[Comparative analysis of enteral feeding practices for prevention of gastrointestinal complications in infants with ductus-dependent congenital heart diseases].

Mesenterial hypoperfusion is one of the main pathogenetic factors of necrotizing enterocolitis (NEC) in infants with ductus-dependent congenital heart diseases. NEC in infants undergoing congenital heart surgery increases mortality and length of hospital stay. NEC is also associated with adverse neurodevelopmental outcome. Optimization of enteral feeding can reduce the risk of gastrointestinal complications. NEC risk factors in infants with congenital heart are of special interest in the literature. This article discusses criteria for enteral feeding initiation and increasing preoperatively and after heart surgery. Enteral feeding protocols of leading cardiac surgical centers are reviewed. Practices to provide high energy and nutrient consumption in infants with congenital heart disease are described.

Coinheritance of HbD-Punjab/ß+-thalassemia (IVSI+5 G-C) in patient with Gilbert's syndrome.

Thalassemia and qualitative hemoglobinopathy are hereditary disorders of Hb synthesis that lead to change in the Hb conformation or a decrease in the synthesis of structurally normal Hb, and consequently, to erythron pathology. Many variants of Hb are unstable or have altered affinity for oxygen, and, in heterozygous form can be associated with clinical and hematological manifestations (hemolytic anemia, hypochromic microcytic anemia, erythrocytosis). HbD-Punjab [ß121 (GH4) Glu → Gln; HBB: C.364G> C] is variant of Hb carrying the amino acid substitution in the 121 position of ß-globin chain. In all cases reported so far, patients with HbD-Punjab/ß+-thalassemia (IVSI+5 G-C) combination experienced typical thalassemia with hypochromic microcytosis. HbD-Punjab was detected by electrophoresis from 37 to 94% of total Hb. The article describes rare clinical case of the cohabitation of HbD-Punjab/ß+-thalassemia (IVSI+5 G-C) in a patient with homozygous variant of Gilbert's syndrome observed in AS Loginov Moscow Clinical Scientific Center.

[THE CYTOGENETIC CHARACTERISTIC OF SOME PALEARCTIC POPULATIONS OF HOLARCTIC MIDGE GLYPTOTENDIPES BARBIPES STAEGER (DIPTERA, CHIRONOMIDAE)].

Set and frequencies of inversion banding sequences in polytene chromosomes in the Palearctic natural populations of a Holarctic chironomid Glyptotendipes barbipes (2n = 8) (the Northwest of Russia, Irkutsk region, Kirghizia, Armenia) have been investigated. The majority of larvae were heterozygotes on inversions. Distinctions in a set and frequencies of inversions between populations form different regions have been ascertained. We have established that G. barbipes karyotype in the populations studied includes inversion banding sequences that are endemic for Palearctic (p'barG2), and also the general sequences met both in Palearctic, and in Nearctic (h'barB3, h'barC3, h'baE2, h'barF2).

[On the possibility of spontaneous interspecific hybridization in the nature of representatives of sibling-Species Chironomus riparius Kieffer and Chironomus piger Strenzke (Diptera, Chironomidae) from Armenia].

F2 hybrid (Chironomus riparius x Chironomus piger) x C. piger was found in mixed community of C. riparius and C. piger. Mechanism of its origin and problem of hybrid viability is considered.

[Karyotypes of four species of chironomids (Diptera, Chironomidae) from Northern Italy].

Karyotypes of 4 chironomid species were studied: Cryptochironomus obreptans Walker, Criptochironomus sp., Chironomus plumosus Linnaeus and Stictochironomus rosenscholdi Zetterstedt. All these species belong to the subfamily Chironominae. Each species is characterized by the specific karyotype structure. The first species in the list has 2n = 4, while the other 3 species have 2n = 8.

[Inversion polymorphism in the population of Camptochironomus tentans from Kaliningrad city].

