[The role of neutrophil CD64 index in the diagnosis of infectious complications after colorectal resection]. / Rol' indeksa CD64-neitrofilov v diagnostike infektsionnykh oslozhnenii posle rezektsii tolstoi kishki.

OBJECTIVE: To determine diagnostic value of neutrophil CD64 index (iCD64n) in the diagnosis of postoperative infectious complications after colorectal resections. MATERIAL AND METHODS: Seventy-three patients underwent colorectal surgery for the period from January to December 2018. These patients were included into a single-center study. Peripheral blood samples were taken on 3 and 6 postoperative days (POD) to check iCD64n level. We analyzed incidence of postoperative infectious complications, sensitivity (Se) and specificity (Sp) of postoperative iCD64n level on the 3rd and 6th POD. RESULTS: Postoperative infectious complications developed in 10 (13.7%) patients. Median iCD64n was significantly higher (p=0.0017 for POD 3; p=0.018 for POD 6) in patients with infectious complications (1.6 on POD 3; 1.3 on POD 6) compared to those without complications (1.1 on POD 3; 0.9 on POD 6). Area under curve (AUC) on the 3rd POD was 0.8 with the cut-off value of 1.4, Se - 70%, Sp - 93.7% (p=0.002). On the 6th POD, AUC was 0.91 with cut-off value of 1.23, Se - 80%, Sp - 93.7% (p<0.001). CONCLUSION: Neutrophil CD64 index is a valuable predictor for the diagnosis of postoperative infectious complications after colorectal resections. It is a useful tool to ensure a safe early discharge.The study is registered on the website «clinictrials.gov¼ (registration number NCT03559335).

[Meta-analysis of management of colorectal anastomotic leakage]. / Meta-analiz metodov lecheniia nesostoiatel'nosti kolorektal'nogo anastomoza.

AIM: To identify the most effective management of colorectal anastomosis failure via analysis of available literature sources. RESULTS: Systematic review included 20 original trials. Effectiveness of redo interventions for colorectal anastomosis failure including open, laparoscopic, minimally invasive techniques (transanal drainage, endoscopic vacuum therapy, endoscopic drainage) was described. Anastomotic failure rate was 6.5%. Medication was effective in 57% (95% CI 34-77%) of cases. Redo open surgery was applied in 43% (95% CI 23-66%) of patients. Postoperative mortality was 21-27%. Redo laparoscopic procedure was performed in 61% (95% CI 50-70%) of cases for anastomotic failure after previous laparoscopy, incidence of conversion was 12% (95% CI 4-28%). Transanal drainage was effective in 85% (95% CI 61-94%) of cases, endoscopic vacuum therapy - in 82% (95% CI 74-87%), healing of anastomosis without need for colostomy was achieved in 16% (95% CI 9-26%) of cases. Endoscopic clipping for colorectal anastomotic defect was effective in 73.3-77% of cases. CONCLUSION: Redo surgery for anastomotic failure is associated with advanced mortality and need for permanent colostomy. Laparoscopic approach reduces incidence of complications after redo surgery and followed by better functional outcomes. Minimally invasive procedures are advisable for colorectal anastomosis failure without need for redo surgery. However, effectiveness of these methods is controversial due to few reports and no comparative trials.

[CRITERIA OF DIFFERENCE EVALUATION FOR VARIOUS TYPES OF HEMORRHAGIC FEVER WITH RENAL SYNDROME FOCI. HFRS FOCI IN VARIOUS BIOTOPES OF TYPICAL BARRENS].

AIM: Examine features of natural, natural-anthropourgic and anthropourgic foci of hemorrhagic fever with renal syndrome (HFRS) in various, mostly forest, biotopes of typical barrens due to differences of non-specific HFRS prophylaxis in foci of various types. MATERIALS AND METHODS: Epizootological and epidemiologic data from 1998 to 2012 were analyzed, gathered in HFRS foci of all types in Saratov area of Saratov Region (typical barrens). 14,606 trap-nights were worked off and 2669 small mammals were procured. The most significant population-ecologic and ecologic-epizootological methods and criteria were used for comparative analysis of differences for 3 types of foci. RESULTS: Based on analysis of multi-year data seasonal differences for HFRS foci of various types were shown by 10 population-ecologic and ecologic-epizootologic criteria. CONCLUSION: The results obtained allow to state that modern means and methods of non-specific prophylaxis of HFRS and other zoonoses in foci of various types different significantly. This allows the most rational use of material and financial resources.

