Problems of blood glucose self-monitoring in patients with diabetes mellitus

Glycemic self-monitoring is essential in  the  treatment of  diabetes mellitus. Compliance with the  recommendations for  selfmonitoring of glycemia is an important condition for the prevention of diabetes complications. The article provides a review of the problems associated with blood glucose self-monitoring faced by diabetic patients and doctors. These include low frequency of blood glucose self-monitoring, technical errors in glucose measurements, errors in keeping a diary and errors in using measurement data to diabetes control. The blood glucose monitoring system, which includes the glucometer, test strips, application, сloud for data storage can be used for blood glucose self-monitoring in patients with diabetes mellitus. The article discusses the features and advantages of the blood glucose monitoring system. The advantages of the glucometer are the no сoding technology and the following options: аpplication of additional amount of blood to the test strip; adding meal marks, testing as the measurement results compare with targets and informing about it; storage a large number of measurement results. In addition to the standard blood glucose measurement, the glucose meter and the application offer many features to improve blood glucose self-monitoring that can help to improve diabetes management: automatic transferring measurement results to smartphone or tablet; saving notes in logbook; display of glucose trends and testing as they compare with targets; offering quick and valuable tips for critical high/low glucose values

Chiroptera as a Potential Reservoir of Dangerous for Humans Viruses in the territory of the Republic of Guinea. Part 1

Chiroptera is one of the largest in numbers orders of mammals which can take on the role of natural host and vector of various viruses, bacteria, and pathogenic fungi. Over the period of 2007–2013, 248 new viruses pertaining to 24 families were detected in chiropterans. Lately, a range of novel infections that provoked severe diseases in humans were associated with bats-carriers. Presently they are viewed as a potential reservoir of Ebola, Marburg, and Hendra viruses, severe acute respiratory syndrome agents, as well as many other lethal diseases. Chiropterans started drawing particular attention after establishment of the fact that they are involved in circulation of ebolavirus Zaire and possibly participate in the formation of natural foci of this infection. Currently chiropterans are considered to be natural reservoirs of ebolavirus Zaire and some other filoviruses (Filoviridae). Accept from filoviruses, other significant for public healthcare viruses were isolated from chiropterans on the African continent – lyssaviruses (Rhabdoviridae, Lyssavirus), henipaviruses (Paramixoviridae, Henipavirus), and coronaviruses (Coronaviridae, Alphacoronavirus, Betacoronavirus) that can also circulate among chiropterans in West Africa. The data available from literature sources on dissemination of chiropterans in the territory of the African continent, their species diversity, peculiarities of ecology and behavior are analyzed in this paper. The information on the infections for which chiropterans can serve as potential reservoirs is also provided. Specifics of interaction between the population residing on African continent and bats of different species are described too. The review is devoted to the assessment of results of studies on population, ecological, and epidemiological factors contributing to maintenance of circulation of a number of dangerous for humans viruses (filoviruses, lyssaviruses, henipaviruses, and coronaviruses) among African chiropterans. The need for further investigation of the mentioned factors affecting chiropteran populations in the Republic of Guinea is substantiated

Chiroptera as a Potential Reservoir of Dangerous for Humans Viruses in the Territory of the Republic of Guinea. Part 2

Among the viruses transmitted by Chiroptera, filoviruses, lissaviruses, henipaviruses, and coronaviruses pose the major threat to humans. The featured review is devoted to the analysis of the results of studies on the role of African Chiropterans in the circulation sustenance of the viruses. Chronology of investigations on the search of natural reservoir of Filoviruses and the evidence of Chiroptera participation in their circulation are described in the paper. Presented are summarized data on the involvement of chiropterans in the circulation of lissaviruses on the African continent. Given is the information concerning the role of African species of Chiroptera in the circulation of henipaviruses - dangerous for humans viruses of Paramyxoviridae family, associated with chiropterans of South-Eastern Asia. Considered is the possibility of SARS and MERS-like coronaviruses circulation in the populations of certain species of African Chiroptera. Engagement of the Chiroptera from Guinean Republic in maintenance of circulation of the mentioned above viruses in potential natural foci in the territory of the country and possibility of occurrence of dangerous human infection outbreaks is also assessed. The necessity for further investigation of the role of Chiroptera as carriers of the stated viruses to clarify the current epidemiological and epizootiological situation on the viral pathogens in the Republic of Guinea is substantiated

