27 research outputs found
ΠΠ ΠΠΠΠΠ ΠΠ Π€ΠΠΠΠΠ‘ΠΠ‘ΠΠΠ’Π ΠΠΠΠΠΠΠ ΠΠ ΠΠ¦ΠΠΠΠ ΠΠ ΠΠ ΠΠΠΠ’ΠΠΠ’Π Π‘ΠΠΠ‘ΠΠΠΠΠ‘Π’ ΠΠ ΠΠΠΠΠΠΠΠΠ’Π
ΠΡΠΎΡΠ΅Π½ΠΊΠ°ΡΠ° Π½Π° ΠΊΡΠ΅Π΄ΠΈΡΠ½Π°ΡΠ° ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡ Π½Π° ΠΊΠΎΠΌΠΏΠ°Π½ΠΈΠΈΡΠ΅ Π΅ Π΅Π΄Π΅Π½ ΠΎΠ΄ Π½Π°ΡΠ²Π°ΠΆΠ½ΠΈΡΠ΅ ΠΏΡΠΎΡΠ΅ΡΠΈ ΠΎΠ΄ ΠΊΠΎΠΈ Π·Π°Π²ΠΈΡΠΈ ΠΊΠ²Π°Π»ΠΈΡΠ΅ΡΠΎΡ Π½Π° ΠΏΠΎΠ±Π°ΡΡΠ²Π°ΡΠ°ΡΠ°, ΠΎΠ΄Π½ΠΎΡΠ½ΠΎ ΠΊΠ²Π°Π»ΠΈΡΠ΅ΡΠΎΡ Π½Π° ΠΊΡΠ΅Π΄ΠΈΡΠ½ΠΎΡΠΎ ΠΏΠΎΡΡΡΠΎΠ»ΠΈΠΎ ΠΈ Π°ΠΊΡΠΈΠ²Π°ΡΠ° Π½Π° Π΅Π΄Π½Π° Π±Π°Π½ΠΊΠ°. Π‘ΠΈΡΠ΅ ΡΠ°ΠΊΡΠΎΡΠΈ ΠΊΠΎΠΈ Π²Π»ΠΈΡΠ°Π°Ρ Π²ΡΠ· ΡΠΈΠ·ΠΈΡΠΈΡΠ΅ ΡΠΎ ΠΊΠΎΠΈ ΡΠ΅ ΡΠΎΠΎΡΡΠ²Π°Π°Ρ Π±Π°Π½ΠΊΠΈΡΠ΅ Π²ΠΎ Π½ΠΈΠ²Π½ΠΎΡΠΎ ΡΠ°Π±ΠΎΡΠ΅ΡΠ΅, ΠΎΠ΄ ΠΊΠΎΠΈ Π½Π°ΡΠ·Π½Π°ΡΠ°Π΅Π½ Π΅ ΠΊΡΠ΅Π΄ΠΈΡΠ½ΠΈΠΎΡ ΡΠΈΠ·ΠΈΠΊ, ΡΠ΅ ΠΏΡΠ΅Π΄ΠΌΠ΅Ρ Π½Π° ΠΈΡΠΏΠΈΡΡΠ²Π°ΡΠ΅ Π²ΠΎ ΠΏΡΠΎΡΠ΅ΡΠΎΡ Π½Π° ΡΠΈΠ½Π°Π½ΡΠΈΡΠΊΠ°ΡΠ° Π°Π½Π°Π»ΠΈΠ·Π°, ΠΎΠ΄Π½ΠΎΡΠ½ΠΎ Π°Π½Π°Π»ΠΈΠ·Π°ΡΠ° Π½Π° ΠΊΡΠ΅Π΄ΠΈΡΠ½Π°ΡΠ° ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡ Π½Π° ΠΊΠΎΠΌΠΏΠ°Π½ΠΈΠΈΡΠ΅. ΠΡΠΎΡΠ΅ΡΠΎΡ Π½Π° ΡΠΈΠ½Π°Π½ΡΠΈΡΠΊΠ° Π°Π½Π°Π»ΠΈΠ·Π° ΠΎΠΏΡΠ°ΡΠ° Π°Π½Π°Π»ΠΈΠ·Π° Π½Π° ΡΠ°Π±ΠΎΡΠ΅ΡΠ΅ΡΠΎ Π½Π° ΠΊΠΎΠΌΠΏΠ°Π½ΠΈΡΠ°ΡΠ° Π²ΠΎ ΠΌΠΈΠ½Π°ΡΠΎΡΠΎ ΠΈ ΡΠ΅Π³Π°ΡΠ½ΠΎΡΡΠ°, ΡΠΎ ΡΠ΅Π» Π·Π° ΡΡΠΎ ΠΏΠΎΡΡΠΏΠ΅ΡΠ½ΠΎ ΠΏΡΠ΅Π΄Π²ΠΈΠ΄ΡΠ²Π°ΡΠ΅ Π½Π° Π½Π΅ΡΠ·ΠΈΠ½Π°ΡΠ° ΠΈΠ΄Π½Π° Π΄Π΅Π»ΠΎΠ²Π½Π° Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡ. ΠΡΠ΅Π΄ΠΌΠ΅Ρ Π½Π° ΠΈΡΡΡΠ°ΠΆΡΠ²Π°ΡΠ΅ Π²ΠΎ ΠΎΠ²ΠΎΡ ΡΡΡΠ΄ ΠΏΡΠ΅ΡΡΡΠ°Π²ΡΠ²Π° ΡΡΠ²ΡΠ΄ΡΠ²Π°ΡΠ΅ ΠΈ Π°Π½Π°Π»ΠΈΠ·Π° Π½Π° ΠΏΠΎΠ»ΠΈΡΠΈΠΊΠΈΡΠ΅ ΠΈ ΠΏΡΠΎΡΠ΅Π΄ΡΡΠΈΡΠ΅ ΠΊΠΎΠΈ Π³ΠΈ ΠΊΠΎΡΠΈΡΡΠ°Ρ Π±Π°Π½ΠΊΠΈΡΠ΅ Π²ΠΎ ΠΏΡΠΎΡΠ΅Π½ΠΊΠ°ΡΠ° Π½Π° ΠΊΡΠ΅Π΄ΠΈΡΠ½Π°ΡΠ° ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡ Π½Π° ΠΎΠ΄Π΄Π΅Π»Π½ΠΈΡΠ΅ ΠΊΠΎΠΌΠΏΠ°Π½ΠΈΠΈ, ΠΏΠΎΠΊΠΎΠ½ΠΊΡΠ΅ΡΠ½ΠΎ Π΄Π° ΡΠ΅ ΡΡΠ²ΡΠ΄ΠΈ ΠΊΠΎΠΈ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΈ Ρ ΡΠ΅ ΠΏΠΎΡΡΠ΅Π±Π½ΠΈ Π½Π° Π±Π°Π½ΠΊΠ°ΡΠ° Π²ΠΎ ΠΏΡΠΎΡΠ΅ΡΠΎΡ Π½Π° Π°Π½Π°Π»ΠΈΠ·Π° Π½Π° ΡΠΈΠ½Π°Π½ΡΠΈΡΠΊΠΈΡΠ΅ ΠΈΠ·Π²Π΅ΡΡΠ°ΠΈ ΠΈ Π½Π° ΠΊΠΎΡ Π½Π°ΡΠΈΠ½ (ΠΏΡΠ΅ΠΊΡ ΠΏΡΠΈΠΌΠ΅Π½Π° Π½Π° ΠΊΠΎΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ ΠΈ ΡΠ΅Ρ
Π½ΠΈΠΊΠΈ) ΠΈΡΡΠΈΡΠ΅ Π³ΠΈ ΡΠΎΠ»ΠΊΡΠ²Π°, Π·Π° Π΄Π° Π³ΠΎ ΠΎΡΠ΅Π½ΠΈ ΠΊΡΠ΅Π΄ΠΈΡΠ½ΠΈΠΎΡ Π±ΠΎΠ½ΠΈΡΠ΅Ρ Π½Π° ΠΊΠΎΠΌΠΏΠ°Π½ΠΈΡΠ°ΡΠ° ΠΈ Π½Π΅ΡΠ·ΠΈΠ½Π°ΡΠ° ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡ Π·Π° Π·Π°Π΄ΠΎΠ»ΠΆΡΠ²Π°ΡΠ΅
ΠΠ²Π°Π»ΡΠ°ΡΠΈΡΠ° Π½Π° (1,3)--d-Π³Π»ΠΈΠΊΠ°Π½ Π΅ΡΠ΅Ρ Π²ΠΎ Π΄ΠΈΡΠ°Π³Π½ΠΎΠ·Π° Π½Π° ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΠΈ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ ΡΠΎ Πspergillus
