[The prevalence of autoimmune endocrine diseases in vitiligo patients].

Vitiligo is a common polygenic autoimmune disease in which the foci of depigmentation are formed on the skin and/or mucous membranes as a result of the death of melanocytes. There are several hypotheses for the pathogenesis of the disease, the leading role among them is played the autoimmune hypothesis. This review summarizes the available literature data on the prevalence and structure of comorbid endocrine autoimmune pathology in vitiligo patients. In most studies conducted in Europe, America and Asia the prevalence of autoimmune thyroid diseases (including autoimmune thyroiditis and Graves disease), diabetes mellitus and autoimmune adrenal insufficiency was higher in vitiligo patients than in the general population. The results of some studies indicate a frequent association of vitiligo with autoimmune polyglandular syndromes. In the structure of comorbid pathology the highest prevalence was in autoimmune thyroid diseases. A number of studies have established a higher prevalence of autoimmune endocrine diseases in women, as well as in nonsegmental vitiligo patients and in cases of family history of vitiligo and/or other autoimmune diseases. In addition, it was shown that the prevalence of endocrine diseases increases with increasing area of depigmentation. The data obtained justify the advisability of conducting a timely examination of vitiligo patients with the aim of early detection of comorbid diseases and the appointment of appropriate treatment. Further studies are needed to investigate the effect of the identified associations on the course of vitiligo and comorbid endocrinopathies, as well as the effectiveness of therapy and the quality of life of patients.

[Representation of the results when testing for syphilis.] / Оформление результатов ÑÐºÑ€Ð¸Ð½Ð¸Ð½Ð³Ð¾Ð²Ñ‹Ñ Ð¸ Ð²ÐµÑ€Ð¸Ñ„Ð¸Ñ†Ð¸Ñ€ÑƒÑŽÑ‰Ð¸Ñ Ð¸ÑÑÐ»ÐµÐ´Ð¾Ð²Ð°Ð½Ð¸Ð¹ на сифилис.

In medical organizations special forms (approved by orders of the Ministry of health and the Central statistical office) are used to present the results of laboratory examination of the population for syphilis. Currently, these forms include laboratory technologies that do not meet modern standards. In 2018-2019 the normative documents, regulating the use of accounting forms of medical documentation in the public health system, and the practice of using forms with the results of laboratory examination for syphilis were studied in 35 branches of 3 medical organizations of the Lyubertsy district of the Moscow region and in 18 branches of Moscow city was conducted. It is established that in the medical organizations of Moscow and the Moscow region are used the different forms of the registration forms approved by orders of the Ministry of health of the USSR which have now become invalid. The structure of the forms with the results of the population survey for syphilis does not correspond to the applied modern technologies and standards of the survey. On the basis of requirements of modern regulatory documents two new forms of registration forms for the presentation of results of laboratory researches have been developed, within 1,5 years tested and offered for application: one form at screening of the population for syphilis and another - for performing verification examinations for diagnostics and the subsequent clinical and serological supervision.

Neurosyphilis in the modern era: Literature review and case series.

The term of neurosyphilis (NS) refers to infection of central nervous system by Treponema pallidum. Classically, it has been divided into early (meningitis, meningovascular) and late forms (general paresis and tabes dorsalis). The availability of penicillin and high sensitivity of Treponema pallidum to this antibiotic has led to a widely held perception about rarity of syphilitic forms with central nervous system involvement. However, patient can exhibit atypical clinical presentation. Recently different clinical cases with autoimmune encephalitis-mimicking presentation or atypical movement disorders were described. In this article we presented clinical case series with different clinical and MRI presentation and discuss diagnostic and treatment challenges. During our screening period at neurological department we revealed 6 NS cases. Three of them have an atypical presentation. The first patient was misdiagnosed as acute disseminated encephalomyelitis, the second patient had hippocampal sclerosis and epileptic seizures. Another patient had cognitive decline and autoimmune encephalitis-like MRI lesions. We put an emphasis on widening of indication for lumbar puncture and NS tests in patients with syphilitic anamnesis and neurological manifestations.

[The role of some individual amino acid substitutions in penicillin-binding protein (PBP2) of Neisseria gonorrhoeae in the emergence of resistance to ceftriaxone].

