Borrelia burgdorferi sensu lato (s.l.) DNA was detected by PCR in Ixodes persulcatus Schulze, 1930, Haemaphysalis concinna Koch, 1844 , Haemaphysalis japonica douglasi Nuttall et Warburton, 1915 and Dermacentor silvarum Olenev, 1932 ticks collected in the Amur region, the Jewish Autonomous region, the Sakhalin region and on the Khabarovsk territory. Infection rate of I. persulcatus with B. burgdorferi s.l. 10–69% exceeded the corresponding values of three other tick species in all examined regions during 1999–2014 despite different tick abundance and dominance structure. Bacterial loads estimated on the base of quantitative real time PCR varied from 10 2 to 10 9 genome-equivalents per a tick with maximal values for I. persulcatus and H. japonica. Phylogenetic analysis of 16S rRNA gene and 5S—23S rRNA intergenic spacer nucleotide sequences revealed two species: 1) Borrelia garinii of Asian type NT29 with several isolates of European type 20047; 2) Borrelia afzelii with identical sequences of the majority of studied isolates and VS461 reference strain in all regions except the Sakhalin Island where B. afzelii was not found . Borrelia miyamotoi of the relapsing fever group was detected as monoinfection or in combination with B. burgdorferi s.l. in 4.0 ± 0.9% and 4.8 ± 0.9% I. persulcatus ticks, respectively. Multiple locus sequence analysis of three fragments of 16S rRNA, glpQ and p66 genes proved that all the Far Eastern B. miyamotoi isolates belonged to the Asian type identical to FR64b strain (GenBank CP004217 ) from Japan. Wide distribution of Borrelia DNA in ticks, relative genetic homogeneity with similar sequences of the coding regions and the intergenic spacer of Borrelia wild isolates and temporal stability with high homology levels of the Far Eastern isolates of B. garinii , B. afzelii and B. miyamotoi with previously described spirochetes from the surrounding regions of Russia, China and Japan allowed us to suggest multiple ecological niches as the stability factor of the parasitic system.

Borrelia burgdorferi sensu lato infecting Ixodes persulcatus ticks near Novosibirsk, Russia were detected using PCR with primers specific to 5S and 23S rRNA genes. Two genospecies, B. afzelii and B. garinii, were identified by the PCR-based restriction fragment length polymorphism analysis with Tru9-I restriction endonuclease. Comparison of the corresponding nucleotide sequences revealed considerable diversity of the 5S-23S intergenic spacer structure among B. garinii.

Intravitreal injection (IVI) is a drug delivery method, widely used in modern ophthalmology. To increase the awareness of patients receiving treatment in the healthcare system of the Russian Federation, the Expert Council on Retinal and Optic Nerve Diseases of the Association of Ophthalmologists, an All-Russian Public Organization in 2020 proposed a leaflet “Intravitreal injections (information for patients)”.Purpose: to conduct a clinical assessment of the leaflet by multicenter anonymous surveying of patients.Material and methods. Patients who had experienced IVI treatment were asked to read the leaflet for 20 minutes and then answer 12 questions of the specially designed questionnaire. 93 patients were interviewed in clinics in Moscow, St. Petersburg, Yekaterinburg and Novosibirsk: of these, 57 (61.3%), the average age of all patients was 63.9 years, the most common diagnosis was neovascular age-related macular degeneration (52 cases, 55.9%), the experience of previous treatment ranged from 1 to 104 months.Results. The leaflet had a positive response from the patients (91.4% of the questionnaires received “excellent” and “good” ratings), 90.3% patients reported that the information contained was fully or largely consistent with their experience of IVI treatment. The overwhelming majority of respondents (88.2%) did not experience any difficulties in reading the leaflet. At the same time, the patients revealed insufficient awareness on issues related to the treatment. Also, the patients showed insufficient awareness of issues concerning their health: only 20 (21.5%) respondents could answer all five questions of the questionnaire about the understanding of the relevant information, and 31 patients (33.3%) could answer four questions. This fact emphasizes the importance of information support for the patient.Conclusion. The clinical assessment of the leaflet “Intravitreal injections (information for patients)”, which contains brief information about what the procedure is, contraindications, preparation details, symptoms of the postoperative period that require urgent assistance, allows us to recommend the leaflet for use in the clinical healthcare practice of the Russian Federation.

1 ФГБОУ ВО «Уральский государственный медицинский университет» Минздрава России, Екатеринбург; 2 ФГБОУ ВО «Южно-Уральский государственный медицинский университет» Минздрава России, Челябинск; 3 ГАУЗ Тюменской области «Областной офтальмологический диспансер», Тюмень; 4 ГБУ «Курганский областной госпиталь для ветеранов войн», Курган; 5 БУ Ханты-Мансийского автономного округа -Югры «Окружная клиническая больница», Ханты-Мансийск Для цитирования: Коротких С.А., Бобыкин Е.В., Экгардт В.Ф., и др. Интравитреальные инъекции в условиях реальной клинической практики: результаты опроса врачей-офтальмохирургов Уральского федерального округа // Офтальмологические ведомости." Интравитреальные инъекции (ИВИ) широко распространены в современной офтальмологической практике в качестве способа доставки лекарственных препаратов при различных патологиях заднего отрезка глаза. Несмотря на накопленный опыт, некоторые аспекты выполнения процедуры остаются дискутабельными. Кроме того, в литературе нет данных о практических аспектах проведения ИВИ в России в реальных клинических условиях. В данной работе проанализированы результаты анонимного опроса 74 офтальмологов Уральского федерального округа, осуществлённого в 2018 г. с помощью оригинальной анкеты, включавшей 20 вопросов. Установлено, что респонденты в целом разделяют традиционный для России подход к ИВИ как к полостной офтальмологической операции. В ходе опроса выявлено отсутствие единых подходов и неполное следование современным руководящим принципам в отдельных аспектах выполнения процедуры, в связи с чем предложены корректирующие мероприятия." Ключевые слова: интравитреальные инъекции; опрос; реальная клиническая практика; антиангиогенная терапия; профилактика эндофтальмита; руководящие указания.

Background.Anti-VEGF therapy is currently regarded as the gold standard for the treatment of many macular diseases, while the results of its application in real clinical practice are often inferior to those from randomized clinical trials. Materials and methods.A study group was formed on the basis of a retrospective analysis of the medical data of patients who received anti-VEGF therapy with ranibizumab and/or aflibercept according to registered indications, and who discontinued their follow-up in the clinic (n= 214). A phone survey of patients concerning the reasons for loss to follow-up with a statistical analysis of the obtained data was carried out. Results.The majority of patients (81.3%) discontinued observation in the clinic within two years from the start of therapy (the median duration of treatment was 7 (3; 18) months). Patients with all considered diseases had an increase in best corrected visual acuity during treatment (p 0.000001), which confirms the high efficiency of the method. According to the results of the phone survey, the following categories of respondents were identified: complete cessation of treatment 120 (56.1%) patients, change of clinic 20 (9.3%), death 23 (10.7%), status not established 51 (23.8%). The most frequent reasons for stopping treatment were dissatisfaction with its results (59 cases; 49.2%), financial burden (49; 40.8%), and systemic comorbidities (24; 20.0%). Conclusion.Searching approaches to increase patients treatment adherence is one of the priorities for improving anti-VEGF therapy.