Invasive fungal infections caused by Aspergillus are a significant problem in immunocompromised and critically ill patients and associated with increased morbidity and mortality. Early diagnosis of invasive aspergillosis is still a big clinical and diagnostic challenge. Conventional methods are not sensitive enough, and therefore, there is a need for rapid, more sensitive methods for early diagnosis of invasive fungal infections with Aspergillus. The aim of this study was to evaluate the diagnostic performance, sensitivity and specificity of serological panfungal (1,3)-b-D-glucan marker compared to conventional method for diagnosis of invasive fungal infections with Aspergillus. Material and methods: Specimens of 125 patients divided into 4 groups (group I - immune deficiency, group II - prolonged ICU stay, group III - chronic aspergillosis, group IV - cystic fibrosis), classified according to clinical diagnosis and EORTC/MSG criteria, were analyzed at the Institute of Microbiology and Parasitology, with conventional and serological methods, during a period of two years. Results: A total of 71 isolates of Aspergillus were confirmed in this study. Four isolates were recovered from bloodculture of patients with primary immune deficiency. With BAL culture, Aspergillus was detected in the group of chronic aspergillosis (63.33%), followed by the groups of cystic fibrosis (56.67%), primary immune deficiency (51.43%), and the group with prolonged ICU stay (43.33%). Sensitivity and specificity of BAL culture were: 64.29% and 100%, 59.09% and 100%, 54.55% and 12.5%, 100% and 54.17%, in I, II, III and IV group, respectively. In 79.1% (53/67) from positive BAL cultures in all groups, A. fumigatus was confirmed, of which, 32.1% (17/53) in group III, followed by group I β 26.42% (14/53) and group IV β 26.42% (14/53), and 15.1% (8/53) in group II. Other species confirmed in BAL were A. flavus 16.42% (11/67) and A.terreus 4.48% (3/67). Sensitivity and specificity of the serological panfungal (1,3)-b-D-glucan (BDG) marker were: 64.71% and 85.71%, 50% and 87.5%, 36.36% and 50%, in groups I, II and III, respectively. No positive findings of the panfungal (1,3)-b-D-glucan (BDG) marker were found in the group with cystic fibrosis. Conclusion: The results obtained in this study have demonstrated that a positive (1,3)-b-D-glucan assay highlights the value of this test as a diagnostic adjunct in the serodiagnosis of invasive fungal infections with Aspergillus, and along with the results from conventional mycological investigation, helped in reaching a timely antifungal treatment with a favorable clinical outcome.
