DRUG RELATED NITROSOGENESIS, PHOTOCARCINOGENESIS AND ONCOPHARMACOGENESIS OF NODULAR MELANOMA: A CASE RELATED ANALYSIS CONCERNING THE POLYCONTAMINATION OF THE POLYMEDICATION WITH VALSARTAN/HYDROCHLOROTHIAZIDE AND BISOPROLOL.

Despite the fact that the pathogenesis of cutaneous melanoma is shrouded in mystery, factors that have been neglected or unnoticed until now have come to the attention in recent years, and in all likelihood, they could also be pivotal. These factors, known as nitrosamines or NDSRIs, are characterized by high carcinogenic and mutagenic potency, and some of them have demonstrated these properties to human DNA as well. Unfortunately, these ingredients also turn up as contaminants in about 300 of the most widely distributed drugs worldwide. According to the most recent literature, some of these ingredients are also identified as potent photocarcinogens, as well as human carcinogens. The intake of these carcinogens in the context of polycontamination of polymedication, has been associated for years with the occurrence of melanomas. The need for cataloguing of nitrosamines , as well as their accurate labelling on drug packaging, would help to classify them even more accurately as carcinogens affecting human DNA. We present once again a patient , who developed nodular melanoma within the context of the intake of 3 potentially nitrosamine/ NDSRIs contaminated antihypertensive drugs (valsartan/ Hydrochlorothiazide/ bisoprolol). Pathogenetic aspects concerning drug-induced nitrosogenesis, photocarcinogenesis and oncopharmacogenesis of skin cancer are discussed. Nitrosogenesis' of Cancer as concept in the medical literature has been known for decades, but in relation to other forms of human cancer. Exogenously mediated drug-mediated nitrosogenesis is a logically conditioned and newly defined concept whose significance with respect to the clinical manifestation of skin cancer is only beginning to grow.

MORPHEAFORM BCC OF ALA NASI: A SUCCESSFUL DERMATOSURGICAL APPROACH BY TRANSPOSITION FLAP FROM THE ADJACENT AREA. CONTAMINATION OF VENLAFAXINE, BISOPROLOL AND OLANZAPINE WITH NITROSAMINES/NDSRIS: THE MOST LIKELY CAUSE OF SKIN CANCER DEVELOPMENT AND PROGRESSION.

Two steps are able to lead to a significant decrease in the incidence of skin cancer overall and/or to its parallel and successful surgical treatment. The first step concerns its non-occurrence or less frequent clinical manifestation and is largely related to the modern concept known as prevention, but not the one mainly related to solar radiation, but: 1) informing patients about the possible contamination of certain drugs with carcinogens/nitrosamines/NDSRIs and 2) making clinicians aware of the modern concept of limited to completely eliminated intake of nitrosamines/NDSRIs in medications. The ineffectiveness of either of these entities could in all likelihood be seen as one of the major causes of the headline growth in the incidence of skin cancer and keratinocytic cancer in particular. It is also because of this fact that the sun protection so recommended and advertised has been shown to be ineffective, yet it remains universally advertised. Polycontamination with Nitrosamines/NDSRIs within multimedication in polymorbid patients is the most serious obstacle (at the moment) for the current concept of skin cancer prevention to become a reality. The announced official "hypothetical contamination" of more than 250 drugs worldwide by the FDA in April 2023, and the establishment of permissive concentrations for 5 classes of carcinogenic activity of the nitrosamines/NDSRIs - effectively make any preventive step more than impossible or meaningless. The open question remains, how were the 5 subgroups for hypothetical carcinogenic potency of the carcinogens contained in the drugs created? On the basis of what data? What tumors occurred when these concentrations were exceeded? Data that remains hidden from the public and end users, but also data that guarantees the development of real (not hypothetical) skin tumours. The new FDA regulations also do not comment on the issues concerning the use of "hypothetical carcinogens" in the context of polycontamination and polymedication in polymorbid patients. Because of this fact, the follow-up of actual carcinomas after the intake of multiple "hypothetical carcinogens" would also seem to be not unimportant. And it turns out to be quite real and sobering to say the least. The second step, which concerns the successful treatment of skin cancer, is its early surgical treatment. This is the most promising approach, regardless of whether patients are exposed to permanent intake of carcinogens/nitrosamines/NDSRIs in the drugs. We report an 86-year-old patient, who, as part of his polymedication and polymorbidity, takes 3 drugs that, according to the official FDA list of 2023, have strictly defined reference limits for potentially available "hypothetical carcinogens": bisoprolol/carcinogenic potency class 4, olanzapine/ carcinogenic potency class 5 and venlafaxine/ carcinogenic potency class 1. The described patient developed "real carcinoma" after combined long-term intake of the "hypothetical carcinogens" announced in the official FDA lists from April 2023. Proceeding from common sense, regulators in the face of the FDA should have already long observed the development of a heterogeneous type of tumors to be able to determine 1) the potency of the 5 subclasses of carcinogens in the drugs and 2) their reference values. Moreover- they should also have the exact information why which carcinogen in which drug causes which type of tumor. Otherwise, the FDA should not announce its detailed recommendations to drug manufacturers. The present patient was successfully treated surgically by a transposition adjacent flap. The optimal dermatosurgical and reconstructive methodologies for the treatment of tumors in the ala nasi area are discussed.

