[Magnetic resonance imaging in diagnosis of complications of kidney and ureteral injury in different periods of traumatic disease]. / Magnitno-rezonansnaya tomografiya v diagnostike oslozhnenii povrezhdenii pochek i mochetochnikov v razlichnye periody travmaticheskoi bolezni.

OBJECTIVE: To assess the possibility of magnetic resonance imaging in diagnosis of complications of kidney and ureteral injury in different periods of traumatic disease. MATERIAL AND METHODS: There were 139 patients with kidney and ureteral injuries between 2015 and 2019. We clarified the MR-signs of renal complications in different periods of traumatic disease. RESULTS: We analyzed the effectiveness of MRI in identification of renal complications compared to ultrasound, excretory urography, computed tomography, intraoperative and follow-up data. High diagnostic accuracy of MRI for early and late manifestations of traumatic disease was demonstrated.

[Adverse drug reactions of local anesthetics used in dentistry]. / Nezhelatel'nye reaktsii na mestnye anestetiki pri ikh primenenii v stomatologii.

The aim. Study the adverse drug reactions (ADR) that occur when using local anesthetics (LA) in patients living in the Republic of Crimea and registered during the period 2010-2018. MATERIAL AND METHODS: The objects of the study were 122 notification forms about LA ADR recorded in the regional base (Register) of spontaneous reports called ARCADe (Adverse Reactions in Crimea, Autonomic Database). In most cases, ADR was associated with the use of amide LA Lidocaine - 69 cases (56.55% of the total number of cases for LA ADR), less often, ADR was caused by combinations containing Articaine (34 cases, 27.87%). Rare cases of ADR were reported for Novocaine/Procaine (9 cases, 7.38%), Bupivacaine (8 cases, 6.56%) and Mepivacaine (2 cases, 1.64%). The main clinical manifestations of reactions were hypersensitivity-like reactions (38 cases), cardiac and vascular disorders (29 cases) and central nervous system disorders (19 cases). Lack of effectiveness of LA occurred in 13 cases (10.66%). RESULTS: A study of the outcome of ADR revealed a high incidence of life-threatening conditions associated with LA use - 31 cases (25.4%), which indicates the severity of the event and the need to cancel the suspected drug and prescribe additional medications for correction. The need for hospitalization or prolongation of hospitalization was necessary in 7 cases (5.8%), and temporary disability of patients was revealed in 5 cases (4.1%). Of particular interest are 2 cases (1.6%) of the development of a fatal outcome as a result of the suspected anaphylactic shock (1 case) and disorders of the central nervous system (convulsions, development of respiratory failure). CONCLUSION: The high frequency and severity of unwanted effects resulted from the use of LA requires healthcare professionals to make rational choices and strictly monitor patient safety.

[Magnetic resonance imaging for diagnosis of acute appendicitisin pregnant women in multi-field hospital]. / Vozmozhnosti magnitno-rezonansnoi tomografii v diagnostike ostrogo appenditsita u beremennykh v usloviiakh mnogoprofil'nogo statsionara.

OBJECTIVE: Tooptimize MRI protocol in pregnant women with suspected acute appendicitis. MATERIAL AND METHODS: There were 44pregnant women (gestation period 11 - 36 weeks)with suspected appendicitis. RESULTS: Fat-suppressed T2-weighted and diffusion-weighted imaging (DWI) was the most valuable to diagnose inflammation of appendix and surrounding tissues. Sensitivity, specificity and accuracy were 100, 90 and 97.8%. CONCLUSION: MRI was useful to assess appendix and differentiate appendicitis with biliary and urinary diseases.

[Efficacy of laboratory methods of diagnostic of purulent bacterial meningitis.]

According to the World Health Organization, every year about 1 million cases of purulent bacterial meningitis (PBM) are registered in the world, of which 200 thousand cases end in death. Bacterial meningitis is polyethiologic, which makes the task of determining the pathogen the main in the organization of epidemiological surveillance, treatment regimens, planning of preventive and anti-epidemic measures. The quality of laboratory diagnostics has a key influence on this. The true incidence of meningitis of different etiology can be altered at low-efficiency laboratory diagnostics. This work was carried out to assess the effectiveness of existing laboratory methods for the detection of PBM pathogens: Haemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitidis; as a part of the programme on sentinel surveillance of invasive bacterial diseases (IBD) carried out by the WHO regional office for Europe in a number of countries in Europe (Ukraine, Belarus), Transcaucasia (Azerbaijan, Armenia, Georgia), Asia (Uzbekistan, Kyrgyzstan, Kazakhstan) in the period 2010-2017. 2893 samples of clinical material (CSF and blood) obtained from patients with the meningeal syndrome were studied by four diagnostic methods: cultural method, latex-agglutination test, immunochromatographic test (BinaxNOW), PCR (conventional and real-time), used to identify the following pathogens: Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae. When identifying the causative agents of BM, PCR more effective than culture method is 5 times in detecting N. meningitidis; 3 times in the detection of S. pneumoniae; 4 times the detection of H. influenzae b. Latex-agglutination test and immunochromatographic test allow to increase the identification of pathogens of BM for N. meningitidis - by 35.6%; S. pneumoniae - by 67%; H. influenzae b - by 19.2%, it is possible to set them in the field and at the epidpoint if necessary. When working with clinical material from patients diagnosed with GBM, it is advisable for bacteriological laboratories to complement the culture method of microbiological diagnosis of latex-agglutination test, immunochromatographic test or PCR.