Филовирусы Юго-восточной Азии, Китая и Европы (обзор литературы)

Filoviruses are known as causative agents of severe haemorrhagic fevers with a high mortality rate in humans. Zaire ebolavirus and Marburgvirus, the most known of them, are associated with the occurrence of sporadic cases and outbreaks of hemorrhagic fevers in some parts of Africa. Isolation of Reston ebolavirus in 1989 in the United States from samples of dead cynomolgus monkeys imported from the Philippines was the first evidence on the existence of filoviruses outside the Africa. Due to the development of new diagnostic methods, Reston ebolavirus or its markers (RNA, antibodies) were found in different animals in the Philippines, China and some other countries of Southeast Asia. These events significantly changed the concept of the geography of filoviruses at present time. Novel filoviruses have been identified in bats in China using of molecular genetic methods. Detection of filovirus RNA (the Lloviu virus) in samples from dead common bent-winged bats in Spain (2002) and in Hungary (2016) indicates the possibility of circulation of filoviruses with unknown pathogenicity potential for humans and animals among bats of temperate latitudes. This review summarizes data on findings of filovirus markers in animals in Southeast Asia, China and Europe.Филовирусы известны как возбудители тяжелых геморрагических лихорадок с высоким уровнем смертности у людей. Наиболее известные из них – эболавирус Заир и Марбургвирус – связаны с возникновением спорадических случаев и вспышек геморрагических лихорадок в отдельных районах Африки. Выделение эболавируса Рестон в 1989 г. в США из образцов внутренних органов погибших яванских макак, импортированных из Филиппин, стало первым доказательством существования филовирусов за пределами Африканского континента. В начале XXI в. с развитием новых методов диагностики эболавирус Рестон или его маркеры (РНК, антитела) были обнаружены у разных животных на Филиппинах, в Китае и других странах Юго-Восточной Азии, что существенно изменило представление о географии филовирусов. С использованием молекулярно-генетических методов были идентифицированы новые филовирусы у рукокрылых в Китае. Обнаружение генетического материала нового филовируса – Лловиу вируса – в образцах внутренних органов погибших обыкновенных длиннокрылов в 2002 г. в Испании и в 2016 г. в Венгрии свидетельствует о возможности циркуляции филовирусов с неизвестным потенциалом патогенности для людей и животных среди рукокрылых умеренных широт. Настоящий обзор посвящен анализу данных о находках маркеров филовирусов у животных в Юго-Восточной Азии, Китае и Европе

Detection of tick-borne pathogens in wild birds and their ticks in Western Siberia and high level of their mismatch

Abstract: The Tomsk region located in the south of Western Siberia is one of the most high-risk areas for tick-borne diseases due to elevated incidence of tick-borne encephalitis and Lyme disease in humans. Wild birds may be considered as one of the reservoirs for tick-borne pathogens and hosts for infected ticks. A high mobility of wild birds leads to unpredictable possibilities for the dissemination of tick-borne pathogens into new geographical regions. The primary goal of this study was to evaluate the prevalence of tick-borne pathogens in wild birds and ticks that feed on them as well as to determine the role of different species of birds in maintaining the tickborne infectious foci. We analysed the samples of 443 wild birds (60 species) and 378 ticks belonging to the genus Ixodes Latraille, 1795 collected from the wild birds, for detecting occurrence of eight tick-borne pathogens, the namely tick-borne encephalitis virus (TBEV), West Nile virus (WNV), and species of Borrelia, Rickettsia, Ehrlichia, Anaplasma, Bartonella and Babesia Starcovici, 1893, using RT-PCR/or PCR and enzyme immunoassay. One or more tick-borne infection markers were detected in 43 species of birds. All markers were detected in samples collected from fieldfare Turdus pilaris Linnaeus, Blyth’s reed warbler Acrocephalus dumetorum Blyth, common redstart Phoenicurus phoenicurus (Linnaeus), and common chaffinch Fringilla coelebs Linnaeus. Although all pathogens have been identified in birds and ticks, we found that in the majority of cases (75.5%), there were mismatches of pathogens in birds and ticks collected from them. Wild birds and their ticks may play an extremely important role in the dissemination of tick-borne pathogens into different geographical regions