"THE DANGEROUS BRASSIERE" AND THE NEVUS ASSOCIATED POLYPOID MELANOMA: CONNECTION SEEMS PLAUSIBLE?

The development of cutaneous melanoma of the skin based on dysplastic nevus is not uncommon. The causes of the progression of nevi to melanomas are numerous and not well understood at present. Certain genetic and epigenetic factors have a major influence on this evolution. We describe a 46-year-old female patient with multiple dermal melanocytic nevi who developed a polypoid melanoma in one of them. After a carefully performed anamnesis, the mole that developed into melanoma was found to be localized in the dorsal area adjacent to the brassiere and underwent permanent and daily mechanical irradiation during the last 6-7 years. Around this mole there were 5 other moles with similar clinical and dermatoscopic morphology, which did not transform into melanomas and were not subjected to mechanical irritation. The patient had a dermatological examination 6 years ago and it was suggested that this lesion has to be surgically removed, which she declined. The patient was treated surgically and the lesion suspicious for cutaneous melanoma was removed in two stages according to the generally accepted AJCC/EJC recommendations. In parallel, 5 additional melanocytic nevi were removed, which histologically had features of dysplastic dermal melanocytic nevi but no signs of progression to melanoma. This article discusses the causes of nevus -associated melanomas and emphasizes the thesis of potential malignant transformation through mechanical irritation - in this case that of the brassiere. The moles localized in this area, although clinically and dermatoscopically inapparent, should be treated surgically. This painless, short-term manipulation has a preventive effect on the future development of cutaneous melanomas.

[Shrew-borne hantaviruses (Hantaviridae: Orthohantavirus) in the Far East of Russia].

INTRODUCTION: Insectivores are newly recognized hantaviral reservoir worldwide. Four distinct shrew-borne hantaviruses (family Hantaviridae) have been identified in two regions located in southern and northern part of the Russian Far East, two genetic variants of Seewis virus (SWSV), Lena River virus (LENV), Kenkeme virus (KKMV) and Yakeshi virus (YKSV). Here, we describe geographic distribution of shrew-borne hantaviruses in southern part of the Russian Far East: Jewish Autonomous region, Khabarovsk Krai, Primorsky Krai and Sakhalin region. MATERIALS AND METHODS: Lung samples from shrews of genus Sorex, captured in the four regions of Far Eastern Russia, were examined for hantavirus RNA using reverse transcription polymerase chain reaction (RT-PCR). Phylogenetic analysis of the partial nucleotide sequences of viral genome was conducted using MEGA X software. RESULTS: New genetic variant of YKSV was identified in new reservoir host, long-clawed shrew (S. ungiuculatus) from Sakhalin Island. Genetic variant of SWSV, ARTV-Sc, has been found to circulate among S. caecutiens on the seacoast of Khabarovsk and Primorsky Krai. KKMV virus and second genetic variant of SWSV, ARTV-St, were found in S. roboratus and S. tundrensis, respectively from Jewish Autonomous region. CONCLUSION: Sorex-borne hantaviruses were found in all studied regions of Far Eastern Russia. Our results demonstrated co-evolution of SWSV, KKMV, and YKSV viruses throughout the geographic distribution of its hosts.

