Problematics of proving the fact of occupational TB in health care workers.

The incidence of tuberculosis in medical per­sonnel in the Dnipropetrovsk region, incl. TB facilities, was analyzed for the period from 2008 to 2017. Occupational TB is an important indicator of infection control efficacy in health care facilities. Despite reducing trend of incidence in entire population and medical workers, their morbidity rates exceeded Ukrainian average ones by 25.0% and 2.5 times, respectively. There is about one and a half thousand employees in TB facilities of Dnipropetrovsk region. Their TB incidence rate was almost 5 times (p≤0.05) higher than in employees of other health care institutions and 6.6 times (p≤0.05) exceeded incidence of tuberculosis in community. In TB facilities, the highest incidence was registered among nurses – 506.8 per 100000. Non-medical workers have the second rank of incidence (409.4 per 100000). They did not contact TB patients directly, but inhaled air containing Mycobacterium tuberculosis. The incidence of TB in doctors and hospital attendants was lower – 384.6 and 357.1 per 100000, respectively. Nurses prevailed among TB-ill medical personnel of TB facilities – 41±3,4%. Hospital attendants had morbidity of 24±5,4%, non-medical stuff – 22±5,2%, doctors – 13±4,%. The confirmation of healthcare workers’ occupational TB cases is complicated. Taking info account that this infection is widely spread in community it is necessary to reveal active and latent tuberculosis infection with the quantiferon test and other modern methods, as well as to carry out genotyping of mycobacterium tuberculosis for finding epidemiological links in nosocomial TB transmission. To reduce the risks of occupational disease, it is important to carry out trainings on TB infection control for medical personnel and support staff

Cholera in Azov area

The purpose of research is analysis of clinical course and treatment results of patients with cholera in the Azov area. Materials and methods. During the period from 29.05.2011 to 19.08.2011 33 cases of cholera (32 adults and 1 child) and 25 vibrio carriers (22 adults and 3 children), which were caused by toxigenic strains of Vibrio cholera El Tor serogroup O1 Ogawa. Results. Likely factors of disease transmission in Mariupol are sea and river water, and the fish that were caught in the waters of the city. Typical and watery diarrhoea, vomiting, abdominal pain and lack of normal body temperature, dehydration syndrome, characterized clinical cholera for adults in most cases. The mean duration of diarrhoea was 6,6 days. At 46.9% observed atypical symptoms in 10 (31,3%) – abdominal pain (1 patient cramping in 7 cases, localized in the epigastria region, at 2-over stomach). In 5 patients (15,6%) had an increase in body temperature to 37,2–37,7 degrees Celsius. In 15 (46,9%) patients had severe nausea accompanied by vomiting. Easy for cholera was observed in 1 (3.1%), moderate – in 14 (43,8%), heavy – in 17 (53,1%) patients. Dehydration I level is set at 4 (12,5%), II – from 6 (18,7%), III – in 18 (56,3%), IV – 4 (12,5%) patients. Cholera outbreak was characterized by a predominance of severe disease and severe dehydration (III and IV), which was observed in 68.8% of patients. The decisive factor in the treatment of cholera patients was initiated in a timely manner rehydration therapy, in particular the introduction of the solution «Trisol». Against the background of rehydration therapy hyperkalaemia was observed in 9,4% of cases, vascular rehydration at 9,4%, the cell rehydration in 3,1% of patients. Fatal accidents cholera outbreaks have not been observed. Conclusion. Clinical diagnosis of cholera and the provision of medical care in the prehospital phase were poor, indicating the need for systematic conducting training seminars among experts of ambulance, as well as doctors of primary medical network. Cholera hospitals (or base hospitals) must be equipped with a mobile diagnostics (ultrasound, X-rays) and modern laboratory equipment. The required list of drug supply cholera hospitals should be expanded in view of possible complications and comorbidities

ORGANIZATION OF EPIDEMIC CONTROL ACTIVITIES BY LOCALIZATION OF CHOLERA IN THE DONETSK REGION

The article represents the epidemiological characteristics of the cholera outbreak, which originated in Mariupol, Donetsk region (Ukraine) in May and August 2011. Listed the major factors of transmission, causes, contributing to its spread. Outlined the results of laboratory tests of material from patients and objects in the environment. Highlighted the set of epidemic control activities on the localization of cholera aimed at each of the three units of the epidemic process. Defined priority actions for the period after the elimination of epidemic diseases to prevent complications in the future

