRI measurements. We noted a preferential increase in the thickness of visceral fat compared with subcutaneous with increasing degree of BW. Significant increase in adipose tissue and the development of metabolic disorders occurs in overweight, making it the state close to obesity. During a routine ultrasound of the abdomen it is advisable to determine the thickness of subcutaneous and visceral fat separately.