Β ΠΠ½Π²Π°Π·ΠΈΠ²Π½ΠΈΡΠ΅ ΡΡΠ½Π³Π°Π»Π½ΠΈ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ ΡΠΎ Aspergillus ΠΏΡΠ΅ΡΡΡΠ°Π²ΡΠ²Π°Π°Ρ ΡΠ΅ΡΠΈΠΎΠ·Π΅Π½ ΠΏΡΠΎΠ±Π»Π΅ΠΌ ΠΊΠ°Ρ ΠΈΠΌΡΠ½ΠΎΠΊΠΎΠΌΠΏΡΠΎΠΌΠΈΡΠΈΡΠ°Π½ΠΈΡΠ΅ Π»ΠΈΡΠ° ΠΈ ΠΊΡΠΈΡΠΈΡΠ½ΠΎ Π±ΠΎΠ»Π½ΠΈΡΠ΅ Π»ΠΈΡΠ°, ΠΈ ΡΠ΅ Π°ΡΠΎΡΠΈΡΠ°Π½ΠΈ ΡΠΎ Π·Π³ΠΎΠ»Π΅ΠΌΠ΅Π½ ΠΌΠΎΡΠ±ΠΈΠ΄ΠΈΡΠ΅Ρ ΠΈ ΠΌΠΎΡΡΠ°Π»ΠΈΡΠ΅Ρ. Π Π°Π½Π° Π΄ΠΈΡΠ°Π³Π½ΠΎΠ·Π° Π½Π° ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½Π°ΡΠ° Π°ΡΠΏΠ΅ΡΠ³ΠΈΠ»ΠΎΠ·Π° Π΅ ΡΡ ΡΡΡΠ΅ Π³ΠΎΠ»Π΅ΠΌ ΠΊΠ»ΠΈΠ½ΠΈΡΠΊΠΈ ΠΈ Π΄ΠΈΡΠ°Π³Π½ΠΎΡΡΠΈΡΠΊΠΈ ΠΏΡΠ΅Π΄ΠΈΠ·Π²ΠΈΠΊ. ΠΠΎΠ½Π²Π΅Π½ΡΠΈΠΎΠ½Π°Π»Π½ΠΈΡΠ΅ ΠΌΠ΅ΡΠΎΠ΄ΠΈ Π½Π΅ ΡΠ΅ Π΄ΠΎΠ²ΠΎΠ»Π½ΠΎ ΡΠ΅Π½Π·ΠΈΡΠΈΠ²Π½ΠΈ, ΠΈ Π·Π°ΡΠ°Π΄ΠΈ ΡΠΎΠ°, ΡΠ΅ Π½Π°ΠΌΠ΅ΡΠ½ΡΠ²Π° ΠΏΠΎΡΡΠ΅Π±Π° Π·Π° Π±ΡΠ·ΠΈ ΠΈ ΠΏΠΎΡΠ΅Π½Π·ΠΈΡΠΈΠ²Π½ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ Π·Π° ΡΠ°Π½Π° Π΄ΠΈΡΠ°Π³Π½ΠΎΠ·Π° Π½Π° ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΠΈ ΡΡΠ½Π³Π°Π»Π½ΠΈ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ ΡΠΎ Aspergillus. Π¦Π΅Π»ΡΠ° Π½Π° ΠΎΠ²Π°Π° ΡΡΡΠ΄ΠΈΡΠ° Π±Π΅ΡΠ΅ Π΄Π° ΡΠ΅ Π΅Π²Π°Π»ΡΠΈΡΠ° Π΄ΠΈΡΠ°Π³Π½ΠΎΡΡΠΈΡΠΊΠΈΠΎΡ ΠΏΠ΅ΡΡΠΎΡΠΌΠ°Π½Ρ, ΡΠ΅Π½Π·ΠΈΡΠΈΠ²Π½ΠΎΡΡΠ° ΠΈ ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΠ° Π½Π° ΡΠ΅ΡΠΎΠ»ΠΎΡΠΊΠΈΠΎΡ ΠΏΠ°Π½ΡΡΠ½Π³Π°Π»Π΅Π½ ΠΌΠ°ΡΠΊΠ΅Ρ (1,3)-b-D-Π³Π»ΠΈΠΊΠ°Π½ ΡΠΏΠΎΡΠ΅Π΄Π΅Π½ΠΎ ΡΠΎ ΠΊΠΎΠ½Π²Π΅Π½ΡΠΈΠΎΠ½Π°Π»Π½ΠΈΠΎΡ ΠΌΠ΅ΡΠΎΠ΄ Π·Π° Π΄ΠΈΡΠ°Π³Π½ΠΎΠ·Π° Π½Π° ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΠΈΡΠ΅ ΡΡΠ½Π³Π°Π»Π½ΠΈ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ ΡΠΎ Aspergillus. ΠΠ°ΡΠ΅ΡΠΈΡΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ: ΠΡΠΈΠΌΠ΅ΡΠΎΡΠΈ ΠΎΠ΄ 125 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ, ΠΏΠΎΠ΄Π΅Π»Π΅Π½ΠΈ Π²ΠΎ 4 Π³ΡΡΠΏΠΈ (Π³ΡΡΠΏΠ° I - ΠΈΠΌΡΠ½ Π΄Π΅ΡΠΈΡΠΈΡ, Π³ΡΡΠΏΠ° II - ΠΏΡΠΎΠ»ΠΎΠ½Π³ΠΈΡΠ°Π½ ΠΏΡΠ΅ΡΡΠΎΡ Π²ΠΎ ΠΠΠ, Π³ΡΡΠΏΠ° III - Ρ
ΡΠΎΠ½ΠΈΡΠ½Π° Π°ΡΠΏΠ΅ΡΠ³ΠΈΠ»ΠΎΠ·Π°, Π³ΡΡΠΏΠ° IV - ΡΠΈΡΡΠΈΡΠ½Π° ΡΠΈΠ±ΡΠΎΠ·Π°), ΠΈ ΠΊΠ»Π°ΡΠΈΡΠΈΡΠΈΡΠ°Π½ΠΈ ΡΠΏΠΎΡΠ΅Π΄ ΠΊΠ»ΠΈΠ½ΠΈΡΠΊΠ°ΡΠ° Π΄ΠΈΡΠ°Π³Π½ΠΎΠ·Π° ΠΈ EORTC/MSG ΠΊΡΠΈΡΠ΅ΡΠΈΡΠΌΠΈΡΠ΅, Π±Π΅Π° Π°Π½Π°Π»ΠΈΠ·ΠΈΡΠ°Π½ΠΈ Π½Π° ΠΠ½ΡΡΠΈΡΡΡΠΎΡ Π·Π° ΠΌΠΈΠΊΡΠΎΠ±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ° ΠΈ ΠΏΠ°ΡΠ°Π·ΠΈΡΠΎΠ»ΠΎΠ³ΠΈΡΠ°, ΡΠΎ ΠΊΠΎΠ½Π²Π΅Π½ΡΠΈΠΎΠ½Π°Π»Π½ΠΈ ΠΈ ΡΠ΅ΡΠΎΠ»ΠΎΡΠΊΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ, Π²ΠΎ ΡΠ΅ΠΊ Π½Π° Π΄Π²Π΅-Π³ΠΎΠ΄ΠΈΡΠ΅Π½ ΠΏΠ΅ΡΠΈΠΎΠ΄. Π Π΅Π·ΡΠ»ΡΠ°ΡΠΈ: ΠΠΊΡΠΏΠ½ΠΎ 71 ΠΈΠ·ΠΎΠ»Π°Ρ Π½Π° Aspergillus Π±Π΅Π° ΠΏΠΎΡΠ²ΡΠ΄Π΅Π½ΠΈ Π²ΠΎ ΠΎΠ²Π°Π° ΡΡΡΠ΄ΠΈΡΠ°. Π§Π΅ΡΠΈΡΠΈ ΠΈΠ·ΠΎΠ»Π°ΡΠΈ Π±Π΅Π° Π΄ΠΎΠΊΠ°ΠΆΠ°Π½ΠΈ Π²ΠΎ Ρ