Application of Artificial Intelligence to Assess the Risks of Simultaneous Operations for Patients with Concomitant Atherosclerotic Damage of Coronary and Carotid Arteries.

The aim of the study is to assess the possibility of using artificial intelligence to determine the most significant predictors of the operative correction outcomes for patients with damaged coronary and carotid arteries. Materials and Methods: The retrospective study of the simultaneous (or single-stage) surgical intervention results has been carried out in patients with combined atherosclerotic damage of the coronary bed and cerebral arteries (n=42), which was severe and extensive. The parameters which may be predictors of the cardiovascular risk were analyzed using the TADA program. Ten models were built for program learning. The model with 92% predictive accuracy appeared to be the most successful. Results: Simultaneous correction resulted in the absence of 30-day coronary complications in all patients. With respect to the cerebral vascular territory, acute ischemic stroke developed in 2 patients. The lethality rate was 2.4%, the fatal outcome was caused by postoperative gastrointestinal bleeding.The TADA program model considered the following parameters to be the most significant predictors: internal carotid artery cross-clamping time in minutes (51.24%); damage to the left coronary artery stem (30.42%); diastolic AP (18.28%). If cross-clamping of the internal carotid artery lasts for less than 18 min, complications are not likely to occur, while they are practically inevitable if the time exceeds 46 min. The probability of complications grows nonlinearly with the increase of the extent of the left coronary artery stem injury. A high diastolic AP never virtually coincides with the presence of complications, nor does the low one. The highest probability of complications is at the values from 70 to 80 mm Hg.In patients with a triple vessel injury of the coronary arteries, a representative picture of a nonsignificant feature is observed. Conclusion: Application of artificial intelligence for determining risk predictors for patients with concurrent atherosclerotic damage of the coronary and carotid arteries is an effective method for prognosticating the risks of simultaneous interventions.

[Surgical treatment of patients with abdominal aortic aneurysm and ischaemic heart disease]. / Khirurgicheskoe lechenie bol'nykh s anevrizmami infrarenal'nogo otdela aorty i ishemicheskoi bolezn'iu serdtsa.

Presented herein are the results of treatment of 137 patients with infrarenal aneurysms of the abdominal portion of the aorta in a combination with ischaemic heart disease. Severity of lesions to the coronary bed and the risk of cardiac complications were assessed according to the SYNTAX score. Depending on severity of angina pectoris and the clinical course of infrarenal aortic aneurysms, we used different tactical approaches to operative treatment of patients. In a low risk of coronary complications, we performed isolated prosthetic repair or endoprosthetic reconstruction of the abdominal aorta. In patients with haemodynamically significant lesions of the coronary bed and positive non-invasive tests, the first stage consisted in coronary artery bypass grafting or stenting of coronary arteries taking into account the risk of cardiac complications according to the SYNTAX Score. The second stage consisted in prosthetic repair or endoprosthetic reconstruction of the abdominal aorta. The terms of the second stage differed and were determined by the course of abdominal aortic aneurysms. In symptomatic large aneurysms (more than 8 cm), prosthetic repair of the abdominal aorta was carried out within 2 weeks after previous stenting of coronary arteries. Simultaneous myocardial revascularization and abdominal aortic reconstruction were performed only in patients with severe angina pectoris, lesions of the trunk of the left coronary artery, three-vessel lesions of the coronary bed, high risk of cardiac complications according to the SYNTAX Score and a complicated or symptomatic course of an infrarenal aortic aneurysm. During implantation of stent grafts into the abdominal aorta there were neither lethal outcomes nor cardiac complications. In open operations, the 30-day mortality rate amounted to 2.2%, with the 5-year survival rate of 92%.

