ТУБООВАРИАЛЬНЫЕ ГНОЙНЫЕ ОБРАЗОВАНИЯ: СОВРЕМЕННЫЕ АСПЕКТЫ ДИАГНОСТИКИ И ЛЕЧЕНИЯ

RELEVANCE. The increasing frequency of the disease in the population, the young age of the vast majority of patients, the traumatic traditional surgery, followed by removal of the organ, the high rate of postoperative complications.PURPOSE OF THE STUDY. The introduction of transvaginal minimally invasive treatments (under the control of ultrasound scan), the formation of the protocols for patients in accordance with specific models of the pathology.MATERIAL AND METHODS. The women in the number of 224 with the tube-ovarian purulent formations of the uterus. General clinical examination included standard techniques and pelvic ultrasound. The methods of the treatment include: the conservative methods – the combined antibiotic therapy, the minimally invasive methods – the transvaginal puncture-aspiration therapy under ultrasound, the laparoscopy and the traditional laparotomy.Results And Conclusions. The management protocols based on the structural and topographic characteristics of the tubeovarian pus formation of the uterus are offered. The achieving the cold phase of the disease by the transvaginal puncture-aspiration therapy is an important step for addressing the need for, and nature of a post-operative treatment. АКТУАЛЬНОСТЬ. Возрастающая частота заболевания в популяции, молодой возраст подавляющего большинства пациенток, травматичная традиционная операция, сопровождающаяся органоудалением, высокая частота послеоперационных осложнений.ЦЕЛЬ ИССЛЕДОВАНИЯ. Внедрение трансвагинальных малоинвазивных методов лечения (под контролем ультразвукового сканирования), формирование протоколов ведения больных в соответствии с конкретными моделями патологии.МАТЕРИАЛ И МЕТОДЫ. 224 женщины с тубоовариальными гнойными образованиями придатков матки. В стандарт обследования входили общеклинические методы и УЗИ малого таза. Методы лечения включали: консервативный – комбинированная антибиотикотерапия, малоинвазивные – трансвагинальная пунционно-аспирационная терапия под контролем УЗИ, лапароскопия, традиционная лапаротомия.РЕЗУЛЬТАТЫ ИССЛЕДОВАНИЯ И ВЫВОДЫ. Предлагаются протоколы ведения, основанные на структурной и топографической характеристике тубоовариальных гнойных образований придатков матки, определяемые при УЗИ. Достижение холодной фазы заболевания путем трансвагинальной пункционно-аспирационной терапии является важным этапом для решения вопроса о необходимости, характере и способе последующего оперативного лечения.

Characterization of tularemia foci in the Republic of Kazakhstan from 2000 to 2020

The wide distribution of tularemia in the territory of Kazakhstan is associated with landscape and geographical characteristics. This is explained by a combination of natural factors: the presence of certain types of rodents—reservoirs and sources, ectoparasites—carriers of the causative agent of tularemia. The study of the current spatial and temporal characterization of tularemia in Kazakhstan from 2000 to 2020 will determine the epidemiological status of tularemia and improve the monitoring system in Kazakhstan. In this work we demonstrated the results of a retrospective survey of natural foci of tularemia: analysis of vector, small mammal and human data. The spatial and temporal characteristics of tularemia from 2000 to 2020 in the territory of Kazakhstan were studied in comparison with historical data, including the description of tularemia outbreaks, the clinical picture, and the source of infection, transmission factors, and geographical coordinates of outbreak registration. Sampling was carried out by trapping rodents on snap traps and collecting ticks by rodent combing and by "flagging" methods. For the last 20 years, 85 human cases of tularemia have been reported. During the period from 2000 to 2020, more than 600 strains of F. tularensis were isolated from field rodents and ticks in the natural foci of tularemia. MLVA typing of F. tularensis strains isolated from natural foci of tularemia in Kazakhstan over the past 20 years. The results of retrospective monitoring indicate that currently active foci of tularemia include the Aktobe, West Kazakhstan, Almaty, East Kazakhstan, and Pavlodar regions. Low-activity natural foci are located in the territory of the Akmola, Karaganda, North Kazakhstan, Kostanay, Atyrau, Zhambyl, and Kyzylorda regions. There are no active natural foci of tularemia in the Mangystau and Turkestan regions. The widespread occurrence of tularemia in the country is associated with landscape and geographical features that contribute to the circulation of the pathogen in the natural focus. An analysis of natural foci of tularemia showed that it is necessary to continue monitoring studies of carriers and vectors for the presence of the causative agent of the F. tularensis, in order to prevent mass cases of human disease

