EPIDEMIOLOGICAL SITUATION ON CHOLERA ACROSS THE GLOBE AND IN THE RUSSIAN FEDERATION IN 2007–2016. FORECAST FOR 2017

Analysis of epidemiological situation on cholera around the world has demonstrated downward trend in morbidity rates in 2016; annual average decline being 3.907 % (by reference to 2007). Comparative assessment of monthly incidence in 2015 and 2016 shows perennial registration of cholera cases in a number of African countries and in the Caribbean with up-rises in different seasons. Establishment of epidemic foci is on-going. Between 2007 and 2016, 1733 imported cases of cholera took place across the globe. Interstate import dominated in Asia. For forecast development, for the first time ever, risk assessment of epidemic process activation has been performed, taking into consideration emergency situations of varying origin, social and natural environments, using expert evaluation scores. Epidemic manifestations of cholera in the Russian Federation were characterized by import of the infection in 2008, 2010, 2012, and 2014; isolation of V. cholerae O1 biovar El Tor ctxA– tcpA–, ctxA+ and V. cholerae O139 ctxA– and tcpA– from surface water bodies, as well as individual V. cholerae O1 biovar El Tor сtхA+ tсра+. Worked out has been the algorithm for epidemiological investigation of causes and conditions of surface water body contamination with cholera vibrios. Cholera forecast worldwide and in Russia for the year 2017 remains unfavorable

Impact of Cultivating Environment on the Terms of Persistence and Certain Properties of Cholera Vibrios

Objective of the study is to investigate the impact of cultivating temperature and medium on the terms of persistence, ctx gene retention, and enzymatic activity of V. cholerae O1 with various toxigenicity.Materials and methods. Utilized were the strains of V. cholerae El Tor: P-5879, P-19613, and also the strain P-19787.Results and conclusions. In the process of studying cholera vibrios El Tor with different genetic characteristics it was determined that the longest terms of persistence (19 days) on mineral substrates at 5 ºC were observed for toxigenic strains, while for non-toxigenic ones it made less than 17 days. At the same time cholera vibrios can persist continuously and even reproduce on mineral substrates under the conditions of subnormal lowered temperatures (not less than 10 °C). Toxigenic strains of Vibrio cholerae, irrespectively of cultivating medium and temperature, retained ctx gene in their genome and maintained enzymatic activity throughout the experiment. Such long-term persistence of cholera vibrios at low temperatures on mineral substrates may be regarded as possibility of preservation of V. cholerae toxigenic strains in case of import by the infected persons or vibrio-carriers

EPIDEMIOLOGICAL SITUATION ON CHOLERA ACROSS THE GLOBE AND IN THE RUSSIAN FEDERATION IN 2007–2016. FORECAST FOR 2017

Analysis of epidemiological situation on cholera around the world has demonstrated downward trend in morbidity rates in 2016; annual average decline being 3.907 % (by reference to 2007). Comparative assessment of monthly incidence in 2015 and 2016 shows perennial registration of cholera cases in a number of African countries and in the Caribbean with up-rises in different seasons. Establishment of epidemic foci is on-going. Between 2007 and 2016, 1733 imported cases of cholera took place across the globe. Interstate import dominated in Asia. For forecast development, for the first time ever, risk assessment of epidemic process activation has been performed, taking into consideration emergency situations of varying origin, social and natural environments, using expert evaluation scores. Epidemic manifestations of cholera in the Russian Federation were characterized by import of the infection in 2008, 2010, 2012, and 2014; isolation of V. cholerae O1 biovar El Tor ctxA– tcpA–, ctxA+ and V. cholerae O139 ctxA– and tcpA– from surface water bodies, as well as individual V. cholerae O1 biovar El Tor сtхA+ tсра+. Worked out has been the algorithm for epidemiological investigation of causes and conditions of surface water body contamination with cholera vibrios. Cholera forecast worldwide and in Russia for the year 2017 remains unfavorable