This paper present the map of polytene chromosomes and inversion polymorphism of widely distributed Chironomidae species, Camptochironomus tentans, from the most western locality of Russia--Kaliningrad city. Chromosomes banding pattern is designated according to Beermann, 1955. Only one larva (2.9%) had a standard banding pattern, and karyotypes of the rest (97.1%) were polymorphic. We have found 2.0 heterozygous inversions per individual, and the frequency of hetero- and homozygous inversions, taken together, amounted to 2.2 per individual. 17 inversion banding patterns and 20 genotypic combinations of these patterns were found. It was shown that the most frequent inversions in this population were identical to these in European populations.

[Inversion polymorphism of Glyptotendipes glaucus Mg. (Diptera: Chironomidae) from the reservoirs of Kaliningrad].

The karyotypes of larvae Glyptotendipes glaucus Mg. 1804 from three reservoirs of Kaliningrad city (Pen'kovoe and Karasevka lakes and Chistyi pond) were studied. The levels of the natural inversion polymorphism for the three populations were determined. Ten new inversion sequences (gla B4, gla B5, gla B6, gla D5, gla E4, gla E6, gla E7, gla F6, and gla F7) were detected in the species studied. Inversion including the centromeric region in IIIEF (gla E6 + gla F7) was pericentric. Several cases ofgla B5 and gla B6 combination with gla B2 resulting in genotypic combination gla B2.5 and gla B2.6 were found. The dependence of the number of inversion sequences and genotype combinations from the content of heavy metal ions in sediments of the reservoirs was revealed. All populations were characterized by the prevalence of inversion sequence gla B2 in chromosome I.

[Gytogenetics of Chironomus riparius L. from the fishpond in Borok village (Diptera, Chironomidae)].

We have found three inherited inversions in Chironomus riparius populations from the Borok fishpond, namely: (A3d-B1a) in the arm A (C5a-C6a) in the arm D and (B3b-4d/e) in the arm F. Increase of heterochromatin in some bands of chromosome F (B3h, B3h + B3c--C1a) and puffs appearance in the arms C, D and E have been observed. We saw also changes in functional activity of nucleolar organizer (N) and Balbiani rings (BRe/BRb). It has been found that some of inversion breakpoints coincide with the Alu and Hinf satellite DNA localization sites.

[Seasonal variability of the karyotype structure of Chironomus plumosus (Diptera, Chironomidae) from a biotope of Kaliningrad].

Chironomus plumosus larvae from the polluted Shkolnoe lake, Kaliningrad, have 2n = 8 and 2n = 8 + B. In winter season we found 11 types of hetero- and homozygous inversions in A, B, C, D, E, and F arms whereas in summer season we registered 7 types of the same inversions in A, B, C, D, and E arms. All inversions with exception of the inversion in arm C correspond to Hardy-Weinberg equilibrium. The arm IVG shows homozygous increase of centromeric heterochromatin more frequently in summer than in winter (34.4% as compared with 1.8%). The arm E has asynapsis 2 times less frequently in summer than in winter (21.4% as compared with 44.6%).

[Cytogenetic analysis of the noxious bloodsucker Boophthora erythrocephala (Diptera: Simuliidae) from different geographic zones].

Boophthora erythrocephala is a widely spread species inhabiting both small polluted water-bodies and large rivers. Three populations from Samara region in Russia and from Donetsk and Chernigov regions in the Ukraine have been studied. Five populations of this species in Russia were described earlier (Polyanskaya, Tsapygina, 1968; Petrukhina, 1972). For identification of this species the chromosome map of Adler and Werner (personal communication) was used. Comparison of 8 populations studied was performed. All of them belong to the species B. erythrocephala but everyone has its own individual characteristics. Inversion polymorphism was observed in each population comprising from 88 to 100 %. Mean number of heterozygous inversions per individual is low fluctuating around 3.6. There is one inversion in IIS observed in all populations that proves panmixy among them. Other inversions occur in a part of the individuals.