Π΅ΠΌΠΎΠΊΡΠ»ΡΡΡΠ°, ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΡΠΎ ΠΏΡΠΈΠΌΠ°ΡΠ΅Π½ ΠΈΠΌΡΠ½ Π΄Π΅ΡΠΈΡΠΈΡ. Π‘ΠΎ ΠΊΡΠ»ΡΡΡΠ° Π½Π° ΠΠΠ, Aspergillus Π½Π°ΡΡΠ΅ΡΡΠΎ Π±Π΅ΡΠ΅ Π΄Π΅ΡΠ΅ΠΊΡΠΈΡΠ°Π½ Π²ΠΎ Π³ΡΡΠΏΠ°ΡΠ° Π½Π° Ρ
ΡΠΎΠ½ΠΈΡΠ½Π° Π°ΡΠΏΠ΅ΡΠ³ΠΈΠ»ΠΎΠ·Π° (63,33%), ΠΏΠΎ ΡΡΠΎ ΡΠ»Π΅Π΄ΡΠ²Π°Π° Π³ΡΡΠΏΠΈΡΠ΅ ΡΠΎ ΡΠΈΡΡΠΈΡΠ½Π° ΡΠΈΠ±ΡΠΎΠ·Π° (56,67%), ΠΏΡΠΈΠΌΠ°ΡΠ΅Π½ ΠΈΠΌΡΠ½ Π΄Π΅ΡΠΈΡΠΈΡ (51,43%), ΠΈ Π³ΡΡΠΏΠ°ΡΠ° Π»ΠΈΡΠ° ΡΠΎ ΠΏΡΠΎΠ»ΠΎΠ½Π³ΠΈΡΠ°Π½ ΠΏΡΠ΅ΡΡΠΎΡ Π²ΠΎ Π΅Π΄ΠΈΠ½ΠΈΡΠΈΡΠ΅ Π·Π° ΠΈΠ½ΡΠ΅Π½Π·ΠΈΠ²Π½ΠΎ Π»Π΅ΠΊΡΠ²Π°ΡΠ΅ (43,33%). Π‘Π΅Π½Π·ΠΈΡΠΈΠ²Π½ΠΎΡΡΠ° ΠΈ ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΠ° Π½Π° ΠΊΡΠ»ΡΡΡΠΈΡΠ΅ Π½Π° ΠΠΠ Π±Π΅Π°: 64,29% ΠΈ 100%, 59,09% ΠΈ 100%, 54,55% ΠΈ 12,5%, 100% ΠΈ 54,17%, Π²ΠΎ I, II, III ΠΈ IV Π³ΡΡΠΏΠ°, ΡΠΎΠΎΠ΄Π²Π΅ΡΠ½ΠΎ. ΠΠΎ 79,1% (53/67) ΠΎΠ΄ ΠΏΠΎΠ·ΠΈΡΠΈΠ²Π½ΠΈΡΠ΅ ΠΊΡΠ»ΡΡΡΠΈ Π½Π° ΠΠΠ Π²ΠΎ ΡΠΈΡΠ΅ Π³ΡΡΠΏΠΈ, Π±Π΅ΡΠ΅ Π΄ΠΎΠΊΠ°ΠΆΠ°Π½ A.fumigatus, ΠΎΠ΄ ΠΊΠΎΠΈ, 32,1% (17/53) ΠΎΠ΄ Π³ΡΡΠΏΠ° III, ΠΏΠΎΡΠΎΠ° 26,42 % (14/53) ΠΎΠ΄ Π³ΡΡΠΏΠ° I ΠΈ 26,42% (14/53) ΠΎΠ΄ Π³ΡΡΠΏΠ° IV, ΠΊΠ°ΠΊΠΎ ΠΈ 15,1% (8/53) ΠΎΠ΄ Π³ΡΡΠΏΠ° II. ΠΡΡΠ³ΠΈ ΡΠΏΠ΅ΡΠΈΠ΅ΡΠΈ ΠΏΠΎΡΠ²ΡΠ΄Π΅Π½ΠΈ Π²ΠΎ ΠΠΠ Π±Π΅Π° A.flavus 16,42% (11/67) ΠΈ A.terreus 4,48% (3/67). Π‘Π΅Π½Π·ΠΈΡΠΈΠ²Π½ΠΎΡΡΠ° ΠΈ ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΠ° Π½Π° ΡΠ΅ΡΠΎΠ»ΠΎΡΠΊΠΈΠΎΡ ΠΏΠ°Π½ΡΡΠ½Π³Π°Π»Π΅Π½ (1,3)-b-D-Π³Π»ΠΈΠΊΠ°Π½ (BDG) ΠΌΠ°ΡΠΊΠ΅Ρ Π±Π΅Π°: 64,71% ΠΈ 85,71%, 50% ΠΈ 87,5%, 36,36% ΠΈ 50%, Π²ΠΎ Π³ΡΡΠΏΠΈΡΠ΅ I, II ΠΈ III, ΡΠΎΠΎΠ΄Π²Π΅ΡΠ½ΠΎ. ΠΠ΅ Π±Π΅Π° Π΄Π΅ΡΠ΅ΠΊΡΠΈΡΠ°Π½ΠΈ ΠΏΠΎΠ·ΠΈΡΠΈΠ²Π½ΠΈ Π½Π°ΠΎΠ΄ΠΈ ΠΎΠ΄ ΠΏΠ°Π½ΡΡΠ½Π³Π°Π»Π½ΠΈΠΎΡ (1,3)-b-D-Π³Π»ΠΈΠΊΠ°Π½ (BDG) ΠΌΠ°ΡΠΊΠ΅Ρ Π²ΠΎ Π³ΡΡΠΏΠ°ΡΠ° ΡΠΎ ΡΠΈΡΡΠΈΡΠ½Π° ΡΠΈΠ±ΡΠΎΠ·Π°. ΠΠ°ΠΊΠ»ΡΡΠΎΠΊ: Π Π΅Π·ΡΠ»ΡΠ°ΡΠΈΡΠ΅ ΠΎΠ΄ ΠΎΠ²Π°Π° ΡΡΡΠ΄ΠΈΡΠ° ΠΏΠΎΠΊΠ°ΠΆΠ°Π° Π΄Π΅ΠΊΠ° ΠΏΠΎΠ·ΠΈΡΠΈΠ²Π΅Π½ Π½Π°ΠΎΠ΄ Π½Π° (1,3)-b-D-Π³Π»ΠΈΠΊΠ°Π½ ΡΠ° ΠΈΡΡΠ°ΠΊΠ½ΡΠ²Π° Π²ΡΠ΅Π΄Π½ΠΎΡΡΠ° Π½Π° ΠΎΠ²ΠΎΡ ΡΠ΅ΡΡ ΠΊΠ°ΠΊΠΎ Π΄ΠΈΡΠ°Π³Π½ΠΎΡΡΠΈΡΠΊΠΎ Π½Π°Π΄ΠΎΠΏΠΎΠ»Π½ΡΠ²Π°ΡΠ΅ Π²ΠΎ ΡΠ΅ΡΠΎΠ΄ΠΈΡΠ°Π³Π½ΠΎΠ·Π°ΡΠ° Π½Π° ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΠΈΡΠ΅ ΡΡΠ½Π³Π°Π»Π½ΠΈ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ ΡΠΎ Aspergillus, ΠΈ Π·Π°Π΅Π΄Π½ΠΎ ΡΠΎ ΡΠ΅Π·ΡΠ»ΡΠ°ΡΠΈΡΠ΅ ΠΎΠ΄ ΠΊΠΎΠ½Π²Π΅Π½ΡΠΈΠΎΠ½Π°Π»Π½ΠΈΡΠ΅ ΠΌΠΈΠΊΠΎΠ»ΠΎΡΠΊΠΈ ΠΈΡΠΏΠΈΡΡΠ²Π°ΡΠ°, ΠΏΠΎΠΌΠ°Π³Π°Π°Ρ Π²ΠΎ Π½Π°Π²ΡΠ΅ΠΌΠ΅Π½Π° ΠΏΡΠΈΠΌΠ΅Π½Π° Π½Π° Π°Π½ΡΠΈΡΡΠ½Π³Π°Π»Π½Π° ΡΠ΅ΡΠ°ΠΏΠΈΡΠ°, ΠΈ ΠΏΠΎΡΡΠΈΠ³Π½ΡΠ²Π°ΡΠ΅ ΠΏΠΎΠ²ΠΎΠ»Π΅Π½ ΠΊΠ»ΠΈΠ½ΠΈΡΠΊΠΈ ΠΈΡΡ
ΠΎΠ΄.