[Threatened paradoxical embolism, massive occlusion of pulmonary artery: risk stratification, treatment policy]. / Ugrozhaiushchaia paradoksal'naia émboliia, massivnaia okkliuziia legochnoi arterii: stratifikatsiia riska, taktika lecheniia.

Described in the article is a clinical case report regarding a male patient presenting with pulmonary thromboembolism, with a floating thrombus in the common femoral vein, in the right atrium, prolapsing into the right ventricle and propagating through a patent foramen ovale to the left atrium, thus being a threat of paradoxical embolism. The echocardiography findings demonstrated the following: mean pressure in the pulmonary artery amounting to 56 mm Hg, dilatation of the right atrium and right ventricle. The patient was subjected to simultaneous thrombectomy from the common femoral artery, from the right, left atria and pulmonary artery in conditions of cardioplegia, as well as ligation of the superficial femoral artery. The postoperative period proved uneventful. The patient was discharged on postoperative day 15, with pressure in the pulmonary artery amounting to 38 mm Hg. Besides, analysed herein are the contemporary literature data, clinical guidelines, and opinions of experts concerning treatment policy in this complex pathology.

Rapid use of resources as a basis of the Heracleum sosnowskyi invasive syndrome.

The functional properties of the invasive Heracleum sosnowskyi were compared with those of the native Heracleum sibiricum. The leaf and root traits, as well as those of a whole plant and of the mycorrhiza formation, were studied. H. sosnowskyi can fulfill the high-productivity potential only under the optimum availability of resources (especially water), while it is poorly adapted to maintain a high physiological activity under the unfavorable soil conditions. An important component of the H. sosnowskyi invasiveness is an ability to utilize rapidly resources in both the above- and underground areas at the optimum conditions.

Comparative analysis of genomes of tick-borne encephalitis virus strains isolated from mosquitoes and ticks.

The tick-borne encephalitis virus (TBEV) strain Lazo MP36 was isolated from the pool of mosquitoes Aedes vexans collected in Lazo region of Khabarovsk territory in August 2014. Phylogenetic analysis of the strain Lazo MP36 complete genome (GenBank accession number KT001073) revealed its correspondence to the TBEV Far Eastern subtype and differences from the following strains: 1) from ticks Ixodes persulcatus P. Schulze, 1930 [vaccine strain 205 (JX498939) and strains Khekhtzir 1230 (KF880805), Chichagovka (KP844724), Birobidzhan 1354 (KF880805) isolated in 2012-2013]; 2) from mosquitoes [strain Malyshevo (KJ744034) isolated in 1978 from Aedes vexans nipponii in Khabarovsk territory; strain Sakhalin 6-11 isolated from the pool of mosquitoes in 2011 (KF826916)]; 3) from human brain [vaccine strain Sofjin (JN229223), Glubinnoe/2004(DQ862460). Kavalerovo (DQ862460), Svetlogorie (DQ862460)]. The fusion peptide necessary for flavivirus entry to cells of the three TBEV strains isolated from mosquitoes (Lazo MP36, Malyshevo and Sakhalin 6-11) has the canonical structure 98-DRGWGNHCGLFGKGSI-113 for the tick-borne flaviviruses. Amino acid transition H104G typical for the mosquito-borne flaviviruses was not found. Structures of 5'- and 3'-untranslated (UTR) regions of the TBEV strains from mosquitoes were 85-98% homologous to the TBEV strains of all subtypes without recombination with mosquito-borne flaviviruses found in the Far East of Russia. Secondary structures of 5'- and 3'-UTR as well as cyclization sequences (CS) of types a and B are highly homologous for all TBEV isolates independently of the biological hosts and vectors. similarity of the genomes of the TBEV isolates from mosquitoes, ticks and patients as well as pathogenicity of the isolates for new-borne laboratory mice and tissue cultures might suggest a possible role of mosquitoes in the TBEV circulation in natural foci as an accidental or additional virus carrier.

Genetic variability of Rickettsia spp. in Ixodes persulcatus ticks from continental and island areas of the Russian Far East.

