[Preponderance of Mycobacterium tuberculosis strains of the family Beijing and risk factors of their transmission in the Samara Region].

Current molecular and epidemiological studies could reveal individual families of Mycobacterium tuberculosis strains. The purpose of the present study was to reveal the spread of Mycobacterium tuberculosis strains of the family Beijing in the Samara Region and to define risk factors for their transmission. This was a cross-sectional populational molecular epidemiological study that showed that the Beijing genotype prevailed among the obtained isolates (66.6%; 586/880) and it was encountered among convicts and young persons (RR 1.3; 95% CI 1.2-1.5 and RR 1.2; 95% CI 1.0-1.3, respectively), which is indicative of active and recent transmission. Multifactorial analysis indicated that male sex (OR 1.5; 95% CI 1.1-1.9), younger age (OR 1.3; 95% CI 1.1-1.7), homelessness (OR 5.6; 95% CI 1.1-6.3), and prior or current confinement (OR 2.0; 95 CI 1.5-2.7) were substantially associated with the risk of contamination with the strain of the Beijung family. Drug resistance, including multidrug resistance, was twice higher among the strains of this family.

Social factors influencing hospital utilisation by tuberculosis patients in the Russian Federation: analysis of routinely collected data.

OBJECTIVE: To establish whether admissions, discharges and hospital utilisation for tuberculosis (TB) in Russia are independent of sex, age, disability and employment status. STUDY POPULATION AND METHODS: Analysis of hospital admissions, discharges and in-patient utilisation using routinely collected data in Samara Region of the Russian Federation. RESULTS: Male, unemployed and disabled adults were significantly more likely to be hospitalised (P < 0.001). The unemployed and pensioners were more likely to have multiple admissions. Unemployed adults were more likely to have longer average lengths of stay per admission (P < 0.001), with a cumulative length of stay for unemployed and disabled adults significantly greater than for employed adults and adults with no disability. Interruption of hospital care was significantly more frequent in male, disabled and unemployed patients (P < 0.001). CONCLUSIONS: Socio-economic factors influence hospital admission patterns and the length of stay for patients when hospitalised, as the providers of TB services attempt to mitigate the lack of social care provision for patients. For the WHO DOTS strategy to be effectively implemented and sustained in the Russian Federation health system, social sector linkage issues need to be addressed.

[Analysis of risk factors of the occurrence of drug resistance in patients with tuberculosis from civil and penitentiary sectors in the Samara Region].

The true prevalence rates of multidrug-resistant tuberculosis (MDRT) are unknown for most regions of Russia. This study was conducted in the Samara Region that differs from other regions in the rapid spread of HIV infection. The purpose of this study was to determine the primary and acquired resistance of Mycobacterium tuberculosis (MBT) to first-line antituberculous drugs in patients from civil and penitentiary sectors and to reveal risk factors of drug resistance of MBT. Six hundred patients (309 civilians and 291 prisoners who had been bacteriologically diagnosed as having tuberculosis. The authors have established the following:--in new cases, primary drug resistance is as follows: to isoniazid [38.9% (95% CI, 31.3-36.9%)], to rifampicin [25.9% (95% CI, 19.4-33.4%)] and to MDRT [23.0% (95% CI, 16.7-30.3%)];--in prisoners, the primary resistance of MBT was statistically more significant than in civilians;--male sex, in adequate prior or current treatment for tuberculosis for more than 4 weeks, the presence of fibrocavernous tuberculosis and previous prison stay are essential risk factors of the development of resistance of MBT to both any first-line drug and MDRT;--HIV infection is unassociated with resistance.

[An analysis of cedar of Lebanon (Cedrus libani A. Rich.) pollen grain development in cultural plantings]. / Analiz razvitiia pyl'tsevogo zerna kedra livanskogo (Cedrus libani A. Rich.) v kul'turnykh nasazhdeniiakh

A cytological study of the Cedrus libani mature pollen from 3 culture areas (Italy, France, USSR) has shown that 69-71% of pollen grains have two-celled protallium and antheridial cell. About 5% of pollen grains are characterized by accelerated of delayed development, otherwise apparently normal. The pollen sterility (up to 30% of grains) is due to the abortive spore development. Anomalous cenocyte and multinuclear pollen grains were found thus suggesting that multicellular haploid structures capable of further growth and development may arise in the course of natural anther development.

[The clinical efficacy of treating patients with nonspecific lung diseases using low-energy laser irradiation and intrapulmonary drug administration]. / Klinicheskaia éffektivnost' lecheniia bol'nykh nespetsificheskimi zabolevaniiami legkikh s primeneniem nizkoénergeticheskogo lazernogo oblucheniia i intrapul'monal'nogo vvedeniia lekarstvennykh veshchestv.