[B chromosome polymorphism of blackflies (Diptera, Simuliidae) from the north-western region of Russia].

We have studied karyofonds of natural populations and B-chromosome morphology of 8 species of blackflies from the North-Western region of Russia: Odagmia ornata Mg., Hellichiella crassa Rubz., Simulium morsitans Edw., Simulium argyreatum Mg., Shoenbaueria pusilla Fries., Cnetha fontinalis Radzv., Stegopterna duo-decimata Rubz., and Archesimulium tuberosum Lundstr. For this purpose we made slides of squashed blackflies larvae with salivary gland polytene chromosomes stained by aceto-orcein, in addition to similarly stained slides with mitotic chromosomes from gonads and ganglia. Morphology of polytene B-chromosomes of Shoenbaueria pusilla Fries., Cnetha fontinalis Radzv., Stegopterna duodecimata Rubz., and Archesimulium tuberosum Lundstr. has been first described. B-chromosome polymorphism was found in all species, but the number of B chromosomes was conserved within each differences in polytene individual. Stable and distinct interspecific differences in the morphology of polytene B-chromosomes were demonstrated, and these characters are advisable to use to distinguish the species. We have investigated for the first time karyofonds of Od. ornata populations from Arkhangelsk Region (Solovetskie Islands) and Leningrad Region (railway station Sablino), and those of S. argyreatum populations from Murmansk Region (Kandalaksha environs) and Karelia (railway station Chupa). A long term study of Od. ornata and S. argyrestum population from North-Western Russia revealed interspecific and interpopulation dynamics of the occurrence of specimens with B-chromosomes. Some populations showed an increased percentage of individuals with B-chromosomes. It is suggested that B-chromosomes may play a role in adaptation of polulations to severe environmental conditions.

[Infectious complications after transplantation of autologous hemopoietic blood cells in patients with hematological malignancies].

AIM: To characterize infectious complications arising within 30 days after transplantation of autologous hemopoietic blood cells in 42 patients with hematological malignancy (HM); to compare the course of early posttransplantation period with reference to a kind of high-dose conditioning and dose of transplanted CD34+ cells. MATERIAL AND METHODS: Autotransplantation (AT) was conducted as consolidation of a complete or partial remission in 20 patients with multiple myeloma, 14 patients with lymphogranulomatosis and lymphosarcoma, 7 patients with acute leukemia and 1 patient with rabdomyosarcoma. The program of pretransplantation conditioning corresponded to the disease form and included: melphalan, BEAM, busulphane-cyclophosphamide. The number of transplanted CD34+ cells was 1.7-20.1 (median 5.3) x l0(6) cell/kg. The transplantation was followed by selective intestinal decontamination and mycosis prophylaxis. Fever was managed with antibiotics. RESULTS: An early period after AT ran without febrile episodes in 7 (17%) patients. This allowed physicians to avoid systemic antibiotic therapy. The infectious focus was not definitely localized in 35 patients with febrile fever in 77% cases. Clinically and bacteriologically verified infections were detected in 8 (19%) patients: 7 cases of pneumonia and 1 of bacteriemia. None of the patients died of infection early after AT. Not a single case of invasive aspergillesis was registered. CONCLUSION: Incidence and features of infections did not vary with the above diseases and did not depend on the dose of transplanted CD34+ cells. The kind of high-dose conditioning had a significant influence on the time of granulocyte recovery, duration of agranulocytosis, duration of one febrile episode and of antibiotic therapy. The dose of transplanted CD34+ cells also influenced the time of granulocyte recovery and duration of antibiotic therapy.

[Possible sources of aspergilla infection in a hematological hospital].

