Point of care HbA1c level for diabetes mellitus management and its accuracy among tuberculosis patients: a study in four countries.

BACKGROUND: Diabetes mellitus (DM) is common among tuberculosis (TB) patients and often undiagnosed or poorly controlled. We compared point of care (POC) with laboratory glycated haemoglobin (HbA1c) testing among newly diagnosed TB patients to assess POC test accuracy, safety and acceptability in settings in which immediate access to DM services may be difficult. METHODS: We measured POC and accredited laboratory HbA1c (using high-performance liquid chromatography) in 1942 TB patients aged 18 years recruited from Peru, Romania, Indonesia and South Africa. We calculated overall agreement and individual variation (mean ± 2 standard deviations) stratified by country, age, sex, body mass index (BMI), HbA1c level and comorbidities (anaemia, human immunodeficiency virus [HIV]). We used an error grid approach to identify disagreement that could raise significant concerns. RESULTS: Overall mean POC HbA1c values were modestly higher than laboratory HbA1c levels by 0.1% units (95%CI 0.1-0.2); however, there was a substantial discrepancy for those with severe anaemia (1.1% HbA1c, 95%CI 0.7-1.5). For 89.6% of 1942 patients, both values indicated the same DM status (no DM, HbA1c <6.5%) or had acceptable deviation (relative difference <6%). Individual agreement was variable, with POC values up to 1.8% units higher or 1.6% lower. For a minority, use of POC HbA1c alone could result in error leading to potential overtreatment (n = 40, 2.1%) or undertreatment (n = 1, 0.1%). The remainder had moderate disagreement, which was less likely to influence clinical decisions. CONCLUSION: POC HbA1c is pragmatic and sufficiently accurate to screen for hyperglycaemia and DM risk among TB patients.

Are there optimal alanine aminotransferase and HBV DNA thresholds for discriminating HBeAg-positive chronic infection from chronic hepatitis? An evaluation of 215 young and male cases.

OBJECTIVES: To define the importance of biochemical and virological thresholds for the prediction of significant liver diseases. METHODS: A total of 215 young and male HBeAg-positive cases followed up in a tertiary training and research hospital in Turkey between 2008 and 2017 enrolled in the retrospective diagnostic accuracy study. Results: Fibrosis scores varied between 0-4, F1 (n=81, 37.6%) and F2 (n=82, 38.1%) were the most frequent fibrosis stages. Of the patients, 58.6% (126/215) had a significant histopathological abnormality (SHA). The ratio of SHA was higher for ALT greater than 90 U/L (n=68/95; 71.6%) and HBV-DNA between 2,000,000-200,000,000 IU/mL (n=47/73; 64.4%). Thresholds for the higher odds ratio (OR) for SHA were greater than 90 U/L for alanine aminotransferase (ALT) and greater than 2,000,000 IU/mL for HBV-DNA. Based on receiver operating characteristic analysis, 90.5 U/L of ALT and 22,607,500 IU/mL of HBV-DNA were levels with the optimum sensitivity and specificity for the prediction of SHA. CONCLUSION: Hepatitis B virus-DNA levels between 106 and 108 IU/mL and ALT levels of 2~3 x ULN might be considered to be good indicators for discriminating chronic hepatitis phase from chronic infection in  hepatitis B e-antigen-positive chronic hepatitis. However, we think that the current biochemical, serological and molecular markers are inadequate for differentiating chronic hepatitis phase than chronic infection, and non-invasive test and/or liver histopathology should be carried out in selected cases.

Morphological study of burn wound healing with the use of collagen-chitosan wound dressing.

Experiments on the model of thermal skin burn in rats showed that the use of wound dressing based on collagen-chitosan complex Kollakhit-Bol in local treatment of grade IIIb skin burns increased healing rate by accelerating the formation of granulation and fibrous connective tissues and reducing crust thickness in comparison with Kollakhit coating. Kollakhit-Bol provided targeted stimulation of reparative processes in the treatment of grade IIIb burns by creating favorable conditions for grafting full thickness skin transplant or dermal-epidermal skin equivalent. In the topical treatment of thermal burn, Kollakhit-Bol application shortened the phases of alteration and exudation and accelerated transition to the productive phase of the inflammatory process with phagocytosis and neoangiogenesis activation.