Холера в Приазовье

The purpose of research is analysis of clinical course and treatment results of patients with cholera in the Azov area. Materials and methods. During the period from 29.05.2011 to 19.08.2011 33 cases of cholera (32 adults and 1 child) and 25 vibrio carriers (22 adults and 3 children), which were caused by toxigenic strains of Vibrio cholera El Tor serogroup O1 Ogawa. Results. Likely factors of disease transmission in Mariupol are sea and river water, and the fish that were caught in the waters of the city. Typical and watery diarrhoea, vomiting, abdominal pain and lack of normal body temperature, dehydration syndrome, characterized clinical cholera for adults in most cases. The mean duration of diarrhoea was 6,6 days. At 46.9% observed atypical symptoms in 10 (31,3%) – abdominal pain (1 patient cramping in 7 cases, localized in the epigastria region, at 2-over stomach). In 5 patients (15,6%) had an increase in body temperature to 37,2–37,7 degrees Celsius. In 15 (46,9%) patients had severe nausea accompanied by vomiting. Easy for cholera was observed in 1 (3.1%), moderate – in 14 (43,8%), heavy – in 17 (53,1%) patients. Dehydration I level is set at 4 (12,5%), II – from 6 (18,7%), III – in 18 (56,3%), IV – 4 (12,5%) patients. Cholera outbreak was characterized by a predominance of severe disease and severe dehydration (III and IV), which was observed in 68.8% of patients. The decisive factor in the treatment of cholera patients was initiated in a timely manner rehydration therapy, in particular the introduction of the solution «Trisol». Against the background of rehydration therapy hyperkalaemia was observed in 9,4% of cases, vascular rehydration at 9,4%, the cell rehydration in 3,1% of patients. Fatal accidents cholera outbreaks have not been observed. Conclusion. Clinical diagnosis of cholera and the provision of medical care in the prehospital phase were poor, indicating the need for systematic conducting training seminars among experts of ambulance, as well as doctors of primary medical network. Cholera hospitals (or base hospitals) must be equipped with a mobile diagnostics (ultrasound, X-rays) and modern laboratory equipment. The required list of drug supply cholera hospitals should be expanded in view of possible complications and comorbidities.Цель исследования – анализ клинического течения и результатов лечения больных холерой в Приазовье. Материалы и методы. За период с 29.05.2011 г. по 19.08.2011 г. зарегистрировано 33 случая заболевания холерой (32 взрослых и 1 ребенок) и 25 вибрионосителей (22 взрослых и 3 детей), которые были вызваны токсигенными штаммами холерного вибриона Эль-Тор серогруппы O1 Огава. Результаты. Вероятными факторами передачи заболевания в г. Мариуполе являлись морская и речная вода, а также рыба, которая была выловлена в акватории города. Клиническое течение холеры у взрослых в большинстве случаев было типичным и характеризовалось водянистой диареей, рвотой, отсутствием болей в животе, нормальной температурой тела, синдромом обезвоживания. Средняя продолжительность диареи составила 6,6 суток. У 46,9% наблюдались нетипичные симптомы: у 10 (31,3%) – боль в животе (у 1 больного схваткообразная, в 7 случаях локализовалась в эпигастральной области, у 2 – по всему животу). У 5 пациентов (15,6%) отмечено повышение температуры тела до 37,2–37,7 °С. У 15 (46,9%) пациентов рвота сопровождалась выраженной тошнотой. Легкое течение холеры отмечено у 1 (3,1%), средней тяжести – у 14 (43,8%), тяжелое – у 17 (53,1%) больных. Дегидратация I степени установлена у 4 (12,5%), II – у 6 (18,7%), III – у 18 (56,3%), IV – у 4 (12,5%) пациентов. Вспышка холеры характеризовалась преобладанием тяжелых форм болезни и выраженной дегидратацией (III и IV степени), которая отмечена у 68,8% больных. Решающим фактором в терапии больных холерой была своевременно начатая регидратационная терапия, в частности, введение раствора «Трисоль». На фоне регидратационной терапии наблюдали гиперкалиемию в 9,4% случаев, сосудистую гипергидратацию у 9,4%, клеточную гипергидратацию у 3,1% больных. Летальные случаи на вспышке холеры не наблюдались. Заключение. Клиническая диагностика холеры и оказание лечебной помощи на догоспитальном этапе были неудовлетворительными, что свидетельствует о необходимости систематического проведения учебно-зачетных семинаров среди специалистов СМП, а также врачей первичной врачебной сети. Холерные госпитали (или базовые лечебные учреждения) должны быть оснащены передвижной диагностической (УЗИ, рентген) и современной лабораторной аппаратурой. Необходимый перечень лекарственного обеспечения холерных госпиталей следует расширить с учетом возможных осложнений и сопутствующих заболеваний. 