THE EPIDEMIOLOGICAL SITUATION ON CHOLERA IN THE REPUBLIC OF KAZAKHSTAN IN 2011

The analysis of registered cholera cases that occurred during 1993-2008 showed that all epidemic cases of cholera in Kazakhstan were imported. The toxigenic cholera microbes were isolated from the water reservoirs which started in the neighbor country. The spatial distribution of non-toxic cholera vibrio has the regional features. The climatic and anthropogenic factors affect the distribution of the cholera vibrio in the Kazakhstan. The results of the analysis show that the complex approach has to be used for cholera epidemiological monitoring

Zoning of the Territory of the Republic of Kazakhstan by the Degree of Intensity of the Epizootic Situation on Plague in Camels

The aim of the study was to improve epizootiological monitoring and increase the effectiveness of preventive (anti-epidemic) measures for camel plague control in Kazakhstan.Materials and methods. We used the data on epizootiological and epidemiological monitoring in natural plague foci of Kazakhstan, long-term measurements and indicators for the period of 2000–2020 of the anti-plague and veterinary services of the Republic for the analysis. To process the evidence, epidemiological, epizootiological, microbiological, and statistical research methods, as well as GIS technology were applied.Results and discussion. The number of camels has increased by 2.2 times in Kazakhstan over the past 20 years.  Where there were 98.2 thousand heads in 2000, it amounted to 216.4 thousand heads in 2020. Over the past 10 years, 152 camels died of unknown causes in the focal area of the country, but laboratory tests for plague turned out negative. According to the hazard criteria, the territory of the country has been conditionally divided into three zones: five regions with a high degree of hazard with a total area of 953.15 sq. km, five regions with medium degree of hazard with a total area of 1230.72 sq. km, and with a low degree of hazard – four regions and three cities of republican significance with a total area of 541.1 sq. km. Constant epizootiological monitoring over plague in camels is a necessity for the system of preventive measures

Demarcation of the Boundaries of the Central Asian Desert Natural Focus of Plague of Kazakhstan and Monitoring the Areal of the Main Carrier, <I>Rhombomys opimus</I>

The aim of the study was to clarify the boundaries of the Central Asian natural plague focus of Kazakhstan and the modern boundaries of the areal of the great gerbil (Rhombomys opimus) in order to improve epizootiological monitoring and increase the effectiveness of preventive (anti-epidemic) measures.Materials and methods. Data from the epizootiological monitoring of the great gerbil populations in 14 autonomous foci of the Central Asian desert natural plague focus in the Republic of Kazakhstan between 2010 and 2020 were used for the analysis. An epizootiologic survey of an area of 875350 km2 was carried out. When processing the data, epidemiological, epizootiological, statistical research methods, as well as GIS technologies were used.Results and discussion. An increase in the total area of the Central Asian desert natural plague focus of the Republic of Kazakhstan by 79710 km2 (9.98 %) has been established for the period of 1990–2020. It is noted that the change in the area of plague-enzootic territory was a consequence of the ever changing areal of the main carrier of plague pathogen – the great gerbil – under the influence of climatic and anthropogenic factors. The most significant changes were found in the southeastern part of the plague-enzootic territory, including those for the Betpakdala (50 %), Balkhash (34.3 %), Taukum (13.3 %) and Mojynkum (0.32 %) autonomous foci. The area of the Aryskum-Dariyalyktakyr autonomous focus decreased by 2100 km2 (4 %). In 2000–2002, new Alakol’sky and Ili intermountain autonomous foci with a total area of 26759 km2 were discovered. It is shown that due to the regression of the Aral Sea, the areal of the great girbil expanded and the area of the North Aral and Kyzylkum natural plague foci increased by 10500 km2 (29.2 %) and 560 km2 (0.4%), respectively. The areas of the Aral-Karakum and UralEmba desert autonomous foci, on the contrary, decreased by 2000 km2 (2.6 %) and 12300 km2 (17.6 %), respectively. Passportization and landscape-epizootiologic zoning of the territory of the Central Asian desert natural plague focus of the Republic of Kazakhstan has been completed