Molecular Genetic Analysis of the Complete Genome of Tick-Borne Encephalitis Virus (Siberia Subtype): Modern Kolarovo-2008 Isolate

Determined is the complete genome sequence of Kolarovo-2008 strain (Siberia subtype) of Tick-borne encephalitis virus (TBEV), isolated from a tick in the suburbs of the Tomsk city. Nucleotide sequence analysis testifies of the fact that the level of genetic differences within the Siberian subtype of TBEV amounts to 10 % of the nucleotide sequence and to 7 % of amino-acid sequence for certain virus genes. 3'-HTO of the genome of Siberian subtype has the highest rate of variability and the homology level ranging from 65 to 97 %. Kolarovo-2008 and Vasilchenko (isolated in Novosibirsk in 1969) strains have the highest level of genome homology. The level of dissimilarity between the two Tomsk strains is substantially higher: the total number of amino-acid substitutions in Tomsk Zausaev and Kolarovo-2008 strains equals to 124, and 3'HTO level of homology is 79 %. Identified genetic variability of the Siberian subtype of TBEV is of a great importance for further development and enhancement of tick-borne encephalitis virus diagnostics

ПРИМЕНЕНИЕ ТЕРЛИПРЕССИНА С ЦЕЛЬЮ УМЕНЬШЕНИЯ КРОВОПОТЕРИ ПРИ КЕСАРЕВОМ СЕЧЕНИИ

The objective of the study: to assess the impact of the agonist of vasopressin receptor V-1 (terlipressin) in the operative delivery of obstetric patients with a high risk of hemorrhage during cesarean section.Subjects and methods. 60 women were examined, all of them had planned cesarean section; the median age made 32.7 years and gestation time made 38 weeks. Group 1 (n =30) included patients who underwent surgery without terlipressin; Group 2 (n =30) included women who had 0.4 mg of terlipressin intra-operatively introduced endometrially (into the place of the uterus incision) immediately after omphalotomy. The volume of the blood loss was measured intra-operativelly. The arterial tension and hemodynamic rates were assessed during the surgery and in 24 hours after it in the morning.Results. It was found out that there was a statistically significant difference in the volume of intra-operative blood loss and need for blood transfusion. Using terlipressin resulted in the reduction of blood loss by 37–50% which was due to its pharmacological effects, i.e. vasoconstrictive and antihemorrhagic ones.Conclusions. Using terlipressin within comprehensive intensive care during cesarean section in the patient facing the high risk of hemorrhage allows reducing the intra-operative blood loss to a significant extent and reducing transfusion of donor blood components.Цель исследования: оценка влияния агонистов V1-вазопрессиновых рецепторов (терлипрессин) при оперативном родоразрешении у родильниц с высоким риском развития кровотечения при операции кесарева сечения.Материал и методы. Обследовано 60 женщин, родоразрешенных путем кесарева сечения в плановом порядке, средний возраст которых составил 32,7 года, срок гестации – 38 недель. В 1-ю группу (n = 30) включены пациентки, оперированные без применения препарата «Терлипрессин», 2-ю группу (n = 30) составили женщины, которым интраоперационно сразу после пересечения пуповины внутриматочно (в место разреза на матке) вводили терлипрессин в дозе 0,4 мг. Интраоперационно измеряли объем кровопотери. Артериальное давление и показатели гемодинамики оценивали во время операции и через 24 ч после операции в утренние часы.Результаты. Выявлена статистически значимая разница в объеме интраоперационной кровопотери и потребности в гемотрансфузии. Терлипрессин приводил к уменьшению кровопотери на 37–50%, что обусловлено его фармакологическими эффектами – сосудосуживающим и кровоостанавливающим.Выводы. Использование терлипрессина в комплексной интенсивной терапии при операции кесарева сечения у пациенток с высоким риском развития кровотечения позволяет существенно уменьшить объем интраоперационной кровопотери и снизить трансфузию компонентов донорской крови

Высокая суммарная доза облучения улучшает выживаемость больных локализованной формой мелкоклеточного рака легкого: результаты одноцентрового ретроспективного анализа

