[The diagnostic value of antibodies to annexin and B2-glycoprotein for verification of active course of herpesviral infections of pregnant women].

The article deals with results of analysis of hemostasiological and immunological alterations under reactivation of herpesviral infections during pregnancy. The formation of pathological thrombinemia, activation of intra-vascular blood clotting, increasing of factors resulted in damage of endothelium under active course of herpesviral infection and increasing risk of development of obstetric pathology are demonstrated. The antibodies to B2-glycoprotein class IgM and antibodies to annexin class IgM, IgG can be operated as diagnostic signs of activation of herpesviral infection during pregnancy.

[Clinical effects of packed red blood cells transfusion according to storage life and time of transfusion].

It was studied 66 males aged 39.5±5.3 years with hemorrhagic shock II degree. Gas composition of arterial and venous blood was studied twice (before and after transfusion). It was revealed that succinct transfusion of packed red blood cells (to 2 doses) with storage life to 3 days after bleeding stop and hypovolemia filling is the most effective correction of hemorrhagic shock II degree. Replacement therapy in operating room in condition of stopped bleeding and unrepaired hypovolemia is burdening factor because it does not conducive to transfer of oxygen at the tissue level and inhibits stimulation of bone marrow in response to hypoxia.

[The system of quality management in medical laboratory: the problematic issues of implementation of GOST RKS 9001-2008, GOST R ISO 15189-2009 and GOST R ISO 53079-2008].

The article presents the approaches to development and implementation of system of quality management in laboratory as an integral part of the given system in whole medical institution. The costs of works execution concerning quality support are to be weighted with economic profitability and timeliness of medical care provision to ill people considering pre-analytic stage (out-laboratory and in-laboratory) laboratory analysis. Factually it is a matter of development of system of balanced indicators concerning quality management of institution and laboratory functioning. The problematic issues are presented concerning maintenance of particular requirements of GOSTR ISO 15189 about quality of production. The emphasis is made on the necessity of training of administrations of laboratories in the field of quality management and economics of laboratory business.

[Fecal calprotectin in complex diagnostics of intestinal diseases].

The review of evidential base is presented in article about a place of a noninvasive laboratory method--dough on Calprotectin in complex diagnostics of diseases of intestines.

[Western blot as a confirming test in the laboratory diagnosis of syphilis].

Two hundred and ninety-five patients who had been found to have Treponema pallidum antibodies detected by enzyme immunoassay were additionally studied by a Western blot test to confirm their presence. Every four cases were ascertained to be false-positive, false seropositivity being more frequent in the presence of IgM antibody against T. palladium. Spinal fluid analysis provided evidence for the course of neurosyphilis in 5 cases. The diagnosis of congenital syphilis was verified in 2 children who had p15, p17, p45, and 47. The findings demonstrate it necessary to extensively use a Western blot in the health care system.

[Phagocyte activity and the interferon system in patients with different types of multiple sclerosis].

Phagocyte activity and the interferon system was studied in 40 patients with multiple sclerosis (MS), including 22 patients with remitting MS type, 7 patients with primary progressive MS and 11 patients with secondary progressive MS. A control group included 15 healthy people. Changes in the parameters studied were found in all groups of patients. The most marked changes in the phagocyte section of immunity and in the interferon system were seen in patients with primary progressive and secondary progressive MS. The data obtained may be used in diagnosis and choice of treatment in MS patients.

[Verotoxin as a major laboratory criterion for Escherichia coli O157-induced enteric infection complicated by hemolytic uremic syndrome in infants in the Omsk region].

The paper presents the results of etiological interpretation of the outbreak of Escherichia coli O157-induced enteric infection complicated by hemolytic uremic syndrome in Omsk in spring 2009. Seventeen infants aged 5 months to 2.5 years were examined; of them 9 patients were on hemodialysis. The diagnosis was verified in 7 children, by isolating verotoxin after fecal enrichment on the concentrating nutrient RIDA Enrichment Bouillon medium containing bile salts and mitomycin C, E. coli O157:H7 cultures on the sorbitol medium and/or by identifying E. coli O157 DNA. Six (4 having verotoxin) infants were found to have rotavirus and noro-virus antigens or DNA/RNA, which may make a contribution into the development of mixed infection and increase the risk of complications.

[Problems in organization of work at laboratories and metrological provision for an analytical process].

In the organization of a present-day laboratory, there are 8 fundamental elements that provide its activity and are integrated into the uniform system: safety; the correct organization of work; the range of studies; a current material-and-technical basis; the metrological provision of diagnostic and analytical processes; manpower; and adequate sanitary-and-hygienic and antiepidemic measures. The problems of the laboratory's activity are outlined in the light of implementation of Federal Law on the Uniformity of Measurements under No. 102 - dated June 26, 2008, and ways of their solution are proposed.

