Comparative study of OMNIgene®â€¢SPUTUM reagent versus cold-chain for the transportation of sputum samples to GeneXpert®MTB/RIF testing sites in Malawi.

BACKGROUND: The study was conducted in a remote sputum sample collection sites and GeneXpert® MTB/RIF testing centers to detect Mycobacterium tuberculosis in Malawi. The main purpose of the study was to evaluate whether sputum samples stored and transported with OMNIgene®â€¢SPUTUM (OM-S) medium perform comparably to the routine cold-chain stored and transported samples for GeneXpert testing to detect Mycobacterium tuberculosis. METHODS: Two sputum samples from each of 362 tuberculosis suspects were randomly assigned to the OMNIgene treated (OM-S group) or the standard-of-care group (SOC; transported via cold chain). All specimens were tested at regional GeneXpert testing sites using the expectorated (raw) sputum protocol. Demographic, clinical, transport/storage and Xpert data were recorded for each specimen pair. Agreement between the SOC and OM-S groups' Xpert results was evaluated using Cohen's kappa analysis. RESULTS: Mean patient age was 42.3 years (range 2-79 years), 77% of patients were female, and 80% were HIV-positive. Mean transport/storage time was 6.7 days (range, 0-29 days). The rates of MTB positivity for the OM-S and SOC groups were comparable (11.8 and 11.2%, respectively), inter-test agreement was "very good" (κ = 0.97), and overall percent agreement was 99%. Two specimen pairs (both mucoid, one 13 days transport, one 1 day transport) had discordant Xpert results. CONCLUSION: OM-S-treated sputum specimens can undergo multi-day ambient-temperature storage as well as transport and yield Xpert results comparable to those of cold-chain-transported samples in Malawi.

[Pathological anatomy in A/H1N1 influenza].

Forty autopsy cases died from A/H1N1 influenza in Moscow, the Moscow Region, and Chita were analyzed. Major changes were found to develop in the trachea and lung. The lung showed the pattern of exudative and proliferative stages of diffuse alveolar lesion. In addition, the signs of viremia-associated infectious-toxic shock, as suggested by pronounced changes in the brain, kidneys, liver, spleen, adrenals, and lymph nodes were revealed. Bacterial bronchopneumonia was detected only in 20% of cases.

[Pathomorphology of the lung in severe influenza A/H1N1].

Thirty-five autopsy cases of influenza A/HIN1 in Moscow were analyzed. Primary pathological changes were found in the trachea and lung. The lung showed a pattern of the exudative and proliferative stages of diffuse alveolar damage. In addition, there were signs of infectious-toxic shock associated with viremia, as suggested by pronounced changes in the brain, kidneys, liver, spleen, adrenals, and lymph nodes. Bacterial bronchopneumonia was detected in only 20% of cases.

Complex electrooptic research of nano-particle parameters in colloids.

A research of some colloids has been carried out by means of dynamic light scattering, electrooptical and magnetooptical techniques. Intensity autocorrelation functions of scattered light have been compared to the relaxation curves of electrooptical effect for colloid particles of different shapes. The results of complex research confirm that the complicated character of light scattering by particles allows us to use the methods of birefringence and dichroism only formally when studying most colloid systems. Very thin nano-disperse structures are an exception to this rule. The investigation of polydispersity of some colloids was carried out by magnetooptical and two electrooptical techniques. Size distribution functions resulted from the different techniques agree. This justifies the suppositions about particle light scattering that are required for the use of the methods.

Evaluation of the Tuberculosis Infection Control Training Center, Tajikistan, 2014-2015.

SETTING: Training center on tuberculosis (TB) infection control (IC) for health care workers in the Central Asian Republics region. OBJECTIVE: To assess the effects of TB IC training courses conducted at the Tuberculosis Infection Control Training Center in Machiton, Tajikistan. DESIGN: Participants who participated in training (n = 89) during the first year of operation (April 2014-February 2015) were invited to participate in a post-training interview. RESULTS: Of the 89 participants, 84 (94%) completed the interview and expressed satisfaction with the training. Eighty (95%) participants reported meeting with workplace leadership to discuss the training. Of these, 69 (85%) reported discussing changes required to meet TB IC standards. Self-reported changes in TB IC practices at work facilities post training included the creation of TB IC committees, designation of a TB IC focal person, TB IC planning, policies to separate infectious patients in waiting rooms, provision of masks for infectious patients, development of cough etiquette policies, improved glove availability, hand hygiene programs, and TB IC posters in waiting rooms. CONCLUSIONS: Participant satisfaction and reported changes in TB IC activities illustrate the potential of these training courses to improve TB IC in the region. Future training courses may be tailored to specific audiences using a structured conceptual framework to impact administration, budgeting, and facilities management of TB IC practices.