[Criteria of difference evaluation for-various types of hemorrhagic fever with renal syndrome foci. HFRS foci in various biotopes of northern barrens].

AIM: Determine qualitative and quantitative criteria of evaluation of features for natural, natural-anthropourgic and anthropourgic foci of hantaviruses (using hemorrhagic fever with renal syndrome--HFRS foci as an example), that have formed in various areas of Saratov Region. MATERIALS AND METHODS: Epizootological and epidemiologic data from 1998 to 2012 were analyzed. During this period in all the types of foci of Atkarsk area (Northern barrens) 13,004 trap-nights were worked off, 2577 small mammals were procured. Genetic, population-ecological and ecological-epizootological methods and criteria were used for comparative analysis of 3 types of loci: PCR diagnostics and sequencing of pathogenic for humans hantaviruses, species cadaster and features of season dynamics of species composition of hantavirus carriers, domination indexes, parameters of quantity and infection of carriers by hantaviruses; distribution of the latter by biotopes, degree and character of population contacts with natural-foci complexes, epizootic potential of foci. RESULTS: Based on multi-year data analysis features of 3 types of HFRS foci were shown in various, mostly forest, biotopes of Northern and a part of typical barrens. A stable domination of Pumala genotype hantavirus was noted; a weakly expressed circulation in parasite systems with Apodemus genus carriers, first of all Dobrava genotype Apodemus agrarius, was established as well. CONCLUSION: A certain specter of most universal criteria;that are closely interconnected, are necessary during typing of HFRS foci and a number of other zoonozes.

[Role of burrow microbiocenosis in plague enzootia].

The paper analyzes relationships of the plague bacilli to the representatives of different types of living organisms inhabiting the burrows. The authors give their own data on the qualitative and quantitative composition of indicoles of the burrow of little sousliks (Spermophillus pygmaeus). They assess the role of mutagenic agents in burrow microbiocenoses.

[The manifestation of necrophagy in the populations of rodents carrying the virus of hemorrhagic fever with renal syndrome].

The role of necrophagy in the epizootic manifestations of hemorrhagic fever with renal syndrome (HFRS) is first shown. By analyzing a great body of data obtained in the Saratov Region in 1982-2000, it has been established that the frequency of manifestations of necrophagy depends on many factors, the most important of which are a season, the size (density) of populations of small mammals, their species composition and the type of biotopes inhabited by these animals. Necrophagy is ascertained to be of great importance in HFRS foci as one of the alimentary routes of infection transmission in the parasitic systems. The presence or absence of necrophagy may serve as a preliminary test for the activity of HFRS foci.

[The ecology and prevalence of arboviruses on the territory of the Saratov Region].

The territorial spread of Tahyna, Batai, Sindbis, West Nile fever and Crimean-Congo hemorrhagic fever viruses throughout the Saratov region in 1998 - 2000 was analyzed. The characteristics of the epizootic activity of the natural foci of these arboviruses in different landscape zones (temperate forest-steppes, steppes and semi-deserts) were calculated. The species composition of small mammals, the natural reservoirs of the causative agents of arbovirus infections, was determined.

[Complex evaluation of endemicity level of the territory affected by hemorrhagic fever with renal syndorome]. / Kompleksnaia otsenka éndemichnosti territorii po gemorragicheskoi likhoradke s pochechnym sindromom.

A new formula for the calculation of the endemicity index of the territory affected by hemorrhagic fever with renal syndrome (HFRS) based on empiric data collected in the Volga region near Saratov in 1982-2000 is proposed. As found in this research 21% of the administrative districts of the region have a high endemicity level (with the average index for several years reaching 35 points), 8% of the districts have a medium enemicity level (20 points) and 71% of the districts--a low endemicity level (9 points). It is pointed out that under conditions of financial constraints territories with high and medium endemicity levels should be first examined for HFRS; these territories should also be given priority in prophylactic deratization in the field and human settlements.