[Cytomegalovirus infection in Omsk region].

Epidemiologic studies of prevalence of cytomegalovirus infection (CMVI) in Omsk region during a period of 15 years showed 1.6-fold increase of population seropositivity to CMV with rate of increase +2.94. In recent years antibodies to CMV were detected in 90.3 - 94.8% of cases. Diagnostics of innate and acquired CMVI was improved. Feasibility of detection of infectious process activity during complex use of new laboratory methods (IgA detection, assessment of IgG avidity, IgG to individual antigens in immunoblotting as well as detection of DNA and "early phase" viral ptoteins) was demonstrated. High rates of infection in population determine the necessity of revision of strategy for examination of children and adults, including screening of pregnant woman, on this infection.

[Epidemiological and clinicoimmunological monitoring of toxoplasmosis in the Omsk Region].

The toxoplasmosis epidemiological surveillance system is being improved in the Omsk Region. The prevalence of toxoplasmosis has been analyzed among 31475 inhabitants from the Omsk Region over 15 years (from 1992 to 2006). There was a 1.7-2.5-fold increase in the rates of infection in the normal and abnormal pregnancy women. IgM was detected in 7% of the adult patients with suspected toxoplasmosis, 5.2% of the physiological pregnancy women, and 2.2 times more frequently (p < 0.01) in the pregnant women with threatening interruption. The study of avidity showed that in pregnant females, primary infection occurred in 4.2% of cases; the signs of subacute toxoplasmosis were noted in 6.09%. The IgA detection rate was 33%. IgM was found in 7.2% of children, 7.8% having low-avidity antibodies. Subacute toxoplasmosis was established in 10.4% of the patients with central nervous system and eye lesions or hepatitis. In 38.1% of cases, toxoplasmosis was concurrent with active cytomegalovirus infection. The authors show it expedient to determine IgA and its avidity and to detect Toxoplasma antigens, as well as antibodies to different Toxoplasma antigens.

[Analysis of chromosomal aberrations in the chorionic cells of induced abortions as a method for estimating the level of spontaneous mutagenesis].

Chromosomes were morphologically studied in the chorionic fibroblasts of induced abortions. Chorionic villi biopsy specimens taken during 103 abortions at gestational weeks 6-12 served as a material for this investigation. They were taken from women with pregnancies interrupted due to that there were social indications. Metaphase and prometaphase chromosomal specimens were obtained by the test modified by V. Baranov 4-5 hours after chorionic villi biopsy, without preliminarily tissue cultivation. A cytogenetic analysis revealed an abnormal karyotype in 2.91%. The frequency of chromosomal aberrations may serve as a control for prospective studies of spontaneous mutagenesis in a region and the chorion of induced abortion may be regarded as a test unit of mutagenic and embryotoxic effects on the fetus.

[Epidemiological aspects of cytomegalovirus infection in babies aged under one]. / Epidemiologicheskie aspekty tsitomegalovirusnoi infektsii u detei pervogo goda zhizni.

Sreening data obtained on babies aged under one and selected by random (1,910 children) or target (2,658 children) choice for cytomegalovirus (CMV) infection during the period of 10 years (1992-2001) were compared with mortality rate. The methods used were enzyme immunoassay, immunofluorescence and polymerase chain reaction. The babies were divided as follows: newborn infants (group I), babies aged 1-3 months (group II), 4-6 months (group III) and 7-12 months (group IV). Specific clinical features of CMV infection in newborn infants were studied on 69 cases (37--with CMV monoinfection and 32--with mixed infection). The serological screening revealed a 2.1-fold growth of the infection rate among randomly selected newborn infants during the 10 year period. Positive correlation between the infection rate among children of this age group and the neonatal mortality rate was established. High risk factors of CMV infection were revealed as well as increased infection rate and frequency of clinical cases with the prevailing neurological pathology in group III. Early diagnosis, the exclusion of mixed infections and early adequate therapy were shown to play a decisive role in the outcome of the disease. The algorithm of epidemiological surveillance and the regional program of prophylaxis were worked out.

[Cytomegalovirus infection in melanoma patients]. / Tsitomegalovirusnaia infektsiia u bol'nykh melanomoi.

The occurrence of active cytomegalovirus (CMV) infection in 30 patients with skin melanoma, aged 18-76 years, was studied with the enzyme immunoassay, the direct immunofluorescence test and the polymerase chain reaction. The patients were divided into two groups: group I consisted of 20 patients examined in a month after radical surgical treatment, group II consisted of 10 patients at the stage of the process generalization. For comparison, group III was formed consisting of 89 patients with diagnosed secondary immunodeficiency and clinical manifestations of CMV infection. The control group included 80 donors. The study showed that in group II the occurrence of active CMV infection was 4 times higher than in group I and practically coincided with the results registered in group III. In the evaluation of the immune status of the members of group II the most profound changes were revealed in T-cell mediated immunity and in phagocytic immunity; the adequate production of tumor necrosis factor alpha and interleukin 1beta was absent, which created prerequisites for the activation of CMV and the aggravation of the prognosis.