[Organization and contents of the specialized surgical care in multiprofile military hospitals of the 1st level during counter-terrorist operations on the northern Caucasus (report V)].

The principle difference of the work of multiprofile military hospitals (MMH) of the Ist level during the armed conflicts on the Northern Caucasus, particularly during the second, was rendering specialized surgical care to the primary contingent of the wounded, evacuated during the nearest hours after a wound. The incoming flow to MMH of the 1st level - in connection with the primary entering of the wounded practically from a battle field - was characterized by severity (one third of the wounded had severe and extremely severe wounds) and the significant number of the wounded with multiple and combined injuries (up to 60% of the wounded). Effective treatment of the above-mentioned wounded can only be carried by specially trained surgeons in appropriately-equipped multiprofile medical hospitals. The rendered volume of specialized surgical care in MMH of the 1st level included the following operations: neurosurgical (2,4%), thoracoabdominal (19,8%), traumatologic (17,0%), angiosurgical (8,2%), special (otorhinolaryngologic, maxillofacial, ophthalmologic, urologic) - 17,7%, general surgery (35,4%). During the armed conflict of 1999-2002 due to the introduction of the early specialized surgical care concept three MMH of the 1st level in the advanced way executed 86,4 % of all complex operations in medical units and hospitals of the combat zone.

[Surgical care rendered to the wounded during the antiterrorist operations in the Northern Caucasus in the distant medical battalions of divisions. (Communication 3)].

Broad usage of helicopters for an evacuation of wounded from the battle orders and forward aid station directly to Multiprophyle Military Hospitals of 1-st level during armed conflicts on Northern Caucasus has essentially changed the purposes and nature of a medical care to wounded in Separate Medical Battalions (SMB) of divisions. The primary goal of SMB became valuable preparedness of wounded to an evacuation from the battle orders of a division, that was reached by moving out of the surgeons and anesthesiologists to regimental aid station and medical companies. For adding up during armed conflicts on Northern Caucasus of medico tactical conditions it was justified: 73% wounded, admitted in SMB with damages of minimal and mean severity and not required emergency operations, after rendering them of initial physician care were evacuated by helicopters to Multiprophyle Military Hospitals of 1-st level. The analysis of experience of three SMB in Armed conflict 1999-2002 has shown, that the measures of initial surgical care should appear only for saving life of injured under the specially designed indications and with observance of a number of the relevant technical features, directional on acceleration and decreasing of surgical operations severity.

[Surgical care rendered to the wounded in the antiterrorist operations on the Northern Caucasus: premedical and initial medical care in the combat zone (Report II)].

The analysis of organization and contents of the first aid, premedical and initial medical care rendered to the wounded in the armed conflicts on the Northern Caucasus (1994-1996, 1999-2002) was conducted. It was established that the first aid was rendered to the most casualties who needed it (65% in the first conflict and 79% in the second conflict). The mean terms of rendering the first aid in the second conflict as compared with the conflict of 1994-1996 were decreased from 29 +/- 2 min to 18 +/- min. The role of premedical care was minimal in both conflicts: it was rendered to 3% casualties only. The premedical care was rendered in those cases when the first aid appeared to be ineffective, had obvious defects or in the delay of further evacuation of the wounded. The initial medical care became the central type or pre-hospital care in the combat zone. It was rendered to 56% casualties in the first conflict and to 59% in the second conflict. The mean terms of initial medical care rendered in the second armed conflict were 1.5 +/- 0.2 h. They have considerably decreased as compare with the first conflict (2.5 +/- 0.4 h). The introduction of the physicians with initial surgery and intensive care training in the staffs of regimental medical companies was resulted in significant improvement of initial medical care quality. It provided the adequate preparedness of the wounded for aeromedical evacuation to multipurpose military hospitals of the first level.