DEVELOPMENT OF SPATIAL ANALYSIS TECHNIQUES FOR IDENTIFICATION OF "RISK AREAS" IN CASE OF EXTERNAL THREATS REALIZATION AS REGARDS SANITARY AND EPIDEMIOLOGICAL WELLFARE

Objective of the study was to develop the methodology for identification of administratively independent areas under potential risk of “external” epidemiological threat realization, by the example of cholera.Materials and methods. Analysis was conducted using free software package with open source code (QGIS 2.8 and GRASS GIS 7.0) on the basis of the data received from Rosgranitsa and the Federal State Statistics Service. The construction of risk cartogram was performed on the base of Euclidean distance and estimation of nuclear density.Results and conclusions. In accordance with the obtained results, the GIS containing information about the checkpoints on the Russian border, settlements, roads and railway lines was worked out. The method of identification of risk areas due to importation of infectious diseases based on the cholera model has been developed, and the total area of such territories was less than 1 % of the total area of the country. It was found that in some cases the risk area is located at a certain distance from the checkpoint, but the existence of checkpoint does not lead to the formation of risk areas. The developed GIS is available on the geo-information portal of FGHI Rostov-on-Don Research Anti-Plague Institute of Rospotrebnadzor

СРАВНЕНИЕ ЭФФЕКТИВНОСТИ ХИМИОТЕРАПИИ И АЛЛОГЕННОЙ ТРАНСПЛАНТАЦИИ ГЕМОПОЭТИЧЕСКИХ СТВОЛОВЫХ КЛЕТОК ПРИ ОСТРОМ МИЕЛОБЛАСТНОМ ЛЕЙКОЗЕ В ПЕРВОЙ РЕМИССИИ У ВЗРОСЛЫХ

The aim of the study was to compare the efficacy of allogeneic hematopoietic stem cell transplantation (alloHSCT) and chemotherapy (CT) of acute myeloid leukemia (AML) in first remission (CR1), to identify factors influencing the results. We compare the efficacy alloHSCT in CR1 (n = 70) and CT (n = 52). Patients were stratified by age, the level of leucocytes, the origin of AML, cytogenetic risk group and response to induction CT. Five-years overall and disease-free survival (OS and DFS) were higher in the group alloHSCT (67 and 65 % vs 46 and 30 % (p = 0.02 and p = 0.001)). Benefits of DFS after alloHSCT was in standard and high-risk cytogenetic groups (78 % versus 29 % (p = 0.001), and 34 % vs 17 % (p = 0.007)). The risk of relapse (RR) was 24 % in patients after alloHSCT vs. 57 % for CT (p = 0.003). Comparing the RR after alloHSCT and CT depending on the cytogenetic risk groups: standard (HR0.2(CI95 %0.07 - 0.56) p = 0.002), and high (HR0.27(CI95 %0.08-0.86) p = 0.03). Additional factors affect the RR were the origin of AML (de novo) (HR0.47 (CI95 %0.3-0.74) p = 0.001), the hyperleukocytosis (HR1.91 (CI95 %1.09 - 3.32) p = 0.02), and no remission after the first course CT (HR3.32(CI95 %1.57-7.0) p = 0.002). The efficacy of alloHSCT compared with CT is higher both in standard and high-risk cytogenetic group.Цель - сравнить эффективность аллогенной трансплантации гемопоэтических стволовых клеток (аллоТГСК) и химиотерапии (ХТ) при остром миелобластном лейкозе (ОМЛ) в первой ремиссии и выявить факторы, влияющие на результаты лечения. Сравнивалась эффективность в первой ремиссии ОМЛ алло ТГСК (n = 70) и ХТ (n = 52). Пациенты были разделены по возрасту, уровню лейкоцитов, происхождению ОМЛ, цитогенетическим группам риска и ответу на индукционную ХТ. Пятилетняя общая и бессобытийная выживаемость (ОВ и БСВ) были выше в группе аллоТГСК (67 и 65 % против 46 и 30 % (р = 0,02 и р = 0,001)). При анализе БСВ от цитогенетических групп риска выявлены преимущества аллоТГСК в стандартной и высокой группах риска (78 % против 29 % (р = 0,001) и 34 % против 17 % (р = 0,007)). Совокупный риск рецидива (РР) составил 24 % у пациентов после аллоТГСК против 57 % при ХТ (р = 0,003). При сравнении РР после аллоТГСК и ХТ от цитогенетических групп риска: стандартная (HR,0,2(CI95 %0,07-0,56) p = 0,002) и высокая (HR,0,27(CI95 %0,08-0,86) p = 0,03). Дополнительными факторами, оказывающими влияние на РР, были: происхождение ОМЛ (de novo) (HR,0,47(CI95 %0,3-0,74) p = 0,001), гиперлейкоцитоз в дебюте заболевания (HR,1,91(CI95 %1,09-3,32) p = 0,02) и отсутствие ремиссии после одного курса индукции (HR,3,32(CI95 %1,57 - 7,0) p = 0,002). Эффективность алло ТГСК по сравнению с ХТ выше при стандартной и высокой цитогенетических группах риска