Ultrastructural evidence of the excretory function in the asteroid axial organ (Asteroidea, Echinodermata).

The ultrastructure of the axial organ of Asterias amurensis has been studied The organ is a network of canals of the axial coelom separated by haemocoelic spaces. The axial coelom is lined with two types of monociliary cells: podocytes and musculo-epithelial cells. Podocytes form numerous basal processes adjacent to the basal lamina on the coelomic side. Musculo-epithelial cells form processes running along the basal lamina. Some bundles of these processes wrapped in the basal lamina pass through haemocoelic spaces between neighboring coelomic canals. It is hypothesized that the axial organ serves for filtration of fluid from haemocoelic spaces into the axial coelom cavity, from which urine is excreted through the madreporite to the exterior.

[Way to the peptide vaccine against hepatitis C].

In order to surpass the problem of genetic variability of hepatitis C virus envelope proteins during vaccine development, we used the so-called "reverse vaccinology"approach--"from genome to vaccine". Database of HCV protein sequences was designed, viral genome analysis was performed, and several highly conserved sites were revealed in HCV envelope proteins in the framework of this approach. These sites demonstrated low antigenic activity in full-size proteins and HCV virions: antibodies against these sites were not found in all hepatitis C patients. However, two sites, which contained a wide set of potential T-helper epitope motifs, were revealed among these highly conserved ones. We constructed and prepared by solid-phase peptide synthesis several artificial peptide constructs composed of two linker-connected highly conserved HCV envelope E2 protein sites; one of these sites contained a set of T-helper epitope motifs. Experiments on laboratory animals demonstrated that the developed peptide constructs manifested immunogenicity compared with one of protein molecules and were able to raise antibodies, which specifically bound HCV envelope proteins. We succeeded in obtaining antibodies reactive with HCV from hepatitis C patient plasma upon the immunization with some constructs. An original preparation of a peptide vaccine against hepatitis C is under development on the basis of these peptide constructs.

[Comparative analysis of informative-diagnostic properties of mucosa immune-reactivity parameters].

AIM: Study the features of immune-reactivity expression in mucosa depending on their topicity and etiopathogenesis of the pathological process. MATERIALS AND METHODS: Data from 30 clinically healthy children and 77 children with acute and recurrent diseases of respiratory tract: 51--with acute and 15--with chronic bronchitis; as well as 132 women: 41--with active stage of acute urogenital chlamydia infection, 29--with recurrent chronic process, 30--with non-recurrent form and 32 clinically healthy women were analyzed. Saline and urogenital tract mucosa discharge was analyzed for IgG, sIgA and secretory component, IL-1beta, 4, 6, 8, 9, 10, 12, IFNgamma, TNFalpha and GM-CSF, TLR-2, TLR-3, TLR-4, TLR-8 gene expression levels as well as content of lysozyme, total protein and leucocytes. RESULTS: Solidity, universality and practically single-stage triggering of mucosa immune reaction mechanisms to intervention by foreign agents regardless of their localization was confirmed. A dependence of immune-reactivity expression on the form of pathologic process, its localization and qualitative and quantitative characteristics of the infectious agents was clearly seen. The highest level of clinical-laboratory and immunological parameters is inherent for patients with acute processes in urogenital tract (cervical canal and urethra), especially cause by mixed infections. CONCLUSION: Immune diagnostic parameters of mucosa among which TLR system is especially notable have high information properties allowing not only diagnostics of inflammatory process but also differentiating its form and character our course.

[Cone-beam computed tomography in paleoanthropology].