The goal of the study was to identify amino acid replacements in the structure of penicillin-binding protein PBP2, which may influence on the development of resistance N. gonorhoeae to the III cephalosporins generation. The gene penA of 50 strains of N. gonorrhoeae was sequenced: 20 strains with high sensitivity to ceftriaxone (MIC, Minimum Inhibitory Concentration, = 0.002 mg/L) and 30 strains with decreased sensitivity to ceftriaxone (MIC = 0.03-0.25 mg/L). The difference of MIC sensitivity between these strains was 30-250 times. Then nucleotide sequence was transformed into the amino acid sequence of PBP2 protein. Mutations in the gene penA and amino acid replacements in the protein PBP2 were found in 16 of 20 strains (80%) with high sensitivity to ceftriaxone and in all strains with decreased sensitivity to ceftriaxone. Amino acid replacements in the PBP2 protein were compared with amino acid replacements in groups, which characterize the PBP2 structure in accordance with the international classification Ito M. The amino acid replacement of PBP2 at positions 346, 505, 511, 517, 543, 567, 575, 576 are associated with V group by Ito M and have features of resistance of N. gonorrhoeae to ceftriaxone authentically (OR = 3.9 ± 2.5; χ2 = 4.9; p < 0.05). It was shown that the replacement of glycine to serine at position 543 of PBP2 in the analyzed strains induced the multiple increase of resistance to ceftriaxone. These data may be significant as showing strong influence of amino acid replacements at positions 346, 505, 511, 517, 567, 575 and, in particular, 543 for development of resistance N. gonorrhoeae strains to ceftriaxone.

The Russian gonococcal antimicrobial susceptibility programme (RU-GASP)--national resistance prevalence in 2007 and 2008, and trends during 2005-2008.

Antimicrobial resistance (AMR) in Neisseria gonorrhoeae is a major problem worldwide. In the former Soviet countries including Russia, the knowledge regarding AMR has been highly limited. However, in 2004 the Russian gonococcal antimicrobial susceptibility programme (RU-GASP) was initiated. The aims of this study were to examine and describe the prevalence of N. gonorrhoeae AMR in 2007 and 2008 in Russia, and reveal trends in the period from 2005 to 2008. Gonococcal isolates (660 in 2007 and 900 in 2008) from 36 surveillance sites were examined using agar dilution method. From 2005 to 2008, the proportion of isolates resistant to spectinomycin increased from 0% to 7.2%, and remained high for those resistant to ciprofloxacin (approximately 49%). The resistance to azithromycin was 2.3% and 0.4% in 2007 and 2008, respectively. All isolates between 2005 and 2008 were susceptible to ceftriaxone. In conclusion, the AMR of N. gonorrhoeae in Russia is high, as in most countries in the European Union, and ceftriaxone should be the first line for treatment. If there is no access to ceftriaxone or in the presence of severe beta-lactam antimicrobial allergy, spectinomycin should be used; however, the resistance to spectinomycin has increased. Regular, quality-assured national and international surveillance of AMR in N. gonorrhoeae is crucial globally for public health.

Guidelines for the laboratory diagnosis of trichomoniasis in East European countries.

The laboratory diagnosis of sexually transmitted infections in many Eastern European countries remains suboptimal. The main objective of the present evidence-based guidelines is to provide comprehensive information regarding the laboratory diagnosis of infections caused by Trichomonas vaginalis in East European countries. In particular, the present guidelines recommend: (i) to encourage examination of the wet mounts of vaginal exudates, instead of stained smears, at all clinical settings; (ii) nucleic acid amplification tests (NAATs) or culture could be employed if no trichomonads are detected on microscopic examination of the wet preparation and there is a strong indication of infection and (iii) the use of NAATs is encouraged in screening, using non-invasive specimens, or high volume testing situations. In the absence of internationally recognized commercial NAAT systems, tests developed in-house should be validated using obtainable international standards and quality assured strictly. Individual East European countries may be required to make minor national adjustments to these guidelines as a result of lack of accessibility to some reagents or equipment, or laws in a specific country.

Guidelines for the laboratory diagnosis of Chlamydia trachomatis infections in East European countries.

The present guidelines aim to provide comprehensive information regarding the laboratory diagnosis of infections caused by Chlamydia trachomatis in East European countries. These recommendations contain important information for laboratory staff working with sexually transmitted infections (STIs) and/or STI-related issues. Individual East European countries may be required to make minor national adjustments to these guidelines as a result of lack of accessibility to some reagents or equipment, or laws in a specific country.

Guidelines for the laboratory diagnosis of syphilis in East European countries.

The present guidelines aim to provide comprehensive and precise information regarding the laboratory diagnosis of the sexually transmitted infection (STI) syphilis in East European countries. These recommendations contain important information for laboratory staff working with STIs and/or STI-related issues. Individual East European countries may be required to make minor national adjustments to these guidelines as a result of lack of accessibility to some reagents or equipment, or laws in a specific country.

[Comparative study of immunochromatographic sets for rapid diagnosis of syphilis].

The paper presents the results of the comparative study of 9 commercial kits made in foreign countries for the rapid diagnosis of syphilis, performed at the Central Research Institute of Dermatovenereological Infections, Russian Agency for Health Care, within the framework of the International Sexual Transmitted Diseases Diagnostic Initiative Program under the aegis of the World Health Organization during 2002-2005. The above diagnostic kits were assessed in the context of the availability of and statement simplicity in the instruction for use; the technological complexity in performing a study procedure and the simplicity in interpreting the findings; the necessity of employing additional laboratory equipment. The parameters of the clinical efficiency (sensitivity and specificity) were studied; a passive sensitized red blood cell agglutination test was used as a reference method. The comprehensive study showed that the "Determine Syphilis TP test system ("Abbot Lab", USA) yielded the best results with a total of 10 scores at 100% sensitivity and 100% sensitivity) while the "Bioline Syphilis anti-TP Test Card" ("Pacific Biotech Co.", Thailand) provided a total of 9 scores at 96% sensitivity and 98% specificity.