[Principles of surgical care organization and structural characteristics of sanitary casualties in counter-terrorist operations in the Northern Caucasus (Report I)].

Two operational-and-tactical factors had the main influence on organization of the surgical care rendered to the casualties on the Northern Caucasus: the fulminant and maneuverable nature of combat operations at the beginning of both armed conflicts and rather small territory of war theatre. The main special features of organization of surgical care to the casualties were the use of Medical Squads of Special Purpose in the combat conditions and maximal approximation of the specialized surgical care to the wounded by echelonment of medical units and wide use of helicopter evacuation. The structure of sanitary losses was characterized by the increase in the frequency of mechanical traumas, thermal and combined injuries, by the high share of the casualties with head injuries. Besides the number of seriously wounded and critical casualties has increased.

TB across the globe (3). Tuberculosis in Russia.

This paper was presented in place of one that was to have been given by the late Professor A.G. Khomenko, Director of the Central Tuberculosis Research Institute, Moscow. Professor Khomenko had a long and distinguished career and with his death Russia has lost one of its finest and most active workers in the fight against TB.

[Anisotropic electric conductivity of bacterial suspensions induced by external electric field]. / Anizotropnaia élektroprovodnost' bakterial'nykh suspenzii, navedennaia vneshnim élektricheskim polem.

The anisotropy of electrical conductivity of suspensions of such bacteria, as E. coli, Serratia marcescens, Pseudomonas fluorescens induced by a sinusoidal external electric field and relaxation of the anisotropy after switching off the field were investigated. On the basis of the experimental relationships the anisotropy of electrical polarizability and coefficient of rotational diffusion of the cells were evaluated. The anisotropy of electrical polarizability and coefficient of the rotational diffusion obtained are in a good agreement with the available data of other methods.

[Study of the orientation of DNA molecules in an electrical field by anisotropy of electrical conductivity of their aqueous solution]. / Issledovanie orientatsii molekul DNK v élektricheskom pole po anizotropii élektroprovodnosti ikh vodnykh rastvorov.

Electro-conductive anisotropy of DNA solution caused by the molecular orientation in the external electric field was investigated. The dependence of a relative change of the conductivity of aqueous-salt DNA solution on the electric field in the amplitude range 0-700 V/cm and in the frequency range 100 Hz-10 kHz was studied. It was pointed out that the field thermal effect is an overcoming factor when the orientation of DNA molecules is investigated by field-free relaxation.

[Structure of an Escherichia coli bacterial suspension]. / Struktura bakterial'noi suspenzii Escherichia coli.

The structure of bacterial suspensions of Escherichia coli M-17 at the counting concentrations of the cells 10(7), 10(8), 10(9) i/ml and in the temperature range of (18-50) degrees C has been investigated by means of orientational conductometric, electron microscopic and UV-spectroscopic methods. On the basis of experimental relationships of the anisotropy of suspensions electric conductivity upon the intensity of a sinusoidal electric field and relaxation of anisotropy after switching off the field the function of the distribution of bacteria with respect to their sizes was evaluated at different temperatures and concentrations. The conductometric function of bacteria distribution is in a good agreement with the analogous function obtained with the help of the electron microscope. In accordance with the functions the suspension of E. coli contained three kinds of cells: high electronic density, low electronic density bacteria and bacteria aggregates. Relative amounts of every kind of bacteria depended on temperature and concentration of cells. The minimum of bacteria aggregates and maximum of low electronic density cells were obtained in the temperature range of (32-42) degrees C. This fact could be explained by the activation of the transport membrane systems in this temperature range. This hypothesis was confirmed by the UV-spectroscopic method.

[Circahoral rhythms of the skin biopotentials outside of digestion and their relationship to the periodic motility of the gastrointestinal tract]. / Okolochasovye ritmy kozhnykh biopotentsialov vne pishchevareniia i ikh otnoshenie k periodicheskoi motorike zheludochno-kishechnogo trakta.