THE TUBE-OVARIAN PUS FORMATION: THE MODERN ASPECTS OF THE DIAGNOSIS AND THE TREATMENT

RELEVANCE. The increasing frequency of the disease in the population, the young age of the vast majority of patients, the traumatic traditional surgery, followed by removal of the organ, the high rate of postoperative complications.PURPOSE OF THE STUDY. The introduction of transvaginal minimally invasive treatments (under the control of ultrasound scan), the formation of the protocols for patients in accordance with specific models of the pathology.MATERIAL AND METHODS. The women in the number of 224 with the tube-ovarian purulent formations of the uterus. General clinical examination included standard techniques and pelvic ultrasound. The methods of the treatment include: the conservative methods – the combined antibiotic therapy, the minimally invasive methods – the transvaginal puncture-aspiration therapy under ultrasound, the laparoscopy and the traditional laparotomy.Results And Conclusions. The management protocols based on the structural and topographic characteristics of the tubeovarian pus formation of the uterus are offered. The achieving the cold phase of the disease by the transvaginal puncture-aspiration therapy is an important step for addressing the need for, and nature of a post-operative treatment

Association of sTREM&#x2010;1 and Neutrophil-to-Lymphocyte Ratio as Prognostic Markers in COVID-19 Short- and Long-Term Mortality

Lyudmila Turgunova,1 Irina Mekhantseva,1 Lyudmila Akhmaltdinova,1 Mikhail Kostinov,2,3 Zhibek Zhumadilova,1 Anar Turmukhambetova1 1Karaganda Medical University, Department of Internal Medicine, Karaganda, Kazakhstan; 2I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, Russia; 3Sechenov First Moscow State Medical University, Department of Epidemiology and Modern Vaccination Technologies, Moscow, RussiaCorrespondence: Irina Mekhantseva, Email [email protected]: Current problem related to COVID-19 is various complications after disease, especially long-term mortality after COVID-19. Routine blood tests presented their effectiveness in the diagnosis, prognosis and mortality of COVID-19. The neutrophil-to-lymphocyte ratio (NLR) is an important marker of systemic inflammation. Soluble Trigger receptor expressed on myeloid cells-1 (sTREM-1) is considered an intrinsic enhancer of inflammatory signals. This study examined the predictive value of these markers in COVID-19 mortality.Methods: A prospective study was conducted involving patients with COVID-19 in Karaganda, Kazakhstan. The neutrophil–to-lymphocyte ratio (NLR) was calculated as the absolute number of neutrophils divided by the absolute number of lymphocytes. The level of sTREM-1 in the blood serum was evaluated by ELISA.Results: Plasma sTREM-1 concentration greater than 59.08 pg/mL and an NLR greater than 2.29 had an increased risk of early mortality (hazard ratio = 8.07; 95% CI: 1.03– 62.17 and 9.24; 95% CI: 1.202– 71.08, respectively); for long-term mortality of sTREM-1 greater than 47.34 pg/mL (hazard ratio = 7.96; 95% CI: 1.072– 59.18) and NLR greater than 2.10 (hazard ratio = 11.52; 95% CI: 1.551– 85.52).Conclusion: This study suggests that early levels of sTREM-1 and NLR are associated with the risk of 6-month mortality after experiencing COVID-19.Keywords: COVID-19, mortality, neutrophil-to-lymphocyte ratio, sTREM‐1, prognostic marker