De facto states
De facto states are also known as βunrecognized statesβ, βpartially recognized statesβ,
and states with limited recognition... They are the target of research, proving facts, debates,
and analyses, about the applicability of international rules and segmenting which states can
enter the group of de facto states, and which do not.For many, the Montevideo Convention is
applicable here, to see the rights and obligations of states. But is there a list of these countries
today? Many mention Kosovo, Northern Cyprus, Abkhazia, and South Ossetia, Palestine,
Transnistria, Nagorno-Karabakh, Donetsk Peopleβs Republic, and Luhansk Peopleβs
Republic... What is the status of these countries and why do they not yet have international
recognition
Gastrointestinal Colonization with Vancomycin-Resistant Enterococci in Hospitalized and Outpatients
BACKGROUND: The incidence of infection and intestinal colonization with vancomycin resistant enterococci (VRE) is increasing in many countries in the last decade. Concerning the difficult antimicrobial treatment of infections caused by VRE, decreasing the incidence and prevalence of these infections is an important factor in VRE-induced morbidity and mortality control.AIM: To determine the prevalence of gastrointestinal colonization with vancomycin resistant enterococci in hospitalized and outpatients, and to determine the genetic base of the vancomycin resistance in VRE isolates.MATERIAL AND METHODS: Seven hundred and eighty stool specimens were investigated for the gastrointestinal carriage of vancomycin-resistant enterococci (VRE). Susceptibility to vancomycin was tested in all isolates by disk-diffusion test and E-test (AB Biodisk, Sweden). Determined vancomycin resistant enterococci were than tested for detection of vanA, vanB and vanC genes by PCR.RESULTS: Vancomycin resistant strains of enterococci were isolated from 46 (16.1 %) of the 285 hospitalized patients and 5 (7.7 %) of the 65 patients living in the community (p < 0.05). The most of the highly resistant enterococci strains to vancomycin (95.2 %), were identified as E. faecium. Minimal inhibitory concentrations (MICs) to vancomycin in all 39 vanA genotypes of E. faecium and two vanA genotypes of E. fecalis were > 256 mg/ml. Three vanB genotypes of E. faecium and one vanB genotype of E. faecalis had MICs of 32 mg/ml. All six vanC genotypes of E. gallinarum had MICs of 8 mg/ml. All vanA genotypes of VRE were highly