AIM: To investigate spread, species spectrum, quantity of aspergilla spores in the air of a hematological hospital. MATERIAL AND METHODS: Air samples (250 I/min, PU-1B device) were collected in hematological departments monthly. Isolation and identification of mycelial fungi were made on Chapek medium. In detection of Aspergillus spp. culture in the biomaterial, additional samples of the air and wash-out from the surfaces were collected. RESULTS: A 4-year mycological monitoring of the air has found that aspergilla constituted dominating micromycetes both by occurrence (45%) and amount (5.66%). The spectrum of Aspergillus spp. were represented by 17 species. Of them A. fumigatus, A. niger, A. flavus, A. terreus and A. nidulans comprised 31%. Aspergillus spp. concentrations in the wards with laminar ventilation was 1.8 CFU/m3, in plenum-air exhaustion ventilation--2.1 CFU/m3, exchange ventilation--12.2 CFU/m3. Increased amount (31%) and concentration (11.9 CFU/m3) of Aspergillus spp spores in the air occurred in autumn. A. fumigatus (44%), a. flavus (42%), A. niger (8%), A. versicolor (3%), Aspergillus spp (3%) were detected in 33 patients. The rate of detection of Aspergillus isolated from the patients was also the highest in autumn (34%). Aspergillus spores mean concentration in the wards of patients with invasive aspergillesis was 13.1 CFU/m3, in the nearby wards--12.4 CFU/m3. Morphologically identical strains Aspergillus spp. isolated from the patient and environment were obtained in 9 cases. CONCLUSION: Minimal concentration of aspergilla spores was in the wards with laminar air flow furnished with plenum-air exhaustion ventilation. Annual correlation (for 4 years) of seasonal dynamics of the incidence of Aspergillus spp. from patients with invasive aspergillesis and number of spores in the air support suggestion that air is one of the sources of infection in immunocompromised patients. In spite of wide prevalence of Aspergillus spp. in hospital air, morphologically identical strains from the patient and environment are encountered rarely. There may be additional sources of infection and mechanisms of invasive aspergillesis onset in immunocompromised patients. Genotyping of morphologically identical strains was not made.

[Invasive pulmonary aspergillesis].

AIM: To evaluate the results of therapy of invasive pulmonary aspergillesis (IPA) in one medical center from 2000 to 2005. MATERIAL AND METHODS: Diagnosis of IPA was made according to the International criteria. Incidence of verified IPA was 2%, probable--84%, possible--14%. RESULTS: IPA was diagnosed in 50 cases in 49 patients aged 16- 78 years, median 35. Most of the patients consisted of acute leukemia cases (54%). Intensive cytostatic therapy was given in 41% cases. In 54% IPA developed in critical neutropenia, median of duration of which being 29 days (3 to 144 days). 29 patients received glucocorticoid drugs. In diagnosis of IPA Aspergillus spp was isolated in 46% cases (A. fumigatus-59%, A. flavus-29%, A. niger-4%, A-versicolor-4%, in 1 (4%) case identification was not made. Positive antigen Aspergillus was detected in 27 cases. All the patients had pulmonary involvement detected at x-ray or computed tomography. Coincidence of pulmonary lesions seen at x-rays and computer tomograms was only in 30% patients. Cure was achieved in 44%, lethality was 56%. Overall survival in IPA for 90 days was 47%. Amphotericine was effective in 29%. Voriconasol--in 3 of 5 patients, kaspofungin--in 3 of 7. Surgical treatment was given to 4 patients. CONCLUSION: Lethality in IPA for 5 years when basic therapy was amfotericin B reached 56%. Reduction of lethality can be achieved due to early diagnosis of the infection and administration of voriconasol at the initial stage of IPA. It is necessary to conduct multicenter studies to ascertain indications for combined antifungal therapy.

[Comparative cytogenetic variability of polytene chromosomes from salivary glands of Chironomus riparius Mg., 1804 (Diptera, Chironomidae) from two polluted biotopes in Bulgaria and Russia]. / Sravnitel'no-tsitogenetichekaia izmenchivost' politinnykh khromosom sliunnykh zhelez Chironomus riparius Mg., 1804 (Diptera, Chironomidae) iz dvukh zagriaznennykh bioptopov Bolgarii i Rossii.