The overall survival of patients with locally advanced small cell lung cancer who received at least 2 courses of chemotherapy and external beam radiation therapy at a total dose >50 Gy delivered to the primary tumor was retrospectively studied. Patients were dividedinto 2 groups. Patients in the standard treatment group (n=71) were treated to 50–58 Gy total dose. The dose escalation group (n=69) was treated to 60–74 Gy. Accelerated fractionation regimen in radiotherapy was more frequently given in dose escalation treatment group. The 1-, 3- and 5-year survival rates in the dose escalated and standard dose groups were respectively 54 % (95 % CI 42–65 %) and 32 % (95 % CI 23–44 %), р=0,11; 25 % (95 % CI 16–36 %) and 1 % (95% CI 0–8 %), р=0,0003; 17 % (95 % CI 10–28 %) and 0 % (95 % CI 0–5 %) (р=0.0007). The median survival was 14 months (95 % CI 10–17 months) in the dose escalated treatment group and 9 months (95 % CI 8–11months) in patients of the standard treatment group (χ2=16,8, р<0,0001). Multifactorial analysis showed that a total dose of ≥60 Gy resulted in reduction in risk of death (RR 0,57 (CI 0,37–0,88), р=0,012). Radiation dose escalation can result in improvement of local control for patients with locally advanced small cell lung cancer. Prospective randomized studies are required to finally confirm this hypothesis. Проведено ретроспективное изучение общей выживаемости больных Л-МРЛ, получавших не менее 2 курсов химиотерапии и дистанционную ЛТ в СОД не менее 50 Гр на первичный очаг. Больные группы СОДст (n=71) получили облучение грудной клетки в стандартно рекомендованной дозе, в группе СОДэск (n=69) суммарная доза составляла 60–74 Гр по биологическому эквиваленту. Лучевую терапию в режиме ускоренного фракционирования с эскалацией дозы (УГФЭД) чаще применяли в группе СОДэск. Более 1, 3 и 5 лет жили пациенты из группы СОДэск и СОДст соответственно в 54 % (95 % ДИ 42–65 %) и 32 % (95 % ДИ 23–44 %), р=0,11; в 25 % (95 % ДИ 16–36 %) и 1 % (95% ДИ 0–8 %), р=0,0003; в 17 % (95 % ДИ 10–28 %) и 0 % (95 % ДИ 0–5 %) случаях (р=0,0007). Медиана выживаемости в группах составила 14 (95 % ДИ 10–17 мес) и 9 (95 % ДИ 8–11 мес) мес, χ2=16,8, р<0,0001 соответственно. При многофакторном анализе только СОД 60 Гр и выше независимо снижала риск смерти (ОР 0,57 (ДИ 0,37–0,88), р=0,012). Увеличение СОД выше стандартно рекомендуемых 50–58 Гр может привести к улучшению выживаемости больных Л-МРЛ. Окончательное подтверждение этой гипотезы возможно только в рамках проспективного рандомизированного исследования

Circulation of Lyssaviruses (Lyssavirus) among the Small Mammals in the Territory of the Republic of Guinea

Objective is to study the role of small mammals, habitant in the Republic of Guinea, in Lyssavirus circulation. Materials and methods. Investigations were conducted using RT-PCR; nucleotide sequence of Lyssavirus cDNA fragments was identified with the help of sequencing with further phylogenetic analysis. Results and conclusions. Tested have been 356 brain samples from small mammals for the presence of Lyssavirus RNA using RT-PCR with genus-specific primers. The animals were caught in the suburbs of Kindia city in 2016. The samples were obtained from wild animals pertaining to Rodentia, Chiroptera, Eulipotyphla, and Carnivora orders.Lyssavirus RNA was detected in 31 samples (8.7 %). For 14 PCR positive samples the appurtenance to Lyssavirus was confirmed through identification and analysis of nucleotide sequences of the collected short cDAN fragments of viral genome. The presence of rabies virus RNA in positive tests was excluded from PCR with the help of species specific primers. The pool of samples from black rats, Rattus rattus, positive for Lyssavirus RNA, contained RNA characteristic of Mokola lyssavirus species. Specified has been nucleotide sequence of matrix protein M gene fragment of Mokola virus. Genetic material of Mokola virus was detected in the Republic of Guinea for the first time ever