Rickettsia spp. are intracellular Gram-negative bacteria transmitted by arthropods. Two potentially pathogenic rickettsiae, Candidatus Rickettsia tarasevichiae and Rickettsia helvetica, have been found in unfed adult Ixodes persulcatus ticks. The aim of this study was to assess the prevalence and genetic variability of Rickettsia spp. in I. persulcatus ticks collected from different locations in the Russian Far East. In total, 604 adult I. persulcatus ticks collected from four sites in the Khabarovsk Territory (continental area) and one site in Sakhalin Island were examined for the presence of Rickettsia spp. by real-time PCR. Nested PCR with species-specific primers and sequencing were used for genotyping of revealed rickettsiae. The overall prevalence of Rickettsia spp. in ticks collected in different sites varied from 67.9 to 90.7%. However, the proportion of different Rickettsia species observed in ticks from Sakhalin Island significantly differed from that in ticks from the Khabarovsk Territory. In Sakhalin Island, R. helvetica prevailed in examined ticks, while Candidatus R. tarasevichiae was predominant in the Khabarovsk Territory. For gltA and ompB gene fragments, the sequences obtained for Candidatus R. tarasevichiae from all studied sites were identical to each other and to the known sequences of this species. According to sequence analysis of gltA, оmpB and sca4 genes, R. helvetica isolates from Sakhalin Island and the Khabarovsk Territory were identical to each other, but they differed from R. helvetica from other regions and from those found in other tick species. For the first time, DNA of pathogenic Rickettsia heilongjiangensis was detected in I. persulcatus ticks in two sites from the Khabarovsk Territory. The gltA, ompA and оmpB gene sequences of R. heilongjiangensis were identical to or had solitary mismatches with the corresponding sequences of R. heilongjiangensis found in other tick species.

[Individual resistance card in health care for patients with urogenital diseases].

Currently, practical health care does not have a means to transfer patients health data when they change the place of residence and employment. In this regard, there was a need to develop a health-related instrument to accompany an individual when he/she changes the place of residence and work. The aim of the study was to develop an "individual resistance card" to use in health care for patients with diseases of the genitourinary system. MATERIALS AND METHODS: We developed an "individual resistance card" proposed to implement in the practice of health care, as an information document on the state of reactivity and resistance (health) of the organism in terms of urologic diseases. RESULTS: The degree (index) of relative organism resistance is calculated based on impaired individual reactivity and power (intensity) of the environmental pathogenic factors. Its application allows for significant improvement in the effectiveness of periodic health checks, primary and secondary prevention of diseases, because it takes into account both a primary (genotypic) and secondary (acquired) reactivity. CONCLUSION: The developed Card can be used to record the state of the organism reactivity and resistance regarding urologic diseases and monitor these indicators when the patients change the place of residence and employment. This e-card (in encrypted form) and paper versions may accompany the individuals throughout their lives and will be used for to effectively organize primary and secondary disease prevention by a general practitioner and an urologist.

Molecular-genetic and ultrastructural characteristics of 'Candidatus Ehrlichia khabarensis', a new member of the Ehrlichia genus.

Recently, a new Ehrlichia genetic variant, Ehrlichia sp. Khabarovsk, was identified in tissue samples of small mammals captured in the Russian Far East. To further characterize Ehrlichia sp. Khabarovsk, tissue homogenate from a naturally infected gray red-backed vole (Myodes rufocanus) was passaged three times in newborn laboratory mice. Using nested PCR Ehrlichia sp. Khabarovsk DNA was detected in tissue samples from infected mice at 1-4 weeks post inoculation. Electron microscopic examination revealed morulae containing gram-negative bacterial cells in monocytes of mouse spleen and liver. The size and ultrastructure of these cells corresponded to those described previously and allowed us to identify the bacteria as Ehrlichia sp. The comparison of ehrlichial 16S rRNA, groEL and gltA genes and putative GroEL and GltA amino acid sequences has demonstrated that Ehrlichia sp. Khabarovsk, like Ehrlichia ruminantium, is more distant from all other Ehrlichia species than these species are between themselves. Phylogenetic analysis has shown that Ehrlichia sp. Khabarovsk belongs to the clade formed by Ehrlichia spp. but clusters separately from other Ehrlichia species and genetic variants. These data indicate that Ehrlichia sp. Khabarovsk can be considered as a new candidate species. We propose to designate it as 'Candidatus Ehrlichia khabarensis' according to the territory where this species was found.