resistant to vancomycin, with MICs above 256 mg/ml. Three vanB genotypes of VR E. faecium and one VR E. fecalis were resistant, with MICs 32 mg/ml. vanC genotypes of VR E. gallinarum were intermediate resistant to vancomycin with MICs of 8 mg/ml.CONCLUSIONS: The prevalence of vancomycin resistant enterococci in Republic of Macedonia was 2-fold higher in hospitalized than in outpatients. VanA genotype was dominant in isolates of E. faecium and it was highly associated with the MIC values above the 256 mg/ml. Since most of the enterococcal infections are endogenous, there is a need for screening the colonization of patientΓ’β¬β’s intestinal flora with VRE at the hospital entry. Identification and genotyping of faecal enterococci, together with their susceptibility testing to vancomycin, could be useful marker for the infection control
ΠΠΎΠ½ΡΠ΅ΠΏΡΠΎΡ Π½Π° ΠΎΠ΄ΡΠΆΠ»ΠΈΠ² ΡΠ°Π·Π²ΠΎΡ Π½ΠΈΠ· ΠΏΡΠΈΠ·ΠΌΠ°ΡΠ° Π½Π° ΠΏΡΠ°Π²ΠΎΡΠΎ ΠΈ ΠΏΠΎΠ»ΠΈΡΠΈΠΊΠΈΡΠ΅/The concept of sustainable development through the prism of law and policies
ΠΡΠΎΠ΅ΠΊΡΠΎΡ βΠΠΎΠ½ΡΠ΅ΠΏΡΠΎΡ Π½Π° ΠΎΠ΄ΡΠΆΠ»ΠΈΠ² ΡΠ°Π·Π²ΠΎΡ Π½ΠΈΠ· ΠΏΡΠΈΠ·ΠΌΠ°ΡΠ° Π½Π° ΠΏΡΠ°Π²ΠΎΡΠΎ ΠΈ ΠΏΠΎΠ»ΠΈΡΠΈΠΊΠΈΡΠ΅β ΠΏΡΠ΅ΡΡΡΠ°Π²ΡΠ²Π° ΠΌΠ΅ΡΡΠ½Π°ΡΠΎΠ΄Π΅Π½ Π½Π°ΡΡΠ½ΠΎ-ΠΈΡΡΡΠ°ΠΆΡΠ²Π°ΡΠΊΠΈ ΠΏΡΠΎΠ΅ΠΊΡ ΠΏΡΠ΅Π΄Π²ΠΎΠ΄Π΅Π½ΠΎ ΠΎΠ΄ Π¦Π΅Π½ΡΠ°ΡΠΎΡ Π·Π° Π°Π½Π°Π»ΠΈΠ·Π° Π½Π° ΠΏΡΠ°Π²ΠΎ ΠΈ ΠΏΠΎΠ»ΠΈΡΠΈΠΊΠΈ ΠΏΡΠΈ ΠΡΠ°Π²Π½ΠΈΠΎΡ ΡΠ°ΠΊΡΠ»ΡΠ΅Ρ, Π£ΠΠ - Π¨ΡΠΈΠΏ, Π²ΠΎ ΡΠΎΡΠ°Π±ΠΎΡΠΊΠ° ΡΠΎ Π£Π½ΠΈΠ²Π΅ΡΠ·ΠΈΡΠ΅ΡΠΎΡ ΠΠΈΡΠΊΠΎΠ»Ρ Π²ΠΎ Π£Π½Π³Π°ΡΠΈΡΠ°. ΠΠ΄Π΅ΡΠ°ΡΠ° Π½Π° ΠΏΡΠΎΠ΅ΠΊΡΠΎΡ Π΅ Π΄Π° ΡΠ΅ ΡΠΎΡΠΌΠΈΡΠ° ΠΈΡΡΡΠ°ΠΆΡΠ²Π°ΡΠΊΠΈ ΡΠΈΠΌ Π²ΠΎ ΡΠ°ΠΌΠΊΠΈΡΠ΅ Π½Π° ΠΡΠ°Π²Π΅Π½ ΡΠ°ΠΊΡΠ»ΡΠ΅Ρ ΠΊΠΎΡΡΡΠΎ ΡΠ΅ ΡΠ°Π±ΠΎΡΠΈ Π½Π° ΡΠ΅ΠΌΠ°ΡΠΈΠΊΠ°ΡΠ° ΠΏΠΎΠ²ΡΠ·Π°Π½Π° ΡΠΎ ΠΊΠΎΠ½ΡΠ΅ΠΏΡΠΎΡ Π½Π° ΠΎΠ΄ΡΠΆΠ»ΠΈΠ² ΡΠ°Π·Π²ΠΎΡ Π²ΠΈΠ΄Π΅Π½ Π½ΠΈΠ· ΠΏΡΠΈΠ·ΠΌΠ°ΡΠ° Π½Π° ΠΏΡΠ°Π²ΠΎΡΠΎ ΠΈ ΠΏΠΎΠ»ΠΈΡΠΈΠΊΠΈΡΠ΅ ΠΊΠ°ΠΊΠΎ Π²ΠΎ ΠΠ°ΠΊΠ΅Π΄ΠΎΠ½ΠΈΡΠ°, ΡΠ°ΠΊΠ° ΠΈ Π½Π° ΡΠ΅Π³ΠΈΠΎΠ½Π°Π»Π½ΠΎ/Π΅Π²ΡΠΎΠΏΡΠΊΠΎ ΠΈ Π½Π° ΠΌΠ΅ΡΡΠ½Π°ΡΠ΄Π½ΠΎ Π½ΠΈΠ²ΠΎ. ΠΡΠ²Π΅Π½ ΡΠΎΡΠΌΠΈΡΠ°ΡΠ΅ Π½Π° ΡΠΈΠΌ Π½Π° ΠΈΡΡΡΠ°ΠΆΡΠ²Π°ΡΠΈ, ΠΊΠΎΡΡΡΠΎ Π΅ Π΅Π΄Π½Π° ΠΎΠ΄ Π³Π»Π°Π²Π½ΠΈΡΠ΅ ΡΠ΅Π»ΠΈ, ΠΏΡΠΎΠ΅ΠΊΡΠΎΡ ΠΈΡΡΠΎ ΡΠ°ΠΊΠ° ΠΈΠΌΠ° Π·Π° ΡΠ΅Π» Π΄Π° ΡΠ΅Π³ΡΡΡΠΈΡΠ° ΡΡΡΠ΄Π΅Π½ΡΠΈ ΠΎΠ΄ ΡΠ°Π·Π»ΠΈΡΠ½ΠΈ Π³ΠΎΠ΄ΠΈΠ½ΠΈ ΠΊΠΎΠΈΡΡΠΎ Π±ΠΈ ΡΠ°Π±ΠΎΡΠ΅Π»Π΅ Π½Π° ΡΠ΅ΠΌΠ°ΡΠΈΠΊΠΈ ΠΏΠΎΠ²ΡΠ·Π°Π½ΠΈ ΡΠΎ ΠΎΠ΄ΡΠΆΠ»ΠΈΠ²ΠΈΠΎΡ ΡΠ°Π·Π²ΠΎΡ Π²ΠΎ ΡΠΎΡΠ°Π±ΠΎΡΠΊΠ° ΠΈ ΠΏΠΎΠ΄ ΠΌΠ΅Π½ΡΠΎΡΡΡΠ²ΠΎ Π½Π° ΡΠ»Π΅Π½ΠΎΠ²ΠΈΡΠ΅ Π½Π° ΠΈΡΡΡΠ°ΠΆΡΠ²Π°ΡΠΊΠΈΠΎΡ ΡΠΈΠΌ. ΠΠ° ΠΎΠ²ΠΎΡ Π½Π°ΡΠΈΠ½ ΡΠ΅ ΡΠ΅ ΠΎΡΡΠ²Π°ΡΠΈ Π΅Π΄Π½Π° ΠΎΠ΄ Π΄Π΅Π»Π΅ΠΊΡΡΠ΅ΠΆΠ½ΠΈΡΠ΅ ΡΠ΅Π»ΠΈ Π½Π° ΠΏΡΠΎΠ΅ΠΊΡΠΎΡ, Π° ΡΠΎΠ° Π΅ ΠΏΠΎΠ΄ΠΈΠ³Π°ΡΠ΅ Π½Π° ΡΠ²Π΅ΡΡΠ° ΠΊΠ°Ρ ΠΌΠ»Π°Π΄Π°ΡΠ° ΠΏΠΎΠΏΡΠ»Π°ΡΠΈΡΠ° Π·Π° ΠΊΠΎΠ½ΡΠ΅ΠΏΡΠΎΡ Π½Π° ΠΎΠ΄ΡΠΆΠ»ΠΈΠ² ΡΠ°Π·Π²ΠΎΡ ΠΈ ΠΎΠ±Π΅Π·Π±Π΅Π΄ΡΠ²Π°ΡΠ΅ Π½Π° ΠΎΠ΄ΡΠΆΠ»ΠΈΠ²ΠΎΡΡ Π·Π° ΠΊΠΎΠ½ΡΠ΅ΠΏΡΠΎΡ Π½Π° ΠΎΠ΄ΡΠΆΠ»ΠΈΠ² ΡΠ°Π·Π²ΠΎΡ ΠΏΡΠ΅ΠΊΡ ΠΏΡΠ΅Π½Π΅ΡΡΠ²Π°ΡΠ΅ Π½Π° Π·Π½Π°Π΅ΡΠ΅ ΠΈ ΠΈΠ½ΡΠ΅ΡΠ΅Ρ Π·Π° ΠΈΡΡΠΈΠΎΡ