Structural Biology by NMR: Structure, Dynamics, and Interactions

The function of bio-macromolecules is determined by both their 3D structure and conformational dynamics. These molecules are inherently flexible systems displaying a broad range of dynamics on time-scales from picoseconds to seconds. Nuclear Magnetic Resonance (NMR) spectroscopy has emerged as the method of choice for studying both protein structure and dynamics in solution. Typically, NMR experiments are sensitive both to structural features and to dynamics, and hence the measured data contain information on both. Despite major progress in both experimental approaches and computational methods, obtaining a consistent view of structure and dynamics from experimental NMR data remains a challenge. Molecular dynamics simulations have emerged as an indispensable tool in the analysis of NMR data

Problematics of Proving the Fact of Occupational TB in Health Care Workers.

The incidence of tuberculosis in medical per­sonnel in the Dnipropetrovsk region, incl. TB facilities, was analyzed for the period from 2008 to 2017. Occupational TB is an important indicator of infection control efficacy in health care facilities. Despite reducing trend of incidence in entire population and medical workers, their morbidity rates exceeded Ukrainian average ones by 25.0% and 2.5 times, respectively. There is about one and a half thousand employees in TB facilities of Dnipropetrovsk region. Their TB incidence rate was almost 5 times (p≤0.05) higher than in employees of other health care institutions and 6.6 times (p≤0.05) exceeded incidence of tuberculosis in community. In TB facilities, the highest incidence was registered among nurses – 506.8 per 100000. Non-medical workers have the second rank of incidence (409.4 per 100000). They did not contact TB patients directly, but inhaled air containing Mycobacterium tuberculosis. The incidence of TB in doctors and hospital attendants was lower – 384.6 and 357.1 per 100000, respectively. Nurses prevailed among TB-ill medical personnel of TB facilities – 41±3,4%. Hospital attendants had morbidity of 24±5,4%, non-medical stuff – 22±5,2%, doctors – 13±4,%. The confirmation of healthcare workers' occupational TB cases is complicated. Taking info account that this infection is widely spread in community it is necessary to reveal active and latent tuberculosis infection with the quantiferon test and other modern methods, as well as to carry out genotyping of mycobacterium tuberculosis for finding epidemiological links in nosocomial TB transmission. To reduce the risks of occupational disease, it is important to carry out trainings on TB infection control for medical personnel and support staff

Specific binding of ethanol to cholesterol in organic solvents.

Although ethanol has been reported to affect cholesterol homeostasis in biological membranes, the molecular mechanism of action is unknown. Here, nuclear magnetic resonance (NMR) spectroscopic techniques have been used to investigate possible direct interactions between ethanol and cholesterol in various low dielectric solvents (acetone, methanol, isopropanol, DMF, DMSO, chloroform, and CCl(4)). Measurement of (13)C chemical shifts, spin-lattice and multiplet relaxation times, as well as self-diffusion coefficients, indicates that ethanol interacts weakly, yet specifically, with the HC-OH moiety and the two flanking methylenes in the cyclohexanol ring of cholesterol. This interaction is most strong in the least polar-solvent carbon tetrachloride where the ethanol-cholesterol equilibrium dissociation constant is estimated to be 2 x 10(-3) M. (13)C-NMR spin-lattice relaxation studies allow insight into the geometry of this complex, which is best modeled with the methyl group of ethanol sandwiched between the two methylenes in the cyclohexanol ring and the hydroxyl group of ethanol hydrogen bonded to the hydroxyl group of cholesterol