Diabetes risks and health literacy in southern African American and Latino women.

Minority women experience health disparities, especially related to diabetes. The purpose of this article is to examine diabetes risk in minority women. A survey design was used to recruit 52 African Americans (AA) and 48 Latina women. Participants described their health, health behaviors, and health literacy. Blood pressure and body mass index were measured. AA women had more diabetes risks than Latinas, and older women had more risks than younger women. All of the women had low health literacy. Women with higher numbers of diabetes risks had lower health literacy. Findings can be used to develop diabetes prevention and education programs.

[Revascularization of the myocardium and kidneys in patients with combined atherosclerotic lesions of coronary and renal arteries].

The study included a total of 109 patients presenting with combined atherosclerotic lesions of coronary and renal arteries. Depending on severity of angina pectoris, the patients were subdivided into two groups. Group One consisted of patients subjected to revascularization of the myocardium and kidneys, and Group Two comprised those with a dominating clinical picture of vasorenal hypertension syndrome and undergoing surgery on renal arteries alone. Combined revascularizations were carried out in 31 patients. Of these, five underwent single-stage endovascular interventions on coronary and renal arteries. Isolated interventions were performed in 78 patients. Selectivity of revascularisations of vascular basins was determined first of all by the degree of coronary impairments, arterial hypertension, and the presence of chronic renal failure. No cases of hospital lethality were registered. The 10-year survival rate after renal revascularization amounted to 80.1%, after combined operations to 90.9%. In the immediate postoperative period improvement following isolated renal revascularization was achieved in 62 (86.1%) patients, after isolated coronary artery bypass grafting and combined operation - in all patients. The long-term outcomes turned out to be better after combined operations (80.0%) as compared to those after isolated operations on renal arteries (70.3%).

Genetic variability of Babesia parasites in Haemaphysalis spp. and Ixodes persulcatus ticks in the Baikal region and Far East of Russia.

To study Babesia diversity in Ixodid ticks in Russia, Ixodes persulcatus, Haemaphysalis japonica, Haemaphysalisconcinna, Dermacentor silvarum, and Dermacentor nuttalli ticks collected in the Far East and Baikal region were assayed for the presence of Babesia spp. using nested PCR. In total, Babesia DNA was detected in 30 of the 1125 (2.7%) I. persulcatus, 17 of the 573 (3.0%) H. concinna, and 12 of the 543 (2.2%) H. japonica but was undetectable in any of the 294 analyzed Dermacentor spp. Partial 18S rRNA gene sequences were determined for all of the positive samples. Among the positive ticks, nine I. persulcatus were infected by Babesia microti 'US'-type, five I. persulcatus were infected by Babesia divergens-like parasites, and 11 I. persulcatus were infected by Babesia venatorum. For all three of these species, the determined 18S rRNA gene sequences were identical to those of the Babesia genetic variants found previously in I. persulcatus in Russia. In addition, five I. persulcatus from the Baikal region and all of the positive Haemaphysalis spp. ticks carried 13 different sequence variants of Babesia sensu stricto belonging to distinct phylogenetic clusters. Babesia spp. from 29 ticks of different species collected in distinct locations belonged to the cluster of cattle and ovine parasites (Babesia crassa, Babesiamajor, Babesiamotasi, Babesiabigemina, etc.). Babesia spp. from four H. japonica ticks in the Far East belonged to the cluster formed by parasites of carnivores. One more Babesia sequence variant detected in an I. persulcatus tick from the Baikal region belonged to the cluster formed by parasites of cattle and wild cervids (B. divergens, Babesiacapreoli, B. venatorum, Babesiaodocoilei, etc.).

[Neurosis and genetic theory of etiology and pathogenesis of ulcer disease].