ΠΡΠΈΠΌΠ΅Π½Π° Π½Π° ΡΠΈΠ½Π°Π½ΡΠΈΡΠΊΠ°ΡΠ° Π°Π½Π°Π»ΠΈΠ·Π° Π²ΠΎ ΠΎΡΠ΅Π½ΠΊΠ° Π½Π° ΠΊΡΠ΅Π΄ΠΈΡΠ½Π°ΡΠ° ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡ Π½Π° ΠΊΠΎΠΌΠΏΠ°Π½ΠΈΠΈΡΠ΅
ΠΡΠΎΡΠ΅Π½ΠΊΠ°ΡΠ° Π½Π° ΠΊΡΠ΅Π΄ΠΈΡΠ½Π°ΡΠ° ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡ Π½Π° ΠΊΠΎΠΌΠΏΠ°Π½ΠΈΠΈΡΠ΅ Π΅ Π΅Π΄Π΅Π½ ΠΎΠ΄ Π½Π°ΡΠ²Π°ΠΆΠ½ΠΈΡΠ΅ ΠΏΡΠΎΡΠ΅ΡΠΈ ΠΎΠ΄ ΠΊΠΎΠΈ Π·Π°Π²ΠΈΡΠΈ ΠΊΠ²Π°Π»ΠΈΡΠ΅ΡΠΎΡ Π½Π° ΠΏΠΎΠ±Π°ΡΡΠ²Π°ΡΠ°ΡΠ°, ΠΎΠ΄Π½ΠΎΡΠ½ΠΎ ΠΊΠ²Π°Π»ΠΈΡΠ΅ΡΠΎΡ Π½Π° ΠΊΡΠ΅Π΄ΠΈΡΠ½ΠΎΡΠΎ ΠΏΠΎΡΡΡΠΎΠ»ΠΈΠΎ ΠΈ Π°ΠΊΡΠΈΠ²Π°ΡΠ° Π½Π° Π΅Π΄Π½Π° Π±Π°Π½ΠΊΠ°. Π‘ΠΈΡΠ΅ ΡΠ°ΠΊΡΠΎΡΠΈ ΠΊΠΎΠΈ Π²Π»ΠΈΡΠ°Π°Ρ Π²ΡΠ· ΡΠΈΠ·ΠΈΡΠΈΡΠ΅ ΡΠΎ ΠΊΠΎΠΈ ΡΠ΅ ΡΠΎΠΎΡΡΠ²Π°Π°Ρ Π±Π°Π½ΠΊΠΈΡΠ΅ Π²ΠΎ Π½ΠΈΠ²Π½ΠΎΡΠΎ ΡΠ°Π±ΠΎΡΠ΅ΡΠ΅, ΠΎΠ΄ ΠΊΠΎΠΈ Π½Π°ΡΠ·Π½Π°ΡΠ°Π΅Π½ Π΅ ΠΊΡΠ΅Π΄ΠΈΡΠ½ΠΈΠΎΡ ΡΠΈΠ·ΠΈΠΊ, ΡΠ΅ ΠΏΡΠ΅Π΄ΠΌΠ΅Ρ Π½Π° ΠΈΡΠΏΠΈΡΡΠ²Π°ΡΠ΅ Π²ΠΎ ΠΏΡΠΎΡΠ΅ΡΠΎΡ Π½Π° ΡΠΈΠ½Π°Π½ΡΠΈΡΠΊΠ°ΡΠ° Π°Π½Π°Π»ΠΈΠ·Π°, ΠΎΠ΄Π½ΠΎΡΠ½ΠΎ Π°Π½Π°Π»ΠΈΠ·Π°ΡΠ° Π½Π° ΠΊΡΠ΅Π΄ΠΈΡΠ½Π°ΡΠ° ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡ Π½Π° ΠΊΠΎΠΌΠΏΠ°Π½ΠΈΠΈΡΠ΅. ΠΡΠΎΡΠ΅ΡΠΎΡ Π½Π° ΡΠΈΠ½Π°Π½ΡΠΈΡΠΊΠ° Π°Π½Π°Π»ΠΈΠ·Π° ΠΎΠΏΡΠ°ΡΠ° Π°Π½Π°Π»ΠΈΠ·Π° Π½Π° ΡΠ°Π±ΠΎΡΠ΅ΡΠ΅ΡΠΎ Π½Π° ΠΊΠΎΠΌΠΏΠ°Π½ΠΈΡΠ°ΡΠ° Π²ΠΎ ΠΌΠΈΠ½Π°ΡΠΎΡΠΎ ΠΈ ΡΠ΅Π³Π°ΡΠ½ΠΎΡΡΠ°, ΡΠΎ ΡΠ΅Π» Π·Π° ΡΡΠΎ ΠΏΠΎΡΡΠΏΠ΅ΡΠ½ΠΎ ΠΏΡΠ΅Π΄Π²ΠΈΠ΄ΡΠ²Π°ΡΠ΅ Π½Π° Π½Π΅ΡΠ·ΠΈΠ½Π°ΡΠ° ΠΈΠ΄Π½Π° Π΄Π΅Π»ΠΎΠ²Π½Π° Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡ.
ΠΡΠ΅Π΄ΠΌΠ΅Ρ Π½Π° ΠΈΡΡΡΠ°ΠΆΡΠ²Π°ΡΠ΅ Π²ΠΎ ΠΎΠ²ΠΎΡ ΡΡΡΠ΄ ΠΏΡΠ΅ΡΡΡΠ°Π²ΡΠ²Π° ΡΡΠ²ΡΠ΄ΡΠ²Π°ΡΠ΅ ΠΈ Π°Π½Π°Π»ΠΈΠ·Π° Π½Π° ΠΏΠΎΠ»ΠΈΡΠΈΠΊΠΈΡΠ΅ ΠΈ ΠΏΡΠΎΡΠ΅Π΄ΡΡΠΈΡΠ΅ ΠΊΠΎΠΈ Π³ΠΈ ΠΊΠΎΡΠΈΡΡΠ°Ρ Π±Π°Π½ΠΊΠΈΡΠ΅ Π²ΠΎ ΠΏΡΠΎΡΠ΅Π½ΠΊΠ°ΡΠ° Π½Π° ΠΊΡΠ΅Π΄ΠΈΡΠ½Π°ΡΠ° ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡ Π½Π° ΠΎΠ΄Π΄Π΅Π»Π½ΠΈΡΠ΅ ΠΊΠΎΠΌΠΏΠ°Π½ΠΈΠΈ, ΠΏΠΎΠΊΠΎΠ½ΠΊΡΠ΅ΡΠ½ΠΎ Π΄Π° ΡΠ΅ ΡΡΠ²ΡΠ΄ΠΈ ΠΊΠΎΠΈ ΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠΈ ΠΈ ΡΠ΅ ΠΏΠΎΡΡΠ΅Π±Π½ΠΈ Π½Π° Π±Π°Π½ΠΊΠ°ΡΠ° Π²ΠΎ ΠΏΡΠΎΡΠ΅ΡΠΎΡ Π½Π° Π°Π½Π°Π»ΠΈΠ·Π° Π½Π° ΡΠΈΠ½Π°Π½ΡΠΈΡΠΊΠΈΡΠ΅ ΠΈΠ·Π²Π΅ΡΡΠ°ΠΈ ΠΈ Π½Π° ΠΊΠΎΡ Π½Π°ΡΠΈΠ½ (ΠΏΡΠ΅ΠΊΡ ΠΏΡΠΈΠΌΠ΅Π½Π° Π½Π° ΠΊΠΎΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ ΠΈ ΡΠ΅Ρ
Π½ΠΈΠΊΠΈ) ΠΈΡΡΠΈΡΠ΅ Π³ΠΈ ΡΠΎΠ»ΠΊΡΠ²Π°, Π·Π° Π΄Π° Π³ΠΎ ΠΎΡΠ΅Π½ΠΈ ΠΊΡΠ΅Π΄ΠΈΡΠ½ΠΈΠΎΡ Π±ΠΎΠ½ΠΈΡΠ΅Ρ Π½Π° ΠΊΠΎΠΌΠΏΠ°Π½ΠΈΡΠ°ΡΠ° ΠΈ Π½Π΅ΡΠ·ΠΈΠ½Π°ΡΠ° ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡ Π·Π° Π·Π°Π΄ΠΎΠ»ΠΆΡΠ²Π°ΡΠ΅.
