Vol 72, No 5 (2017)

The review presents the following division of the African natural foci province into districts: I. Upper Guinea natural focus region includes the following individual natural foci: I.1. Kazamans; I.2. North Guinea; I.3. Volta; I.4. Adamawa; I.5. Sao Tome. II. Central Africa: II.1. Southern Guinea; II.2. Katanga; II.3. Congo; II.4. Azande; II.5. Ruwenzori. III. South-Eastern Africa: III.1. Mafungabusi; III.2. Drakensberg; III.3. Comoros; III.4. Madagascar; III.5. Seychelles; III.6. Mascarenes. For each natural focus the article describes the characteristic landscapes and species list of fruit-bats (Chiroptera, Megachiroptera) which are natural reservoir for viruses belonging to Filoviridae family, the types of epidemic outbreaks and the intensity of filovirus circulation. Possible explanations of narrowness of filoviruses areal in comparison with fruit-bats areal in Africa are discussed.

 

Staphylococcus aureus clonal complex (СС) 30 are associated with hospital-acquired and community-associated invasive infections and may cause outbreaks of staphylococcal food-borne infections (SFI).  In recent years, severe SFI outbreaks caused by S. aureus CC30 in cohorts not linked to high-risk groups have been detected in Russia.

Aim: The aim of the study is to conduct a comparative genomic analysis of S. aureus strains B-7778 and B-7779 isolated during widespread SFI outbreak at the International Youth Forum Seliger in 2014, and S. aureus strains B-7738 and B-7739 isolated during widespread SFI outbreak among construction personnel in Saint Petersburg in 2013.

Methods: Seliger-2014 S. aureus cultures were screened by PCR and sequence typing. S. aureus strains B-7778 and B-7779 were isolated from clinic material and from food handlers, respectively. Draft genome sequencing and phylogenetic analysis of S. aureus strains B-7778 and B-7779 were carried out. The production of enterotoxin A was determined by the enzyme immunoassay.

Results: S. aureus strain B-7778 isolated from 38 patients and S. aureus strain B-7779 isolated from two food handlers at the Forum Seliger-2014 have identical nucleotide sequences, belong to spa-type t122 and sequence-type 30, and carry a set of toxin genes being responsible for SFI manifestations. The core-genome SNP typing has shown that S. aureus B-7738/ B-7739 (St. Petersburg, 2013) and S. aureus B-7778/ B-7779 (Seliger, 2014) belong to different clusters of S. aureus СС30 clade 3. S. aureus B-7778/ B-7779 not closely related with major clusters of S. aureus СС30. The production of enterotoxin A, SFI etiological factor, by S. aureus strains B-7738, B-7739, B-7778, and B-7779 has been confirmed.

Conclusion: The genomic analysis of SFI-associated S. aureus strains isolated in Russia has been conducted for the first time. Two different genetic clones of S. aureus СС30 which are able to cause severe SFI outbreaks in cohorts not linked to high-risk groups have been identified and characterized. SNP typing of Seliger-2014 S. aureus genomes has revealed their genetic specificity among known strains of S. aureus CC30. Identified genome sequences of SFI-associated strains will be used for further studies S. aureus clones circulating through the food chain in Russia.

Background: Tissue-engineered vascular grafts of small diameter have being widely used in coronary artery bypass grafting. However, the rate of settling of these grafts with endothelial cells is insufficient. Aims:

The aim of the study was to selucidate the adhesion of endothelial progenitor cells and mesenchymal stem cells to synthetic materials (polystyrol, polytetrafluoroethylene) preprocessed with extracellular matrix (gelatin, fibronectin, collagen) in vitro.

Materials and methods: For the study,the endothelial progenitor cells (EPC) were isolated from the peripheral blood of patients with ischemic heart disease, and mesenchymal stem cells (MSC) — from bone marrow of Wistar rats. Commercial monoclonal antibodies for flow- cytometry were used to determine the phenotype of EPC. To isolate the early and late EPC from mononuclear cells of peripheral blood, cells were raised for 8 and 16 days on a gelatin or fibronectin based substrate. The commercial kits for enzyme linked immunoassay were applied to assess levels of cytokine production and nitric oxide by early and late EPC conditioned by gelatin or fibronectin on the 8th and 16th days of growth. To conduct the study the MSC were isolated from bone marrow of rats. To determine the attachment of adherent fraction of nucleated bone marrow cells, cell morphology, the adipogenic and osteogenic differentiation were evaluated. To assess migration of MSC in real time within 24 hours on the device Cell-IQ, we used «closure/wound healing» test. The commercial kits for enzyme linked immunoassay were applied to assess levels of cytokine production and nitric oxide by MSC; and components of the extracellular matrix (fibronectin, collagen I and type IV) ― to assess the increased adhesion of MSC to the polytetrafluoroethylene. 

Results: The results demonstrated that endothelial progenitor cells adhere to both gelatin and fibronectin and confirmed the influence of these extracellular matrix components on the cytokine levels produced by early and late endothelial cells. The combination of fibronectin with type I or IV collagen or the combination of thereof promotes the adhesion to polytetrafluoroethylene and colonization of the graft.

Conclusions: Preprocessing of synthetic material (polystyrene, polytetrafluoroethylene) enhances adhesion and growth of EPC and MSC which can be implemented when creating tissue-engineered vascular grafts for small diameter coronary artery bypass grafting with specified conditions of settlement by the cells involved in neointima formation.