The structural-functional variation of Chironomus riparius salivary gland polytene chromosomes was studied in two geographically isolated Palearctic regions, Bulgaria (village Pancharevo) and Russia (St. Petersburg). The two biotopes, where larvae were collected, were polluted with various heavy metals from anthropogenic sources. Hereditary paracentric heterozygous inversions were characteristic of the Russian population, whereas somatic paracentric or pericentric heterozygous inversions were more common in the Bulgarian one. All inversions occurred at low frequencies. Other aberrations found in the two populations included somatic deletions resulting in a pompon structure of chromosome IVG, heterozygous translocation between chromosomes IVG and IIIF, enlargement of individual disks, and the appearance of a heterozygous block close to the centromere of chromosome IVG. In addition, changes in functional activity of the nucleolus organizer and Balbiani rings (BRc/BRb) were observed. Several aberration breakpoints proved to coincide with satellites of the Alu and Hinf families.

[Morphological diversity of centromere regions in polytene chromosomes of blackflies (Diptera, Simulidae)]. / Morfologicheskoe raznoobrazie tsentromernykh raionov politennykh khromosom krovososushchikh moshek (Diptera, Simulidae).

Karyotypes of more than 120 species of 33 genera of the Palearctic blackflies (Simuliidae) were studied on squashed acetoorcein stained preparations of salivary gland polytene chromosomes in larvae. In the course of evolution of the family, a significant complication was noticed in the morphology of centromere regions of polytene chromosomes. In plesiomorphic species, centromeres are not pronounced morphologically and the general picture does not differ from that of other bands and interbands of the polytene chromosome. In species with apomorphic characters, a distinct precentromeric heterochromatin appears, whose manifestation is responsible for morphological diversity of centromere zones in polytene chromosomes. They are represented either by conspicuous slightly thickened heterochromatic bands or by large amplified blocks of heterochromatin or puff-like structure, being considerably extended as a result of despiralization of precentromeric heterochromatin. There are species, which more commonly lack chromocentre and their chromosomes are separated. Some other species have ectopic contacts between pricentromeric heterochromatin. In some species, this heterochromatin is organized as a compact chromocentre. This has been found only in representatives of southern latitudes, most frequently in evolutionarily young species with narrow specialization.

[Karyotype and morphology of Chironomus anthracinus Zett. (Diptera, Chironomidae) from eastern Kazakhstan]. / Kariotip i morfologiia Chironomus anthracinus Zett. (Diptera, Chironomidae) iz Vostochnogo Kazakhstana.

Larval morphology and polytene chromosomes of Chironomus anthracinus from eastern Kazakhstan have been described. Larvae have no lateral tubules on VII abdominal segment, but have paired ventral tubules on VIII abdominal segment. 2 n = 8 (A1.1 B1.1 C2.2 D1.1 E1.1 F1.1 G1.1). Two nucleoli are present in arms IVG and IIIF. Mapping of chromosomes, apart from antC2 arm, was performed after Shobanov (1996). B-chromosomes have been discovered in this species for the first time (in 19.4% individuals). Heterozygous inversions occurred in arms LA and IIIE in 46% of individuals. Compared to C. anthracinus from Yaroslavl Region, differences in morphology and karyology observed in this species from eastern Kazakhstan are related to habitation of the population examined in the deep-water Lake Markakol on the boundary of the area range.

[Prevalence of mycelial fungi in hematological hospital]. / Rasprostranenie mitselial'nykh gribov v gematologicheskom statsionare.