Analysis of Innovative Methods’ Effectiveness in Teaching Foreign Languages for Special Purposes Used for the Formation of Future Specialists’ Professional Competencies

One of the most important tasks of higher educational institutions is the training of specialists to be able to adapt to changes in their professional life. At the end of the twentieth and the beginning of the 21st centuries, some methods for developing foreign language competence, needed for their future professional activity, were created by teachers. However, the effectiveness of these methods has not been studied. This fact has aroused the authors’ interest and generated the idea about the necessity to conduct scientific research in order to identify the most effective methods of teaching foreign languages for special purposes. Methods: The given research paper is based on the analysis of Russian and foreign scholars’ scientific works covering the problem of teaching foreign languages for special purposes to the students of humanitarian professions, as well as on the basis of the results from questioning students of bachelor degree programs who study foreign languages for special purposes in the field of humanitarian professions, and also of the results from questioning teachers specializing in teaching foreign languages for special purposes. Results: In the students’ opinion, the most effective methods of teaching foreign languages for special purposes in the field of humanitarian professions are the following: discussion, ICT (information and communication technologies), and SCRUM (framework that helps teams work together, encourages team to learn through on a problem). According to the interviewed teachers’ opinion, the most effective methods are discussion, ICT, and round table. The “dilemma” method is the least effective according to the students. As for the teachers, the less effective method is CLIL (content and language integrated learning). Conclusions: The study showed some common views among teachers and students concerning the effectiveness of methods of teaching foreign languages for professional purposes, such as discussion and ICT. The effectiveness of the discussion method is explained by the fact that it allows the integration of students’ knowledge from different areas when solving a problem and provides an opportunity to apply language knowledge and skills into practice. This contributes to forming students’ ability to think clearly, to perceive information critically, to highlight the main idea and find the means and arguments to confirm and substantiate it, and, consequently, to improve the understanding of any theoretical material. The use of ICT in the educational process allows the efficiency of the educational process itself to be improved significantly and leads to new approaches and organizational forms of educational work. In fact, while preparing educational programs and creating didactic materials, special attention should be given to the implementation of ICT methods and discussions in educational activities. Nevertheless, the respondents’ subjective opinion should not reduce the scientific value and effectiveness of other methods of teaching a foreign language for professional purposes. The authors of the paper believe that methods that have not found much support from students and teachers should be studied more thoroughly and carefully. To this end, it could be recommended to organize special training seminars that would allow teachers to be informed of new methods of teaching foreign languages for professional purposes, of their particularities, and to help their active implementation in the learning process

THE EFFICACY OF HIGH-DOSE CONSOLIDATION AND AUTOLOGOUS BONE MARROW TRANSPLANTATION IN FIRST REMISSION OF ACUTE MYELOID LEUKEMIA