VEGF-A and VEGF-B mRNA expression in gastro-oesophagela cancers

INTRODUCTION: Angiogenesis is essential for the local growth, invasion and metastasis of the tumours. Vascular endothelial growth factors (VEGFs) play a crucial role in tumour angiogenesis. The aim of our study was to quantify the expression of several VEGF family molecules in human gastro-oesophageal cancers and to analyse possible correlations between genes expression and clinico-pathological features. MATERIALS AND METHODS: Gene expression was quantified in 43 gastro-oesophageal paired samples using qRT-PCR with TaqMan probes specific to VEGF-A, including soluble transcript variants and VEGF-B genes. RESULTS: VEGF-A, including the studied splice variants and VEGF-B mRNAs were expressed in both tumour and peritumour mucosa. The expression of VEGF-A and its isoforms was higher in tumour compared with paired peritumour mucosa, while no significant difference was observed in VEGF-B expression. VEGF-A expression tended to correlate with tumour invasion. CONCLUSION: VEGF-A has a tendency to over-express in gastro-oesophageal cancers, while VEGF-B does not seem involved in these tumours. Further studies are required to establish the utility of anti-VEGF-A therapy and to find biomarkers for pathogenesis or response to therapy in gastro-oesophageal tumours (AU)

[Morphological characteristics of cell populations in bronchial biopsy from mining-chemical factory workers]. / Morfologicheskie osobennosti kletochnykh populiatsii bronkhobioptatov u rabotnikov gornokhimicheskogo predpriiatiia.

A clinicomorphological examination of bronchial and transbronchial biopsies from the workers of a mining and chemical enterprise in Zheleznogorsk has demonstrated that long-term exposure to low-dose radionuclide radiation induces essential inflammatory and scleroticatrophic changes in the bronchopulmonary tissue. All the cell populations of the bronchial epithelium and stroma as well as a respiratory part of the lungs are involved into the pathological process. Squamous metaplasia of the bronchial epithelium is observed in 50% cases, in half of them various dysplastic processes occur. The complex of the above morphological alterations evidences for an oncological trend in pathological processes in the lungs of workers exposed to radionuclides.

Pathomorphological peculiarities of microcirculatory bed in bronchial wall in workers employed in mining and chemical industry.

Morphological alterations of microvessels in bronchial mucosa and blood capillaries of alveolar septa during endobronchitis were examined in workers employed at a plutonium plant and not employed residents (Zheleznogorsk, Krasnoyarsk Region). Alterative, destructive, and dysadaptive changes in pulmonary vessels of workers were paralleled by developing reparative and adaptive processes in neighboring capillaries.

[Concentration of heavy elements and their compounds in the cells from BALF and pulmonary tumors in radiation-exposed subjects]. / Soderzhanie tiazhelykh élementov i ikh soedinenii v kletkakh bronkhoaal'veoliarnykh smyvov i v tkaniakh opukholei legkikh u lits, podvergavshikhsia radiatsionnomu vozdeistviiu.

AIM: Measurement of heavy elements in alveolar macrophages (AM) of bronchoalveolar lavage (BAL) and pulmonary tumor tissue (PTT); investigation of spacial distribution of the heavy particles in the tissues. MATERIALS AND METHODS: Laser mass-spectrometry estimated quantitative and qualitative characteristics of heavy elements (Mn, Fe, Co, Cu, Zr, etc.) in diagnostic and therapeutic BAL of 6 patients exposed to radiation after the Chernobyl accident and in pulmonary tumor tissue of patients operated for central small-cell and peripheral bronchoalveolar cancer who also had been exposed to radiation after the Chernobyl. RESULTS: Heavy elements concentration in the secondary BAL was less than in the primary one. This shows effectiveness of the procedures aimed at removal of heavy particles from the respiratory organs. Heavy elements content was quite different in two histologically different tumors. CONCLUSION: Laser mass-spectrometry proved its usefulness in simultaneous study of the quantity and quality of heavy elements in AM of BAL and tumors in radiation-exposed subjects, in investigation of the elements distribution in the pulmonary tissues and changes of elements composition in the tissues in the course of tumors development.

[Morphologic and molecular-genetic characterization of lung cancer developing in people who have worked at nuclear facilities and who have lived in Russian territories polluted after the accident at the Chernobyl power plant]. / Morfologicheskie i molekuliarno-geneticheskie osobennosti raka legkogo, razvivshegosia u lits, rabotavshikh na radiatsionnykh proizvodstvakh i prozhivavshikh na zagriaznennykh posle avarii na Chernobyl'skoi AES territoriiakh Rossii.

Clinicomorphological analysis of 15 lung carcinomas of patients who had been exposed for a long time to the radiation after the Chernobyl accident was performed. The material consisted of 10 surgical and 5 autopsy cases and was studied at the light, electron microscopic and immunohistochemical level. There were 6 peripheral, 8 central carcinomas and one massive tumor. Fibrous areas with many dust particles were found in peripheral carcinomas. In central tumors chronic obstructive bronchitis with epithelial dysplasia and metaplasia was observed. Carcinoma was represented by various histologic types: small cell (4 cases), combined small cell with squamous differentiation (5 cases), adenocarcinoma (5 cases), adenosquamous type (1 case). Peculiar calcium deposits in both stroma and parenchyma were found in tumors with glandular differentiation. Morphogenesis of calcium microdeposits may be connected with dust radioactive particles elimination. Central carcinoma had, in the majority of cases, a neuroendocrine differentiation and can be related to some types of small cell carcinoma. Peripheral cancer was mostly of a glandular differentiation and was, as a rule, carcinoma in the scar. Lung carcinomas studied had peculiar molecular-genetic features: lack or low bcl-2 expression, low Ki-67 expression and a high degree of c-myc expression. Tumors were characterized by a low apoptosis index independently of a histologic type. Apoptosis was not complete: lack of apoptotic bodies phagocytosis this resulting in postapoptotic detritus formation.