[Dynamics of expression of cytokines and lactoferrin in patients with chronic alcohol pancreatitis and chronic relapsing pancreatitis]. / Dinamika ékspressii tsitokinov i laktoferrina u patsientov s khronicheskim alkogol'nym i khronicheskim retsidiviruiushchim pankreatitami.

The purpose of the research was to estimate the dynamics of production of different cytokines in patients with chronic pancreatitis, depending on the etiologic factor and severity of the disease. Under our supervision there were 112 patients with chronic pancreatitis: 32 patients with alcoholic pancreatitis and 80 patients with chronic relapsing pancreatitis. The dynamics of changes of cytokines parameters was various at chronic pancreatitis, depending on the etiologic factor as well as on the severity of the disease. Our results have allowed revealing significant amplification of production of TNF and have shown that it can be a reliable marker of the severity of aggravation irrespective of the etiologic factor of the disease and can also serve as a prognostic factor.

[Diagnosis of parvovirus B19 infection in patients with secondary immunodeficiency diseases]. / Laboratornaia immunodiagnostika infektsii, vyzvannoi parvovirusom B19, u bol'nykh vtorichnymi immunodefitsitami.

The method of immune-enzyme assay was used to examine 113 patients with secondary immunodeficiency, including 16 HIV-infected drug-addicts (group 1), 36 patients with cytomegalovirus infection (CMVI) and with immunoregating index CD4/CD8 below 1.0 (group 2), 30 patients with CMVI and with CD4/CD8 below 1.2 (group 3) and 31 patients with aplastic anemia and with anemia of unclear genesis (group 4), for parvovirus infection caused by parvovirus B19. As for groups 1 and 4, the antibodies were detected in 50 and 48.4% of cases; it is noteworthy that an active parvovirus infection was registered in the above groups more often than in groups 2 and 3. There were patients with the antibodies in group 2 by 1.8 times more than in group 3. It is suggested that the simultaneous impact of HIV, CMV and parvoviruses significantly aggravates the immunodeficiency and contributes to a more severe clinical course.

[Laboratory diagnosis of cytomegaloviral infection in patients with anemia and hemoblastosis in the Omsk region]. / Laboratornaia diagnostika tsitomegalovirusnoi infektsii u bol'nykh s anemiiami i gemoblastozami v Omskoi oblasti.

Research was carried out in 335 blood specimens of patients in the age of 3-35 y.o. in order to optimize diagnosis and treatment of such patients with aplastic anemia and hemoblastosis who got hemotransfunction to eliminate cytomegaloviral infection (CMVI). IgM were found out in 37.9% cases (2.8 times higher than in donors), low-avide IgG--in 44.8%. "early" proteins CMV--29.9% and DNA--in 36.8% cases. Concerning the DNA presence, preference was given to research of leucocytic suspension compared with blood serum. Of 28 children of 3-13 y.o. with anemia being seropositive in CMV, IgG antibodies were detected in 13 children while IgM antibodies to Parvovirus B19 were found in 10 children. 7 children with a grave form of disease showed combined infection of Parvovirus B19 and CMV with activation signs. It is not excluded that parallel influence of Parvovirus B19 on erythrocytic hemopoiesis growth and that of CMV on lymphocytic-monocytis cells aggravates immunodeficiency and promotes development of infection complications.

[Laboratory diagnostics of infections caused by cytomegalovirus and parvovirus B19 in patients with secondary immunodeficiency]. / Laboratornaia diagnostika infektsii, vyzvannykh tsitomegalovirusom i parvovirusom B19, u bol'nykh s vtorichnymi immunodefitsitami.

To improve the quality of diagnostics and treatment of patients with immunodeficient states, two groups of patients were examined for the presence of cytomegalovirus (CMV) infection, among them 1,348--with clinical manifestations of CMV infection (group 1) and 335 hematological patients (group 2); in addition, 36 patients with secondary immunodeficiency and 31 patients with aplastic and hemolytic anemia, or with anemia of unclear origin were examined for the presence of parvovirusinfection (B19). The results of enzyme immunoassay, polymerase chain reaction and immunofluorescence tests active CMV infection, confirmed by determination of IgM, low avidity IgG, antigen and DNAemia, was registered in group 2 more often than in group 1. Examinations on the presence of parvovirus infection revealed that in anemia patients with the low level of IgG or its absence IgM was also detected more often than in group 1. In mixed infection caused by CMV and parvovirus B19 the disease took a more severe course than in monoinfection, which was probably due to the parallel action exerted by parvovirus on erythrocyte production in hematopoiesis and by CMV on the monocytic and macrophagal row of cell.