OBJECTIVE: To study the capabilities of cone-bean computed tomography (CBCT) in estimating the bone structure when analyzing anthropological findings. MATERIAL AND METHODS: Twenty-four bone fragments (remains) of Napoléon Bonaparte Imperial Army soldiers who had died at a Königsberg military hospital during their retreat from Russia in the War of 1812 were examined by CBCT. A total of 28 tubular bones with different injury healing signs and a skull with maxillofacial trauma marks were investigated. Furthermore, an object from D.G. Rokhlin's paleopathological collection was used to analyze a complicated humeral infectious process. CBCT was performed by individually selecting the scanning foldings, physicotechnical conditions and regimens in relation to the anatomic location and size of fragments. RESULTS: Processing of the obtained images reveled fractures of different bones in 19 (65.5%) cases. The signs of ununited fractures were visualized in 20.7% of the samples. Image post-processing showed intraarticular consolidated fractures in 13.8% of the anthropological findings. The CBCT examination of bone fragments exhibited the signs of their fusion. A wound pattern was established in 31% of the samples. The specific features of a bone amputation stump could be characterized in detail in 17.2% of the anthropological findings. 51.7% of the cases were found to have signs of sustained bone inflammatory diseases of various genesis, which in 41.4% of them were presented by linear, bulbar, and assimilated periostal reactions and significantly detectable on CBCT scans. Sequestral cavities were imaged in 31% of the fragments. CONCLUSION: The CBCT images are characterized by high informative value (from 7.5 to 10.6 pixels/mm), optimal spatial resolution, definition, and hardness. The software of CBCT involves the parameters and possible postprocessing of images (building of panoramic and mulplanar reconstructions, assessment of the density characteristics of tissues), which allow an analysis of anthropological material, by needlessly destroying them.

[Pelvic bone radionecrosis as a late consequence of short-distance radiation therapy].

The paper deals with the estimation of the capabilities and role of different radiation techniques in the detection of late postradiation therapy local tissue responses that are evident as radionecrosis. To specify the nature of changes, it is necessary to take into account clinicoanamnestic data, results of laboratory and instrumental studies (standard X-ray study, multislice computed tomography, and magnetic resonance imaging) at any examination stage. A set of the studies can provide the means of significantly analyzing the bone structures and soft tissues and the degree of injury and identifying complications.

[Molecular-genetic and phylogenetic characteristic of Streptococcus pneumoniae strains isolated from patients with meningitis and carriers].

AIM: Analyze genetic and phylogenetic interrelations between S. pneumoniae strains isolated from meningitis patients and carriers. MATERIALS AND METHODS: 23 S. pneumoniae isolates (9 from bacterial meningitis patients, 9 from nasopharynx of bacterial carriers, 5 strains from museum collection of Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology) were studied. S. pneumoniae ATCC 49619, S. mitis ATCC 49456 served as control strains. S. pneumoniae serotype determination was carried out in latex-agglutination reaction and quelling reaction. Multiplex PCR according to WHO protocols was used for molecular-genetic study and pneumolysin (ply), autolysin (lytA), surface cellular adhesin A (psaA) and capsule polysaccharide (cpsA) gene determination. Multilocus sequence-typing was carried out according to WHO scheme for 7 "housekeeping" segments--aroE, gdh, gki, recP, spi, xpt and ddl. Computer programs from available internet resources were used for data processing and dendrogram building. RESULTS; The S. pneumoniae isolates analyzed were established to belong to 19 sequence types that may be combined into 4 subclusters. Results of molecular-genetic and serologic typing were completely comparable. CONCLUSION: Attribution of isolates from the same serotype and serogroup to different sequence-types gives evidence on the ongoing changes within serotype and as a result changes in allele profile of circulating S. pneumoniae isolates. Membership of isolates in separate subclusters gives evidence on close evolution relationship between isolates obtained from patients with bacterial meningitis and carriers. Certain isolates had not previously been registered in Russia and were probably imported from the territories of other countries.

[Comparative characteristics of the ultrasound signs of tissue injuries of the upper extremities in varying degrees of thermal burns].

The results of ultrasound study of upper extremity tissues were comparatively analyzed in 74 patients with varying degrees of thermal burns. All the victims had thermal burns of the shoulder, forearm, and hand of one or both arms; the injured and contralateral normal areas were comparatively analyzed. The analysis of the findings has revealed that thermal burns of the upper extremities show certain ultrasound symptoms of soft tissue injuries that are indicative of the specific features of changes in the postburn period in relation to the degree of the injury - the duration of detection of edemas and fluid along the muscle bundles and tendon sheaths, their immobility during active and passive movements, the signs of extravasal compression, the determination of vascular wall complications, the signs of cartilaginous tissue damage, and articular complications.

[The phylogenetic position of Chlamydia strains isolated from monkeys and humans with Chlamydial pathology in the family Chiamydiaceae. Genotypic and phenotypic properties of this pathogen].