Introduction. The question of the most adequate treatment strategy of AML in cases when it is impossible to perform allogeneic HSCT because of any reason still remains open.The aim of this study was to assess the long-term survival of patients with AML who received chemotherapy (CT) or autologous HSCT as consolidation in the first remission of the disease. It was included 135 patients aged 18 to 67 years, with a verified diagnosis of AML (except FAB M3) in the study. Of these, 100 patients received only CT, 35 patients received consolidation with autologous bone marrow transplantation. Patients who achieved remission after completion of induction CT courses received one of three treatment options as consolidation: 1) chemotherapy of standard-intensity (sCT), 2) high-dose chemotherapy (HDCT), 3) autologous HSCT (autoHSCT) conducted after 1–2 courses of high-dose CT. Adverse prognostic factors were identified as: age over 40 years, hyperleucocytosis more than 50,0 × 10 9/L and unfavorable cytogenetic and molecular-biological risk group.Materials and methods. Depending on the number of prognostic factors at the onset of disease relapse-free survival (RFS) was 47 % in their absence, 45 % in the presence of 1 factor, in the presence of 2 factors – 14 % (p = 0,000), regardless of the variant of consolidation therapy (sCT, HDCT, autoHSCT). A high level of white blood cells adversely affects OS (38 % vs. 22 %) and increases the frequency of relapse (52 % vs. 69 %) when performing only CT (sCT and HDCT). At initial white blood cells level more than 50,0 × 10 9/L the 5-year OS was 60 % when performing both autoHSCT and HDCT. Performance of autoHSCT at failure to achieve remission after the 1st induction course CT is associated with the best 2-year OS (62 % vs. 35 %, p = 0,05), EFS (50 % vs. 22 %, p = 0,05) and RFS (50 % vs. 37 %, p = 0,05) in comparison with HDCT and sCT. In favorable cytogenetic risk group 5-year RFS was 80 % when performing autoHSCT and 67 % when performing HDCT; the 5-year OS was 80 % regardless of consolidation therapy option.Conclusion. AutoHSCT is the preferred consolidation option in favorable risk group patients, and after failure to achieve remission after the 1st CT course

PROGNOSTIC SIGNIFICANCE OF POSITRON EMISSION TOMOGRAPHY IN AUTOLOGOUS STEM CELL TRANSPLANTATION FOR NON-HODGKIN’S LYMPHOMA

Objective: evaluation and comparison of positron emission tomography (PET) prognostic value with other predictors of effectiveness in patients with non-Hodgkin’s lymphoma (NHL) receiving high-dose chemotherapy with autologous hematopoietic stem cell transplantation (AHSCT).Materials and methods. The retrospective data on 49 consecutive patients with NHL  receiving high-dose chemotherapy with АHSCT was               analyzed. The median age was 36.2 (7–60)  years. Median follow-up is currently 24 (1–82)  months. Prognostic factors analyzed included sex, response to the initial chemotherapy, time to relapse, second-line chemotherapy regimen type, B-symptoms on relapse, serum lactate dehydrogenase and albumin levels, response assessed by computer tomography (CT), number of chemotherapy lines, condition regimen, PET-scan results before (PET1, n = 49) and after (PET2, n = 39) AHSCT.Results. Two-year overall and event-free survivals were 74.4 and 79.1 %, respectively. Patients with CT-confirmed progression prior to AH-SCT had the worse prognosis. Prognostic significance of PET-status  was shown in chemosensitive patients (partial/complete response).The overall survival in PET1-negative and PET1-positive patients were 95.4 vs 71.0 % (р = 0.019), respectively. In PET2-positive and PET2-negative patients the overall and event-free survivals were 59.8 vs 100 % (р = 0.001) and 54.4 vs 94.4 % (р = 0.02), respectively.     In combined analysis of PET1 and PET2 statuses prognostic significance of PET2 prevailed over PET1 results significance. The multivariate analysis confirmed only PET1 significance for survival prediction.   Conclusion. Chemosensitivity of the tumor, assessed by CT, is the most important prognostic factor. In chemosensitive patients achievement PET1 or PET2 negativity means better prognosis. The patients with PET positivity prior and after AHSCT have the worst prognosis