Sarcoma developing in a burn scar: case report and review of the literature.

The development of malignancy in burn scars is a well known entity. However, burn scar sarcomas are rarely seen. This report presents the first case of a leiomyosarcoma arising in a burn scar of scalp in the English literature.

[The morphofunctional characteristics of the cecum in experimental influenza]. / Morfofunktsional'naia kharakteristika slepoi kishki pri éksperimental'nom grippe.

On the model of experimental influenza using morphological, immunomorphological, cytochemical, electron microscopy and morphometric methods, the authors provided morphofunctional characteristics of the caecum, showed the progression of infectious process and confirmed the dissemination of the virus, availability of virus particles in different cell populations, among them in lymphoid cells.

[The morphofunctional characteristics of the cecum in experimental escherichiosis]. / Morfofunktsional'naia kharakteristika slepoi kishki pri éksperimental'nom ésherikhioze.

Using the model of experimental escherichiosis in mice by means of morphological, immunomorphological, morphometrical and electron microscopy methods, the authors give morphofunctional characteristics of caecum 15 minutes to 2 weeks after inoculation. The authors show the dynamics of infectious process, characterized by changes of microcirculation, increasing lymphoplasmocellular infiltration, dystrophic changes in cells of neuroplexes and degranulation of mast and endocrine cells. The data obtained show that pathological process in caecum during experimental escherichiosis has an immune character, that the above portion of the intestine is a part of endocrine system.

[The ultrastructural characteristics of the endocrine cells of the normal murine cecum and in experimental escherichiosis]. / Ul'trastrukturnaia kharakteristika éndokrinnykh kletok slepoi kishki myshei v norme i pri éksperimental'nom ésherikhioze.

Ultrastructural investigations and a quantitative analysis of caecum endocrine cells were performed in the period from 15 minutes to 2 weeks after inoculation, using the model of experimental escherichiosis. The authors identified 5 types of endocrinocytes in the caecum of mice and showed the reaction of these cells: degranulation, extrusion of granules and their accumulation dependent on the time of the exposure.

[Submicroscopic features of cecal cells in experimental Escherichia infection]. / Submikroskopicheskie osobennosti kletok slepoi kishki pri éksperimental'nom ésherikhioze.

Ultrastructural changes of the caecum cells were studied for the period from 15 minutes to 2 weeks after inoculation using the model of experimental escherichiosis. Evolution processes in relation to different caecum cell populations were followed up submicroscopically. Ultrastructural changes observed evidence derangement of protein and water-salt cell metabolism, immune trends of experimental escherichiosis.

[The morphological characteristics of the cecum and its lymphoid tissue in BALB/C mice]. / Morfologicheskaia kharakteristika slepoi kishki i ee limfoidnoi tkani u myshei BALB/C.

The caecum has been studied at the light optic and electron microscopical levels. Amount of immune-competent cells and lymphoid nodules in the distal part of the mice caecum and in the human appendix vermiformis are essentially similar. It is possible to consider the distal (blindly closed) part of the caecum in the mice of the BALB/C line as a morphofunctional equivalent to the human appendix vermiformis and use it as an experimental model in studying diseases of the appendix.

[The immunomorphological characteristics of the appendix in a viral-bacterial lesion in children with appendicitis]. / Immunomorfologicheskaia kharakteristika cherveobraznogo otrostka pri virusno-bakterial'nom ego porazhenii u detei s appenditsitom.

The characteristics of viral-bacterial lesion in the appendix of children with appendicitis are given by means of histologic, histochemical, immunomorphological and morphometric methods. Antigens of influenza viruses A, B, C, entero-, adeno- and paramyxoviruses were observed among which influenza C was found significantly more frequently (64.1%). Viral infection in the majority of cases (79.5%) was found in the association with opportunistic flora, more frequently with E. coli, and less R. aeruginosa and Klebsiella. Analysis of the immunomorphological shifts in the appendix indicated a peculiar dynamics of the antibody production in acute appendicitis: the enhancement of the IgG, IgD and IgE production and the decrease of the production of IgA and IgM. The viral-bacterial effect, the development of the immune responses with IgE hyperproduction and participation in this process of labrocytes and endocrine cells suggest the integration of the two pathogenetic mechanisms-infectious and allergic.