National surveillance of antimicrobial susceptibility in Neisseria gonorrhoeae in 2005-2006 and recommendations of first-line antimicrobial drugs for gonorrhoea treatment in Russia.

OBJECTIVES: To investigate comprehensively the antimicrobial susceptibility and resistance of Neisseria gonorrhoeae during 2005-2006 in a national survey and to recommend effective antimicrobial drugs for the treatment of gonorrhoea in Russia. METHODS: The susceptibility of N gonorrhoeae isolates, cultured mainly from consecutive gonorrhoea patients (n = 1030) during the period January 2005 to December 2006 in Russia, to penicillin G, ceftriaxone, ciprofloxacin, tetracycline and spectinomycin was analysed using the agar dilution method. Nitrocefin discs were used for beta-lactamase detection. RESULTS: All isolates were susceptible to ceftriaxone. During 2005 and 2006, however, 5%, 50%, 70% and 77% displayed intermediate susceptibility or resistance to spectinomycin, ciprofloxacin, tetracycline and penicillin G, respectively. Furthermore, 4% of the isolates were beta-lactamase producing during these years. The different federal districts of Russia displayed substantial heterogeneities with regard to the prevalence of gonorrhoea and antimicrobial resistance among N gonorrhoeae isolates. CONCLUSIONS: In Russia, penicillins, ciprofloxacin, or tetracycline should definitively not be used in the empirical treatment of gonorrhoea. The recommended first-line antimicrobial drug should be ceftriaxone. If ceftriaxone is not available, spectinomycin ought to be used. Increasing levels of intermediate susceptibility and resistance to spectinomycin have, however, been observed during recent years and, accordingly, great care and monitoring should be undertaken when using this agent. Continuous local, national and international surveillance of N gonorrhoeae antimicrobial susceptibility, in order to reveal the emergence of new resistance, to monitor changing patterns of susceptibility and to be able to update treatment recommendations on a regular basis, is crucial.

[Results of study of the diagnostic efficiency of the new linear enzyme immunoassay test system "INNO-Lia Syphilis Score"].

A comparative study of 224 serum samples certified in different serological tests for syphilis has established the high diagnostic effectiveness of the new linear enzyme immunoassay test system (immune blotting assay "Improved INNO-Lia Syphilis ("IMMO-Lia Syphilis Score")) (Immunogenetics, Gent, Belgium). The assay showed a 100% sensitivity and 98% specificity; the reproducibility of positive and negative results was 100%. It is proposed to use the test system in the laboratories engaged in the expert diagnosis of syphilis as an additional or alternative Treponema pallidum immobilization test and immunofluorescence test supporting the assay of serum or plasma samples for this infection, which has yielded positive results on screening.

Persistence of spectral variations in DGD statistics.

We observe distinct variations between the DGD temporal statistics for different channels in a field installed system. This phenomenon is confirmed with statistical analysis, using a model in which DGD dynamics are due only to a finite number of active points along the link.

[The significance of interval characteristics of the quantitative indices of serologic reactions to syphilis in differentiating positive results]. / Znachenie kharakteristik intervalov kolichestvennykh pokazatelei serologicheskikh reaktsii na sifilis pri differentsiatsii polozhitel'nykh reaktsii.

Statistical processing, carried out by the characteristic intervals method, of the results of serologic tests for syphilis in 48 patients with latent syphilis and in 191 patients with false-positive serologic tests has revealed specific and relatively specific intervals of the titers of anti-Treponema antibodies, precipitines and reagines; these intervals make possible a tentative differential diagnosis before specific tests or in cases when these tests cannot be carried out.

Broadband LiTaO(3) guided-wave TE-TM mode converter.

A guided-wave TE to TM mode converter was demonstrated in LiTaO (3). The input mode is Bragg scattered from a collinear electrooptically induced wave of off-diagonal polarizability which couples the TE and TM modes. Compared with LiNbO(3), LiTaO(3) provides a smaller birefringence and thus a larger phase match period and larger optical bandwidth. A novel electrode structure allowed a four-phase drive of the polarizability wave with only two applied voltages. TE-TM mode conversion efficiency of 95% was demonstrated with a 103-A optical bandwidth. Operation as a frequency shifter was confined to low conversion efficiencies due to fringing fields.

Internal rotation of the birefringence axes in polarization-holding fibers.

An internal rotation of the birefringence axes has been measured in a variety of polarization-holding fibers. The rotation of the axes causes coupling of the major-field components of the fundamental modes, which limits the polarization-extinction ratio in short lengths of birefringent fibers to -45 dB in some cases. A practical consequence of the rotation of the axes is a reduction of the polarization-holding ability of devices such as fiber couplers that are made with these fibers.