Based on the analysis of literature data and our own research, we have developed the original concept of etiology and pathogenesis of peptic ulcer disease. An analysis of the literature shows that none of the theories of pathogenesis of peptic ulcer disease does not cover the full diversity of the involved functions and their shifts, which lead to the development of ulcers in the stomach and the duodenum. Our neurogenic-genetic theory of etiology and pathogenesis of gastric ulcer and duodenal ulcer very best explains the cause-and-effect relationships in the patient peptic ulcer, allowing options for predominance in one or the other case factors of neurosis or genetic factors. However, it is clear that the only other: combination of neurogenic factor with genetically modified reactivity of gastroduodenal system (the presence of the target organ) cause the chronicity of the sores. The theory of peptic ulcer disease related to psychosomatic pathologies allows us to develop effective schema therapy, including drugs with psychocorrective action. On the basis of our theory of the role of Helicobacter pylori infection is treated as a pathogenetic factor in the development of peptic ulcer disease.

[Genetic variability of anaplasmataceae bacteria determined in Haemaphysalis spp. and Dermacentor sp. ticks in the territory of the Russian Far East].

Totally 484 Haemaphysalis japonica, 359 Haemaphysalis concinna and 221 Dermacentor silvarumn collected in Amur region and Khabarovsk Territory of the Russian Far East were examined on the presence of Anaplasmataceae bacteria using nested PCR. All positive samples were characterized by analysis of the 16S rRNA gene and/or groESL operone nucleotide sequences. Forty nine H. japonica and three H. concinna were shown to contain DNA of two new Ehrlichia genetic variants. These genetic variants on the basis of the 16S rRNA gene and groESL operone nucleotide sequences analysis were most closely related to Ehrlichia spp. revealed in Haemaphysalis spp. ticks in Japan. Four H. concinna from Amur region were shown to contain DNA of a new Anaplasma bovis genetic variant, which corresponded to A. bovis genetic variant revealed in a red gray-backed vole and a Siberian chipmunk from the Far East. Three H. concinna and nine D. silvarum contained DNA of non-typical bacteria which can't be attributed to any Anaplasmataceae genera based on the determined sequences of the 16S rRNA gene fragments. The revealed non-typical bacteria on the basis of 16S rRNA gene sequences significantly differed from each other and didn't form a separate genetic group.

[Actual problems of hemorrhagic fever with renal syndrome].

From 2000 to 2011 85 600 cases of hemorrhagic fever with renal syndrome (HFRS) were registered in Russian Federation. Epidemically active foci of HFRS infection are located generally in temperate latitudes of the European part and the Far East. In the Far East regions whose fraction of all the HFRS disease cases in Russia is around 2%, the causative agents of the infection are Hantaan, Amur, Seoul hantaviruses, the natural reservoir for those are striped field mouse, Korean field mouse and brown rat. In the European part of Russia the causative agent of the infection are Puumala hantavirus as well as 2 genetic subtypes of Dobrava virus, the main reservoirs of those in the nature are bank vole, striped field mouse and Black Sea field mouse, respectively. 9 strain of Puumala and 10 strains of Dobrava virus were isolated. Based on sequencing of Dobrava virus strains significant differences were detected between Dobrava virus strains isolated from Black Sea field mouse from Sochi and striped field mouse from Lipetsk Region. Cultural inactivated vaccine against HFRS was developed and completed preclinical trials.

Examining the association of health literacy and health behaviors in African American older adults: does health literacy affect adherence to antihypertensive regimens?

Health literacy is the degree to which individuals have the capacity to obtain, process, and understand the health information needed to make appropriate health decisions. The health behaviors of African American adults with inadequate health literacy skills affect their health outcomes. This study examined the association of health literacy and adherence behaviors in African American older adults (N = 121) with hypertension using a descriptive correlational design. Health literacy was measured using the Rapid Estimate of Adult Literacy in Medicine survey, and adherence was measured using the Hill-Bone Compliance Scale. Most of the participants were functioning with inadequate health literacy. No statistically significant association was found between health literacy and adherence, but regression analysis showed that age and health status significantly predicted adherence: Those who were younger and reported poor or fair health status were less likely to adhere to treatment.