ΠΠ»ΡΡΠ½ΠΈ Π·Π±ΠΎΡΠΎΠ²ΠΈ: ΡΠΈΠ½Π°Π½ΡΠΈΡΠΊΠ° Π°Π½Π°Π»ΠΈΠ·Π°, ΡΠΈΠ½Π°Π½ΡΠΈΡΠΊΠΈ ΠΈΠ·Π²Π΅ΡΡΠ°ΠΈ, ΠΊΡΠ΅Π΄ΠΈΡΠ½Π° ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡ, ΠΊΠΎΠΌΠΏΠ°Π½ΠΈ
Correlation of serum leptin with anthropometric parameters and abdominal fat depots determined by ultrasonography in overweight and obese women
Leptin is an adipocytokine that has an important role in energy homeostasis and therefore in the pathophysiology
of obesity. Leptin levels are influenced by many factors such as gender, race, energy intake, fat mass, etc.
The aim of our study is to investigate the relationship of circulating leptin levels to anthropometric parameters
and to the subcutaneous and visceral fat tissue determined by ultrasonography in healthy overweight and obese women.
The study included 50 healthy women, with body mass index (BMI) above 25 kg/m2. Measurements of anthropometric parameters were performed with a standardized technique. The subcutaneous and visceral fat tissue was measured with ultrasound 1 cm above the umbilicus. Leptin was determined by radioimmunoassay. The serum leptin levels presented a positive correlation between the levels of leptin and BMI (r-0.73, p < 0.05) waist circumference (r-0.73, p < 0.05) hip circumference (r-0.74, p < 0.05), thigh circumference (r-0.56, p < 0.05) and abdominal subcutaneous fat tissue (r- 0.46, p < 0.05). There was no correlation between leptin and visceral fat tissue, waist to hip and waist to thigh ratio.
The results of our study confirmed the correlation between leptin and BMI. The correlation between leptin and all measured circumferences cannot be attributed to a particular fat depot, but rather reflect the correlation between this adipocytokine and the total body fat. The subcutaneous fat depot determined by ultrasound showed a correlation with leptin, while this kind of connection was not established for the visceral fat tissue.
Key words: Leptin, abdominal subcutaneous fat, abdominal visceral fat
Hand tracing vs digital methods of cephalometric analysis
Introduction
Cephalometric radiography is an essential tool to orthodontists for studying growth and development of the facial skeleton, diagnosis, treatment planning, and evaluating pre- and post-treatment changes. Manual cephalometric analysis has been performed by tracing radiographic landmarks on acetate overlays and measuring linear and angular values. Rapid technological advances have made it possible to perform cephalometric tracing using computers where the landmarks are usually digitized first.
MatΠ΅rials and method
We reviewed several studies in which comparison was made between manual analysis and using computer software programs for cephalometric analysis. Digital films are transferred to conventional films using a printer. Printed films are hand-tracked and measured by one observer. Digital films are analyzed twice using computer software programs by the same observer, using basic and advanced features.
Results
From the reviewed scientific papers it is registered that the basic and the advanced feature procedures took significantly less time than the total time needed for the hand-tracing procedure. The basic procedure independent of the software took significantly less time than the advanced procedure. Small discrepancies were also found between hand-tracing and computerized measurements, but the differences are minimal and clinically acceptable.
Conclusion
Computerized technique can be regarded equally reliable to hand-tracing as far as cephalometric measurements are concerned. Time-saving characteristics of computerized tracing makes this method preferable to hand tracing for cephalometric analysis of radiographs used in diagnosis, treatment planning, and the evaluation of treatment outcome.
Keywords: Cephalometric analysis; Cephalometric radiography; Comparison studies Digital methods; Hand-tracing
Insulin, insulin resistance and anthropometric parameters in overweight and obese women
Insulin resistance together with obesity, hypertension and dyslipidemia is part of the cluster that represents the metabolic syndrome. The impaired insulin sensitivity has been reported to be linked with obesity; however the
importance of the fat distribution has also been emphasized in the development of this disorder.
The aim of our study was to determine to association of serum insulin and insulin resistance assessed by HOMA with anthropometric parameters in obese and overweight women. Also the correlation of insulin and insulin resistance (HOMA-IR) with the subcutaneous and visceral abdominal fat was evaluated.
The study included 41 overweight and obese women, aged 20- 60 years. The anthropometric parameters like body mass index (BMI), waist, hip and thigh circumference were measured with standard methods. Abdominal subcutaneous fat tissue (SFT) and visceral fat tissue (VFT) were determined by ultrasonography. Insulin values were measured with radioimmunoassay and the insulin resistance was assessed by the HOMA2 method.
The results of our study showed strong correlation of insulin and HOMA-IR with BMI (r 0.36, p<0.01). The
median and mean values of these parameters were much higher in subjects with obesity grade 2 and 3. The insulin
concentrations and HOMA-IR also showed good correlation with waist and hip circumference and with the subcutaneous fat tissue (p<0.05).
The results of our study point to the fact that in addition to the total body fat accumulation, the role of the
subcutaneous fat tissue in the development of insulin resistance in overweight and obese Macedonian women should
not be underestimated.
Key words: insulin resistance, subcutaneous fat, visceral fa