Intrapulmonary administration of glucocorticosteroids and antibiotics combined with low-energy laser radiation was employed in the treatment of patients with infection-dependent bronchial asthma in the phase of exacerbation and frequent asphyxia attacks, long medical history and of patients with lung abscesses. The purpose of the work was to study and compare the clinical effectiveness of the method in the gravest group of patients suffering from nonspecific pulmonary diseases: suppurative (acute lung abscess) and infectious allergic (infection-dependent bronchial asthma of medium gravity with frequent attacks, long medical history, tendency towards aggravation of the status and low efficacy of broncholytics). The results of the treatment and follow-up have shown that the use of the combined treatment suggested is most optimal in patients with acute lung abscesses (the percentage of the cured is 94.1). In patients with infection-dependent bronchial asthma, the use of laser therapy combined with intrapulmonary administration of steroids also noticeably improved the clinical, functional and immunological characteristics, prolonged the phase of remission.

[The clinico-pathogenetic validation and efficacy of using low-energy laser irradiation and glucocorticoids in treating bronchial asthma patients]. / Kliniko-patogeneticheskoe obosnovanie i éffektivnost' primeneniia nizkoénergeticheskogo lazernogo oblucheniia i gliukokortikoidov pri lechenii bol'nykh bronkhial'noi astmoi.

Intrapulmonary administration of glucocorticoids and low-energy laser radiation were used in the treatment of infection-dependent bronchial asthma in the phase of exacerbation. To estimate the efficacy of the combined method suggested, the parameters of external respiration, cellular, humoral and local immunity were determined, the provocation inhalation tests with acetylcholine and histamine and exercise tests were performed. The results of the treatment and subsequent follow-up data have shown that the combined use of local (endolymphatic) administration of steroids makes it possible to reduce immunological disorders, to decrease bronchial reactivity, to prolong the disease remission.

[Classification approach to prognostication of the severity of bronchial asthma]. / Klassifiktsionnyi podkhod v prognizirovanii tiazhesti techeniia bronkhial'noi astmy.

To define the severity of bronchial asthma, to predict its subsequent course, and to prescribe adequate glucocorticosteroid therapy, a mathematical model based on the cluster analysis was used. The authors' algorithm of the classification of bronchial asthma was based on the cluster analysis was used. The authors' algorithm of the classification of bronchial asthma was based on the mean distance value between the objects characterizing patients' status and hyperspatial signs. Each patient was described using a set of 15 clinical, functional, and immunological indices which had a meaning of signs describing the objects. Three clusters corresponding to the groups identified a priori up to two patients were formed to make the classification by the algorithm proposed. The findings make it possible to efficiently analyze the baseline indices in a particular patient from his entrance into or highest relationship to a definite cluster. This may define the severity of bronchial obstruction and predict its progression.

[Assessment of total complement activity of blood plasma (serum) using reader for immunoenzyme analysis]. / Otsenka obshchei komplementarnoi aktivnosti plazmy (syvorotki) krovi na ridere dlia immunofermentnogo analiza.

A method for instrumental assessment of the total complementary activity of human blood plasma (serum) by the classical and alternative activation is proposed. The test is carried out by the micromethod in round-bottom 96-well plates for immunological tests. The results are read by automated analyzer for enzyme immunoassay recording at 405 nm wavelength.

[Immune system cells as mediators in the reaction of other body systems to stress exposure]. / Kletki immunnoi sistemy kak posredniki v reaktsii drugikh sistem organizma na stressornoe vozdeistvie.

This paper first details an acute reaction of mice to the administered syngenic and allogenic live splenocytes from the animals exposed to great emergency. The authors have called it "nonspecific immunogenic shock" as its stages and manifestations which are characteristic of shock are caused only by lymphocytes, but associated with any specific exposure. The most common sequela of nonspecific immunogenic shock may be animal's death within minutes or first days after administration of splenocytes. In this case, marked cataracts (generally after death, but occasionally in life) appear both in recipients and stress-exposed donors. The ability of splenocytes activated by stress in donors to cause sudden or delayed death of most recipients makes the author give the second term of "death transfer" to nonspecific immunogenic shock.

[Determination of circulating immune complexes by immunoenzyme method]. / Opredelenie tsirkuliruiushchikh immunnykh kompleksov metodom immunofermentnogo analiza.

Enzyme immunoassay is proposed to be used for measuring the content of circulating immune complexes (CIC) in human blood serum. S. aureus protein in a concentration of 1 to 5 micrograms/ml optimal for the sensitization of plates is used as the first sandwich layer. The method permits registration of CICs formed by immunoglobulins of different classes. Investigations of the blood sera of donors and cancer patients by the proposed method and by other methods (V. Haskova et al. and M. Digeon et al.) to assess complex formation showed a good correlation of the results of all measurements.

[Development of hospital-substituting forms of medical care in the Samara region]. / Razvitie statsionarzameshchaiushchikh form meditsinskoi pomoshchi naseleniiu Samarskoi oblasti.

