[The organizational aspects of laboratory diagnostics of acute conditions: a lecture].

The article presents data concerning the prevalence of acute diseases and conditions in the Russian Federation. The main requirements are exposed concerning the laboratory diagnostics of acute conditions. The results of analysis of regulating documents concerning this issue are presented. The list of optimal laboratory tests and organizational options to be implemented in laboratory testing of patients with acute diseases and conditions in medical institutions is developed. The role and importance of principles of evidence medicine in choosing an optimal list of laboratory analysis to diagnose the acute conditions is demonstrated.

[Current technologies for enhancing efficiency of laboratory techniques]. / Sovremennye tekhnologii povysheniia éffektivnosti ispol'zovaniia vozmozhnostei laboratorii.

The current approaches to promoting the efficiency of applying the laboratory tools were comprehensively analyzed. It was for the first time that the above issue was considered from the standpoint of a scientifically substantiated management scheme applicable to the laboratory examination volume and within the framework of the modern conclusive medicine. The problem can be solved through starting, in each clinic, an independent research project and through patient management (critical course--technological card) with respect to available technological and personnel resources. Finally, the basic principles are outlined that are needed for designing the technological cards; the related role of experts in clinical laboratory diagnostics is demonstrated.

[Significance of the operational test parameters in selection of a diagnostic test for Helicobacter infection]. / Znachenie operatsionnykh kharakteristik testa pri vybore metoda diagnostiki infektsii Helicobacter pylori.

The group of 89 patients was examined, 63 of them suffered by a duodenal ulcerative disease, 11--by gastric ulcerative disease and 15--by chronic gastritis. It was conducted the comparison of the following indices: sensitivity, specificity, relationship of probability and diagnostic efficiency of histological, cytological methods, urease and respiratory tests, method of polymerase chain reaction, qualitative and quantitative definition of antibodies of the class IgG in serum blood to H. pylori by a method of enzyme immunoassay and Western-blot for H. pylori infection diagnostics was carried out. The results show that in choice of a diagnostic method of infection H. pylori it is better to use such characteristics as sensitivity and specificity, which more objectively reflect the diagnostic possibilities of each test.

[Laboratory diagnosis of hepatitis C]. / Laboratornaia diagnostika gepatita C.

Laboratory algorithm for the diagnosis of viral hepatitis C (HVC) is proposed. Blood sera are screened for antiHVC by third-generation EIA and PCR of HVC RNA. Positive result of PCR is diagnostically significant. In case of positive EIA and negative PCR the serum is to be analyzed in immunoblotting. If immunoblotting is not carried out, the diagnosis is made on the basis of estimated values of hepatitis C probability attached to diagnostic EIA kit used in clinical laboratory. When evaluating the positive result, the increase in optic density (OD) of analyzed samples is compared with the cutoff OD. In OD higher than 9 and below 1.5 the probability of disease is 92.6 and 11.8%, respectively. Patients with doubtful results of serological tests are to be regularly checked up for 1 year, with laboratory tests (immunoblotting and PCR) repeated every 3 months. Complex laboratory diagnosis by biochemical and serological methods and PCR should be carried out in groups at a high risk of HVC.

[Laboratory diagnosis in tuberculosis]. / Laboratornaia diagnostika tuberkuleza.

The most reliable signs of tuberculosis infection is detection of M. tuberculosis complex in biological fluids and biopsy specimens from focus of lesions. The sensitivity of laboratory diagnostic methods is different for different biological materials, which dictates the utilization of a complex laboratory approach, including microscopy, bacteriological methods, detection of specific IgG, IgM, IgA, and polymerase chain reaction.

[Automation and organization of technological process of urinalysis]. / Avtomatizatsiia i organizatsiia tekhnologicheskogo protsessa issledovaniia mochi.

Results of introduction into practice of a working model of industrial technology of laboratory studies and KONE Specific Supra and Miditron M devices are shown as exemplified by clinical analysis of the urine. This technology helps standardize all stages and operations, improves the efficiency of quality control of laboratory studies, rationally organizes the work at all stages of the process, creates a system for permanent improvement of the efficiency of investigations at the preanalytical, analytical, and postanalytical stages of technological process of laboratory studies. As a result of introduction of this technology into laboratory practice, violations of quality criteria of clinical urinalysis decreased from 15 to 8% at the preanalytical stage and from 6 to 3% at the analytical stage. Automation of the analysis decreased the need in reagents 3-fold and improved the productivity at the analytical stage 4-fold.

[Colloid-oncotic pressure in patients with diffuse suppurative peritonitis]. / Sostoianie kolloidno-onkoticheskogo davleniia u bol'nykh s razlitym gnoinym peritonitom.

35 patients with various phases of generalized purulent peritonitis were tested. The goals of this study were to define the colloid-oncotic pressure (COP) and the contents of its main ingredient--albumin, determine the significance of the COP studies for the diagnosis of edema of lungs in cases of purulent peritonitis, and the influence of fluid management and parenteral nutrition upon the COP index. The studies have shown a clear dependency of COP and albumin ratio upon the phase of peritonitis. The authors come to a conclusion that the definition of COP dynamics is one of the most reliable criteria that makes it possible to chart a correct program of fluid management and reduce the number of postinfusional complications.