[Atrial Fibrillation in Patients on Dialysis Therapy: Epidemiology, Prognosis and Choice of Anticoagulant Therapy].

The review presents data on the prevalence of atrial fibrillation in patients on dialysis therapy. It is shown that dialysis-dependent patients with non-valve atrial fibrillation prognosis is extremely unfavorable, significantly increased risk of death due to both ischemic and hemorrhagic complications. Scales to assess the risk of thromboembolic and hemorrhagic complications in patients with atrial fibrillation on program dialysis are not validated. The lack of data from randomized clinical trials makes it much more difficult to choose anticoagulant therapy in patients with terminal stage of chronic kidney disease on dialysis who have undergone kidney transplantation. Therefore, the need for anticoagulant therapy and the choice of drugs in patients in this category should be made on the basis of a personalized multidisciplinary approach, taking into account comorbid pathology and the patient's preferences.

Performance of the GenoType® MTBDRPlus assay in routine settings: a multicenter study.

Former Soviet Union countries including the Baltic States (Latvia, Lithuania, and Estonia) are hot spots for an emerging epidemic of drug resistant tuberculosis (TB). As a part of the development of a co-ordinated network of centers for diagnostic trials across Eastern Europe we conducted a retrospective multicenter analysis of the performance of the GenoType® MTBDRPlus assay for TB identification and susceptibility to isoniazid (INH) and rifampicin (RIF) in routine settings. A total of 1,045 primary samples, 1045 TB cultures derived from these specimens and 306 separate M. tuberculosis isolates tested in 2007-2010 at four participating sites (Tartu, Estonia; Riga, Latvia; Vilnius, Lithuania; and Samara, Russian Federation) were included in the analysis. The pooled sensitivity and specificity values for RIF and INH were 95.3% and 95.5%, 89.9 and 87.1%, respectively; there were no statistically significant variations in performance across sites. The proportion of multidrug resistant (MDR) strains in the collections ranged from 21.8% (in Estonia) to 55.9% (in Russia). In a routine non-trial context, the assay reliably detected both rifampicin and isoniazid resistance. The absence of statistically significant differences between sites suggested that the comparable performance obtained using these assays has helped demonstrate the formation of a successful diagnostic trial network.

Evaluation of two molecular assays for rapid detection of mycobacterium tuberculosis resistance to fluoroquinolones in high-tuberculosis and -multidrug-resistance Settings.

The Russian Federation is a high-tuberculosis (TB)-burden country with high rates of drug resistance, including multidrug and extensive drug resistance to TB (M/XDRTB). Rapid diagnosis of resistance to fluoroquinolones (FQs) using molecular assays is essential for the implementation of appropriate drug regimens and prevention of the transmission of XDR strains. A total of 51 individual MDRTB strains were tested by pyrosequencing of the quinolone resistance determining region of the gyrA gene and the GenoType MTBDRsl assay (Hain Lifescience, GmbH, Nehren, Germany), and the results were evaluated against those obtained by phenotypic drug susceptibility testing (DST). Mutations were detected in 25 (78.1%) FQ-resistant strains, with the majority of mutations (n = 19 [73.0%]) found in codon 94 of the gyrA gene; the novel mutation 1457 Câ†’Τ was found in the gyrB gene. Three mixed allelic variants were detected, which is a well-known phenomenon in areas with high TB and drug-resistant TB rates. The sensitivity and specificity of pyrosequencing (86.2 and 100%, respectively) and MTBDRsl (86.2 and 100%, respectively) were high; however, the results for 5.9% of the analyzed strains were unreadable when MTBDRsl was used. The MTBDRsl and pyrosequencing assays offer a rapid and accurate means for diagnosing resistance to FQs in high-TB-burden areas.

[Use of automated bactec MGIT 960 system in the diagnosis of resistance to reserve drugs agents in Samara].

The paper gives the results of a demonstration project to introduce a test for drug sensitivity to second-line antituberculous agents for patients with multidrug-resistant (MDR) tuberculosis at a routine large Russian laboratory. Two hundred and thirty MDR isolates were examined; of them 8.7% had extreme drug resistance. The cost of this test was estimated to be US $ 33.4. The introduction of this test is possible and essential for the precise and timely choice of antituberculous therapy for patients with MDR tuberculosis.

[Comprehensive diagnosis of cancer of the ovaries]. / Kompleksnaia diagnostika raka iachnikov.

Combined examination of 96 patients with different gynecological diseases included methods of ultrasound tomography, scintigraphy of the small pelvis with 99mTc-pyrophosphate, immunoscintigraphy and radioimmunoassay for determination of the blood level of CA 125. New diagnostic methods for ovarian cancer using 131I labeled monoclonal antibodies and an algorithm for data processing were developed. Of 96 patients 39 had ovarian cancer, 6 patients--uterine tumors, and 51 patients (controls) with nontumorous and benign lesions of the ovaries and uterus. The diagnostic effectiveness of these methods was determined by the indices of sensitivity, specificity and accuracy. The radioimmunoassay for determination of CA 125 possessed the highest sensitivity, ultrasound tomography showed the highest specificity and accuracy. Immunoscintigraphy with Imacis-2 was shown to possess the highest diagnostic effectiveness and unique informative value. An optimum algorithm for the use of the above methods in patients with suspected ovarian cancer was proposed on the basis of these investigations.

[Study of the DNA structure of peripheral blood leukocytes, proliferating lymphoid and tumor cells according to the rate of alkaline denaturation of DNA lysates]. / Izuchenie struktury DNK leikotsitov perifericheskoi krovi, proliferiruiushchikh limfoidnykh i opukholevykh kletok po skorosti shchelochnoi denaturatsii DNK lizatov.

Direct fluorometry was used to identify quantitative differences in the DNA structure of human peripheral blood leukocytes and proliferating lymphoid cells. The differences should be taken into account in the study of varied damaging actions.

[Antiproliferative action of 5'-S-isobutyladenosine in vitro and in vivo on normal and neoplastic mouse cells]. / Antiproliferativnoe deistvie 5'-S-izobutiladenozina in vitro i in vivo na normal'nye i opukholevye kletki myshei.

Antiproliferative activity of 5'-deoxy-5'-S-isobutylthioadenosine (SIBA) was studied in mouse tumor and medullary cells in vitro and in vivo. Essential differences were found in the antiproliferative action of SIBA on medullary and tumor cells in vivo and in vitro. It was shown that in vitro SIBA drastically inhibited DNA synthesis (by more than 80-90%) in all cells under test, whereas in vivo it stimulated 3H-thymidine incorporation into DNA of the ascites tumor cells and medullary cells of mice with lymphoma NK/Ly.

[Follow-up results of reconstructing the knee joint with ligaments of Lavasan (author's transl)]. / Spätresultate der Rekonstruktion des Bandapparates des Kniegelenks mit Lawsan.

Recommendation of synthetic material for reconstructing the knee joint ligaments. 15 years experience in 262 patients (sportsmen, ballet dancers, circus artistis,. The Lavasan implant was used in isolated as well as in combined injuries of the ligaments. The long-term results (13 years) yielded satisfactory results in 91%.