Circahoral rhythms of the skin surface potentials recorded simultaneously with periodic motor activity of stomach in 4 dogs and 7 healthy subjects revealed the rhythms to be an electrophysiological equivalent of the latter in dogs. A "migration" of the group potentials in a certain spatial-temporal sequence was observed among the leads. It corresponded to the cycles of periodic motor activity of the stomach in dogs. The circahoral rhythms are a major topic for research in humans, too.

[A method of thoracoscopic electrosurgical biopsy in the diagnosis of diffuse lung diseases]. / Metod torakoskopicheskoi élektrokhirurgicheskoi biopsii v diagnostike diffuznykh zabolevanii legkikh.

A new method of thoracoscopic electrosurgical biopsy proposed by the authors implies usage of a standard set of thoracoscopic appliances and a diathermic loop. The method warrants obtaining biopsy specimens of an adequate size from any site under visual control, provides reliable aero- and hemostasis.

[Potentials of infusion therapy in enhancing the detoxification effect of hemosorption in patients suffering from suppurative-septic complications of mechanical injury]. / Vozmozhnosti infuzionnoi terapii v usilenii detoksikatsionnogo éffekta gemosorbtsii u postradavshikh s gnoino-septicheskimi oslozhneniiami mekhanicheskoi travmy.

Under study was the application of microvasoplegia as a method of preoperative management in fulfilling hemosorption in patients with pyo-septic complications of a severe mechanical trauma. The method of infusion and medicamentous therapy used before hemosorption is described. Laboratory examinations of the enzyme toxemia level have shown pathogenetic grounds of the complex method of treatment. Positive clinical results were obtained.

[Hemosorption in the treatment of toxemia and septic conditions after severe mechanical trauma]. / Gemosorbtsiia v lechenii intoksikatsii i septicheskikh sostoianii posle tiazheloi mekhanicheskoi travmy.

Under study was the significance of hemosorption in complex therapy of patients with complications resulting from a severe mechanical trauma. Lethality was found to decrease from 68% to 45%. The results obtained allow the use of hemosorption to be recommended for the treatment of endogenous intoxication in patients with complications of a severe mechanical trauma.

[The role and place of surgical efforts in the medical evacuation support of the troops]. / Rol' i mesto khirurgicheskogo usileniia v lechebno-évakuatsionnom obespechenii voisk.

Considering the experience obtained by the collaborators of the Fuild Surgery Chair (Medical-Military Academy) there was suggested the following conception of using surgical strengthening in the Troops medical-and-evacuation security. By strengthening the battalion medical station with physician, including the surgeon the pre-medical care is rendered; in the case of evacuation delay the emergency measures of first aid are conducted. In the regiment medical station the surgical team renders the first medical aid in whole volume and emergency measures of qualified surgical aid respectively; in the leading medical institution the qualified and specialized emergency surgery as well as specialized medical aid in whole volume are rendered by specialized surgical group.

[Surgical care for the wounded in an armed conflict: the organization and support of first aid, prehospital and initial medical care (1)]. / Khirurgicheskaia pomoshch' ranenym v vooruzhennom konflikte: organizatsiia i soderzhanie pervoi, dovrachebnoi i pervoi vrachebnoi pomoshchi (soobshchenie pervoe).

The article is devoted to surgical care organization to the battle casualties in Northern Caucasus, analysis of size and structure of "sanitary losses" (wounded in actions), questions of rendering first aid, battalion medical specialist aid and initial physician care. Gunshot wounds prevailed (64.1%) in the structure of battle surgical casualties. The blunt traumas and non-gunshot injuries have made of 33.2%, burns--4.1%, frost-bites--1.3%. The efficiency of medical care in this armed conflict is investigated on the own experience and retrospective analysis of graduated care to the 1030 casualties. Significance of duly rendering of the first aid to battle casualties is shown: the morality in this group had made 1.3%. Among wounded, which the first aid did not appear, the morality was of 7.0%.

[The use of the principles of military field surgery in rendering medical care to the victims during catastrophes]. / Ispol'zovanie printsipov voenno-polevoi khirurgii pri okazanii meditsinskoi pomoshchi postradavshim vo vremia katastrof.

Despite the existing differences in medical care of war and catastrophe casualties it is possible to apply a variety of organizational and management principles of military medicine for the disaster medicine. The authors express the opinion that in case of big catastrophes the medical service could operate by means of rapid deployment units formed on the basis of territorial principle.