The Influence of the Burning Environment on the Properties of Ceramic Products Based on Fusible Raw Materials

The purpose of this work was to investigate the effect of the burning environment on the properties and phase composition of clinker-based ceramic specimens made from loam with diatomite and bentonite clay in order to develop technological parameters for the manufacture of clinker products. The main raw material used for the experiments was local fusible loam from the Almaty deposit, which is the basis for the production of 75 and 100 grade ceramic bricks. Diatomite from Utesai deposit (Aktobe region) and highly plastic bentonite clay from Darbazin deposit (Turkestan region) were used as additives. Loam and bentonite clay were applied after grinding and sieving through a 1 mm sieve. Diatomite was applied after grinding and milling until it had completely passed through a 0.315 mm sieve. The raw materials are mixed after dosing, and then water is added in the amount required until a pliable mass is obtained. To investigate the properties of the products, standard cylinder samples were prepared with a diameter of 50 mm and a height of 50 mm. The cylinder samples were pressed on a hydraulic press at a pressure of 2–4 kN. The samples were dried in a desiccator at 95–100 °C for 2 h. After drying, the products were burning in a muffle kiln. The analysis of the properties of the burned products showed that the optimum ratio in the ceramic mixture of loam and diatomite to loam and bentonite clay is 85%:15%. After burning in a slightly oxidising environment at 1170 °C, the ceramic specimens correspond to Class 2 for the medium-density and compressive strength grades M 400 and M 500 (GOST 530-2012 (Government standard). X-ray diffractometric analysis showed that the products contain augite, quartz and anorthite as crystalline phases, with the former predominating. After burning in a reducing atmosphere, at 1170 °C, the properties of the samples have higher values compared to the samples burning in a weakly oxidising atmosphere. The resulting properties, according to the regulations, are characteristic of clinker bricks (DIN V 105-1 (technical requirements for clinker façade bricks). After burning in a reducing environment, the phase composition of the products changes qualitatively; in addition to augite and quartz, albite, diopside, orthoclase and haematite are present in the samples

Datasheet1_Characterization of tularemia foci in the Republic of Kazakhstan from 2000 to 2020.xls

The wide distribution of tularemia in the territory of Kazakhstan is associated with landscape and geographical characteristics. This is explained by a combination of natural factors: the presence of certain types of rodents—reservoirs and sources, ectoparasites—carriers of the causative agent of tularemia. The study of the current spatial and temporal characterization of tularemia in Kazakhstan from 2000 to 2020 will determine the epidemiological status of tularemia and improve the monitoring system in Kazakhstan. In this work we demonstrated the results of a retrospective survey of natural foci of tularemia: analysis of vector, small mammal and human data. The spatial and temporal characteristics of tularemia from 2000 to 2020 in the territory of Kazakhstan were studied in comparison with historical data, including the description of tularemia outbreaks, the clinical picture, and the source of infection, transmission factors, and geographical coordinates of outbreak registration. Sampling was carried out by trapping rodents on snap traps and collecting ticks by rodent combing and by "flagging" methods. For the last 20 years, 85 human cases of tularemia have been reported. During the period from 2000 to 2020, more than 600 strains of F. tularensis were isolated from field rodents and ticks in the natural foci of tularemia. MLVA typing of F. tularensis strains isolated from natural foci of tularemia in Kazakhstan over the past 20 years. The results of retrospective monitoring indicate that currently active foci of tularemia include the Aktobe, West Kazakhstan, Almaty, East Kazakhstan, and Pavlodar regions. Low-activity natural foci are located in the territory of the Akmola, Karaganda, North Kazakhstan, Kostanay, Atyrau, Zhambyl, and Kyzylorda regions. There are no active natural foci of tularemia in the Mangystau and Turkestan regions. The widespread occurrence of tularemia in the country is associated with landscape and geographical features that contribute to the circulation of the pathogen in the natural focus. An analysis of natural foci of tularemia showed that it is necessary to continue monitoring studies of carriers and vectors for the presence of the causative agent of the F. tularensis, in order to prevent mass cases of human disease.</p