Based on the results of the comparative analysis concerning relatedness and evolutional difference of the 16S - 23S nucleotide sequences of the middle ribosomal cluster and 23S rRNA I domain, and based on identification of phylogenetic position for Chlamydophila pneumoniae and Chlamydia trichomatis strains released from monkeys, relatedness of the above stated isolates with similar strains released from humans and with strains having nucleotide sequences presented in the GenBank electronic database has been detected for the first time ever. Position of these isolates in the Chlamydiaceae family phylogenetic tree has been identified. The evolutional position of the investigated original Chlamydia and Chlamydophila strains close to analogous strains from the GenBank electronic database has been demonstrated. Differences in the 16S - 23S nucleotide sequence of the middle ribosomal cluster and 23S rRNA I domain of plasmid and non-plasmid Chlamydia trachomatis strains released from humans and monkeys relative to different genotype groups (group B- B, Ba, D, Da, E, L1, L2, L2a; intermediate group - F, G, Ga) have been revealed for the first time ever. Abnormality in incA chromosomal gene expression resulting in Chlamydia life and development cycle disorder and decrease of Chlamydia virulence can be related to probable changes in the nucleotide sequence of the gene under consideration.

[Value of magnetic resonance imaging in the diagnosis of sequels of shoulder joint injuries].

The paper presents the results of examining 45 persons with sequels of shoulder joint injuries, by applying magnetic resonance imaging (MRI) (100%) and arthroscopy (95.6%). The data of arthroscopy were compared with those of MRI; thereafter the sensitivity, specificity, and accuracy of MRI were calculated. The findings suggested that there was no statistically significant difference in the capacities of the two comparable techniques MRI and arthroscopy to diagnose labral tears with degenerative changes, synovitis, bursitis and tendinitis (McNemar's test; p > 0.05). The capacities of MRI are greater than those of arthroscopy only to detect the structural disintegrity of the joint shoulder.

[Clinical and radiation diagnosis of circumscribed peritonitis complicating duodenal perforation].

This paper deals with the results of ultrasound (US) and multislice computed tomography (MSCT) in patients with perforated duodenal ulcer in different periods after the onset of the disease, with varying clinical manifestations, and in the postoperative period. A comparative analysis of the results of radiation studies has indicated that X-ray study is a basic technique that defines treatment policy in the early development periods of perforation; US study (USS) reveals a change in the duodenum, fluid and infiltration outside the duodenum. As circumscribed peritonitis progresses, USS allows the diagnosis of abdominal abscesses and infiltrations. Out of the radiation techniques, MSCT is of most importance in the diagnosis of interintestinal abscesses and in the determination of syntopy of purulent cavities.

[Colonization resistance and immunological reactivity of children's oropharyngeal mucosa in health and bronchopulmonary pathology].

The study group was comprised of 27 practically healthy children, 51 patients with acute bronchitis, 15 with chronic bronchitis and 11 with pneumonia. It was shown that changes of microbiocoenosis in back of the throat (BOT) were related to increased mucosal contamination with normal microflora and opportunistic microorganisms. The highest degree of contamination was observed in children with acute bronchitis. Normocoenosis was detected only in 13 practically healthy children. The disorders of microbiocoenosis took the form of disbiosis and acute inflammatory processes in patients with acute and chronic bronchitis and pneumonia. However, the large amount of normal flora together with the high Ig level ensured marked colonization resistance as evidenced by the values of natural colonization coefficient of nasopharyngeal epithelium (NCCNE) and balance coefficient (BC). These data suggested development of compensated secondary immunodeficiencies. In patients with acute bronchitis and pneumonia, local synthesis of Ig prevailed. It is shown that BC can be used to screen children for disorders of mucosal immunity. The presence of increased saliva IgE levels in patients with acute and chronic bronchitis supports the generally accepted concept of bronchi as a "shock organ" in allergic condition. It was demonstrated that IgE levels in saliva increase earlier than in serum and may be used as a prognostic criterion in patients with bronchopulmonary pathology.

[Multislice spiral computed tomography in the diagnosis of osteomyelitis].

This paper deals with the results of a radiation study in 34 patients with the clinical manifestations of maxillofacial osteomyelitides. It describes the radiation semiotics of changes occurring in the bone and its surrounding soft tissues of the maxillofacial region in different phases of osteomyelitis. Comparative analysis of orthopantograms and images obtained by multislice spiral computed tomography revealed the benefits of the latter in detecting soft tissue changes and subtle bone alterations.

[Molecular mechanisms of induction of innate immunity].

Cellular and molecular mechanisms of congenital immunity at different levels are discussed including single cell expression patterns and intracellular localization of individual TLR, the use of adapter molecules for generation of activation signals in response to microbial and non-microbial pathogens, soluble trap receptors, and intracellular negative regulators.

[Modern methods of laboratory diagnostics of Chlamydia infections].

Need for further improvement of methods for verification of etiological agent of urogenital and respiratory chlamydiosis on the basis of increased biotechnological requirements to antigens for serological reactions, primers for PCR assay (refinement of connection of primers with microorganism's zones of genome most significant for its life activity or formation of most diagnostically significant complexes of primers), and selection of cultivating conditions considering the predicted features of clinical strains of the agent was substantiated.