Development of hospital-substituting forms of medical care in the Samara region is discussed, 13% of patients treated at hospitals were rendered medical care through hospital-substituting institutions, which resulted in economy of 137 million roubles. The authors make their suggestions on optimizing statistical forms of files and records to be used in registration of medical care at day-time hospitals.

[Treatment of acute experimental diphtheria toxemia by immunohemosorption]. / Lechenie éksperimental'noi ostroi difteriinoi toksemii metodom immunogemosorbtsii.

The antitoxic antidiphtheric immunosorbent DATs was tested in experiments on mice and guinea-pigs using the model of acute diphtheric toxemia. In extracorporeal connecting with the circulation system of the animals the sorbent effectively bound and eliminated from the circulation molecules of diphtheric toxin and antitoxin, reduced significantly their levels in the blood after hemoperfusion. The effectiveness of the immunosorbent DATs was confirmed when it saved the ginea-pigs after injection of lethal toxin doses.

[Hemosorption in serotherapy (serosorption) in experimental acute diphtheric toxemia with the use of affinity sorbents]. / Gemosorbtsiia na fone seroterapii (serosorbtsiia) pri éksperimental'noi ostroi difteriinoi toksemii s ispol'zovaniem affinnykh sorbentov.

In modeling acute diphtheric toxemia in guinea pigs, the authors propose to perform hemosorption using selective sorbents under continuous introduction of antitoxic immune sera into extracorporeal contour in front of sorption column. Combination of hemosorption with serotherapy in the same time interval may be denoted as serosorption. As specific sorbents, affine preparations imasorb A-700 and Imasorb G-700 were used. They selectively eliminate from the blood flow CIC produced by diphtheric toxin (anatoxin) and antitoxic rabbit and horse antibodies. Changes in the titers of the diphtheric toxin (anatoxin) and CIC in blood evidence for efficiency of selective sorbents were confirmed by immunohistochemical analysis of the preparations' granules after hemoperfusion.

Seasonal variation and hospital utilization for tuberculosis in Russia: hospitals as social care institutions.

BACKGROUND: Clinical management of tuberculosis in Russia involves lengthy hospitalizations, in contrast to the recommended strategy advocated by the World Health Organization. METHODS: We used Fourier transform, spectral analysis and Student's t-test to analyse periodic and seasonal variations in admission and discharge rates for tuberculosis hospitalizations in 1999-2002, using routinely captured data from the Samara Region, Russia. RESULTS: Hospital admissions in colder months were significantly higher than in warmer months. The mean monthly adjusted number of admissions in colder and warmer months for all adults was 413 and 372 (P < 0.01), for unemployed adults 218 and 198 (P < 0.02) and for pensioners 104 and 82 (P < 0.05). Hospital discharges varied seasonally. Maximum differences between admissions and discharges occurred in colder months and minimum differences were observed in warmer months. CONCLUSIONS: As hospitalizations of tuberculosis patients in colder months fulfil an important social need, shifts to ambulatory care must be carefully managed.

Barriers to sustainable tuberculosis control in the Russian Federation health system.

The Russian Federation has the eleventh highest tuberculosis burden in the world in terms of the total estimated number of new cases that occur each year. In 2003, 26% of the population was covered by the internationally recommended control strategy known as directly observed treatment (DOT) compared to an overall average of 61% among the 22 countries with the highest burden of tuberculosis. The Director-General of WHO has identified two necessary starting points for the scaling-up of interventions to control emerging infectious diseases. These are a comprehensive engagement with the health system and a strengthening of the health system. The success of programmes aimed at controlling infectious diseases is often determined by constraints posed by the health system. We analyse and evaluate the impact of the arrangements for delivering tuberculosis services in the Russian Federation, drawing on detailed analyses of barriers and incentives created by the organizational structures, and financing and provider-payment systems. We demonstrate that the systems offer few incentives to improve the efficiency of services or the effectiveness of tuberculosis control. Instead, the system encourages prolonged supervision through specialized outpatient departments in hospitals (known as dispensaries), multiple admissions to hospital and lengthy hospitalization. The implementation, and expansion and sustainability of WHO-approved methods of tuberculosis control in the Russian Federation are unlikely to be realized under the prevailing system of service delivery. This is because implementation does not take into account the wider context of the health system. In order for the control programme to be sustainable, the health system will need to be changed to enable services to be reconfigured so that incentives are created to reward improvements in efficiency and outcomes.

[Determination of the glucose reserves in the water of the Rybinsk reservoir]. / Opredelenie zapasov gliukozy v vode Rybinskogo vodokhranilishcha.

The concentrations of glucose (Km + Sn) was determined by the method of Parson and Strickland in the water of the Rybinsk and Sheksna Reservoirs. It varied from 11 to 31 mcg C per litre and reached 380 mcg C per litre in swamp waters. The rate of glucose assimilation by the microflora varied from 0.02 to 0.56 mcg C per litre per hour and reached 5--7 mcg C per litre per hour in contaminated waters.