The core target of multifocal IOLs implantation is to provide advanced visual quality at different distances without spectacle or contact lenses that can be valuable when monofocal IOLs are implanted. Patients with monofocal IOLs need spectacles or contact lenses for the near and intermediate distance's vision. Multifocal intraocular lenses due to the optical part construction provide spectacle independence for patients in the postoperative period. The aim of this review was to analyze the modern approach to the several aspects of multifocal intraocular correction: spectacle independence, dysphotopsia, patient satisfaction. Patients’ questionnaire after surgery provides the data for evaluation of the quality of life, vision satisfaction at all range of distances on different levels of illumination, and patient activities of daily living. During the long period, a photic phenomenon (dysphotopsia) had been discussed in the literature as the principal reason for decrease of patients satisfaction with the treatment and lens explantation. Recently, high grade of spectacle independence and low risk of photic phenomena after modern multifocal IOLs implantation determine high-level patient satisfaction after cataract surgery. Multifocal intraocular correction is the effective technology for restoring passive accommodation that the wide range of the clinical studies proved. This review analyzes 33 studies (32 clinical studies and 1 metaanalisis) published in international peer-reviewed targeted titles.

Most of the abiotic environmental factors are electromagnetic in nature. Electromagnetic radiation from various artificial sources exerts a significant inf luence on living systems. It poses a problem of targeted application of electromagnetic waves in health care, ever yday life, and industr y. Recently, a fundamentally new direction in medicine has emerged: the use of low-power terahertz electromagnetic waves at the frequency of oscillation of active cellular metabolites (nitrogen oxide, molecular oxygen, etc.) for disease treatment and prevention. It has been demonstrated that if there is a match in frequency bet ween the emitted electromagnetic wave and the natural oscillation of the molecule, absorption occurs and this alters the amplitude of the molecular oscillation and modifies involvement of the molecule in the metabolic process. This fact is of great interest for biomedical technologies because cellular metabolites may significantly affect regional circulation, microcirculation, and blood rheology; prevent intravascular coagulation; provide anti-inf lammator y and analgesic effects; limit excessive lipid peroxidation and potentiate the antioxidant mechanism; activate cellular anti-stress mechanisms. Today,  terahertz electromagnetic radiation at the frequency of oscillation of nitric oxide, a universal cellular regulator y molecule, has been shown to be beneficial in the treatment of cardiovascular diseases, burns, polyneuropathy, regional pain syndrome, etc. This review summarizes clinical and experimental data on implementation of terahertz electromagnetic waves in medicine and presents our current understanding of the mechanisms of action of terahertz electromagnetic waves at the frequency of oscillation of active cellular metabolites on a living system at the molecular, cellular, tissue, and organ levels of organization.

Development of maternity and childhood protection service is one of the priorities of the Ministry of Health of the Russian Federation. The strategy for its development is included in the National plan of action for the benefit of children formulated according to the international documents on the rights of a child. The preservation of life and health of children under 5 years has been identified as an important strategic task for preserving life and health of the population as a whole. Tendencies of mortality in children under 5 years and infant mortality as a part of the data had been studied basing on the analysis of Federal State Statistics Service of the Russian Federation and World Bank data bases. It is shown that the reduction in mortality of children under 5 years occurred in all age periods. The level of infant mortality decreased significantly to the same extent due to neonatal and post-neonatal mortality. The leading causes for mortality in children under 5 years in general and infant mortality in particular are certain conditions originating in the perinatal period and congenital malformations which slow further reduction of the mortality in children in this age group. Significant reasons for death in children aged 1−4 years are injuries, poisonings, and oncologic diseases. The reserves of infant and child mortality reduction are found in implementation of prenatal and preimplantation diagnostics and «Prenatal consultation» organizational model; broader screening for congenital and hereditary metabolic diseases in the neonatal period including the most common nosological forms of rare (orphan) diseases; expansion of the National Vaccination Calendar; improvement of quality of prehospital medical care to children under the age of 1 year; further development of specialized, rehabilitative, and medical-social support.

Background: Pain in the lower back is an urgent health issue in industrialized countries. The dominant cause of pain in the lumbosacral spine is the degeneration of the inter vertebral discs (I VD). The total prosthetics I VD is a modern method of surgical treatment of I VD degenerative diseases, an alternative method of rigid stabilization.

Aim: To analyze the results of surgical inter vention (I VD prosthesis M6-L implantation) in patients with I VD degeneration of lumbar spine at the 6, 12, 24, and 36 months after the surger y.

Materials and methods: The study included 156 patients (92 men, 64 women) aged 23 to 45 years who under went a single-level discectomy with implantation of an artificial IVD prosthesis M6-L  at the bases of three neurosurgical centers. For dynamic assessment, clinical parameters (pain intensity from the visual analogue pain scale (VAS), quality of life according to the Oswestry index, subjective satisfaction with the result of surgical treatment on the Macnab scale) and instrumental data (amplitude of movements in the operated spinal-motor segment, degree of heterotopic ossification according to McAfeeSuchomel classification) were applied at 6, 12, 24, and 36 months after surger y.

Results: The mean value of the quality of life for the Oswestr y index before surger y was 40.2±6.9%, after ― 12.3±6.1% (t-test, p<0.001). The mean value of the level of pain according to VAS before surger y was 6.9±1.6 cm; after surger y ― 1.3±1.2 cm (t-test, p<0.001). The average range of motion in the operated segment at baseline was 36.8±2.6°, within 36 months after the operation increased up to 41.2±2.9°. During the entire period of obser vation the initial (13.4%) or moderate (10.2%) signs of heterotopic ossification were revealed. Conclusions: The use of prosthetic I VD M6-L can significantly reduce the level of pain, improve the life quality, and maintain the physiological range of motion in the operated spinal motion segment with a low level of adverse outcomes.

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