AIM: To study prevalence, quantity and species of mycelial fungi in the air of a hematological hospital. MATERIAL AND METHODS: Air samples in the hematological departments were taken monthly by PU-1B device in the volume 250 l/min. Seeding and identification of mycelial fungi were made on the Chapeck medium. RESULTS: Tests for mycelial fungi in the air was 95%. Dominating species were the following: Penicillium spp., Cladosporium spp., Aspergillus spp. The fungal contamination was seasonal. Maximal isolation of Penicillium spp was seen in winter and autumn. Aspergillus spp. is represented with 13 species of which most frequent were A.versicolor, A. niger, A. fumigatus, A. ochraceus, A. flavus. Pathological material from 19 patients contained Aspergillus spp.: A. fumigatus, A. flavus, A. niger. The isolation peak was in autumn-winter and coincided with maximal isolation of fungal spores from the air. The analysis of air samples taken in the wards where patients had Aspergillus spp. in biomaterials showed that concentration of spores Aspergillus spp. was higher than in nearby wards and corridor: 45.6 CFU/M3 vs 18.8 CFU/m3 and 24.7 CFU/M3, respectively. However, morphologically identical strains (patient-air) were recognized only in 4 cases from the nearby wards and corridor. None of the air samples taken in the ward of the patient contained identical species. Minimal amount of the spores of micromycetes was registered in the wards furnished with ventilation with laminar air flow. Most contaminated was the air of 4 bed wards in the old building. CONCLUSION: Mycological monitoring of the air in hematological departments determined the structure of mycelial fungi complexes. Though ambient air in the wards is full of fungi, detection of morphologically identical strains causing invasive mycosis in immunocompromised patients is rare. Further studies are necessary.

[Invasive aspergillosis in immunocompromised patients]. / Invazivnyi aspergillez u immunokomprometirovannykh bol'nykh.

AIM: To analyse results of treatment of invasive aspergillesis in immunocompromised patients for 2000-2002. MATERIAL AND METHODS: The study was made of patients who, when treated with antibiotics, exhibited foci in the lungs typical for invasive aspergillesis. Aspergillas were detected in the sputum, bronchoalveolar lavage, bronchial wash-ups, aspergilla antigen (galactomannan) was detected in the blood. RESULTS: Invasive aspergillesis was diagnosed in 25 patients. 13 (52%) patients were treated with adjuvant glucocorticoids. 19 (76%) patients had neutropenia. All the patients had fever. Foci in the lungs were in 24 patients. Aspergillas were detected in 15 patients, a positive antigen galactomannan in 7 patients. A. Fumigatus, A flavus, A. Niger occurred in 67, 26.5 and 6.5% patients, respectively. All the patients received amphotericin B (median of the treatment reached 38 days, total dose 880-3500 mg). In 5 patients amphotericin B was replaced for liposomal amphotericin B because of high creatinine. 7 patients continued with itraconasol in a dose 400-600 mg/day. The foci were removed in 3 patients. The cure was achieved in 12 patients, 13 patients, 13 patients died (cause of death--respiratory insufficiency). CONCLUSION: Lethality in invasive aspergillesis in immunocompromised patients remains high--52%. Cultural detection of mycelial fungi was, as a rule, delayed. Early diagnosis of the disease requires monitoring of the aspergilla antigen in the blood and computer tomography of the chest especially in fever persisting in the treatment of wide-spectrum antibiotics.

[Results of a karyological study of blood-sucking flies (Diptera: Simuliidae) of Armenia]. / Itogi kariologicheskogo izucheniia fauny krovososushchikh moshek (Diptera: Simuliidae) Armenii.

Karyotypes of 31 species of black flies belonging to 11 genera have been examined. The morphology of polytene chromosomes from salivary glands of larvae and mitotic chromosomes of gonads and ganglia have been studied. It was found that most species have 2n = 6, except the Eusimulium species, which have 2n = 4. Each species is characterised by a specific pattern of polytene chromosomes. It was found that widely spread species are polymorphic in heterozygous inversions and additional B-chromosomes. The use of karyological studies in taxonomic diagnostics of black flies, especially in the cases when species are similar morphologically, was shown to be expedient.