Posteriori estimation of teaching and learning process

У статті розглядується питання застосування технології апостеріорного оцінювання навчально-пізнавальної діяльності студентів. Результати апостеріорного оцінювання надають важливу інформацію про ефективність викладання викладачеві та навчальному закладу.В статье рассматривается вопрос использования технологии апостериорного оценивания учебно-познавательной деятельности студентов. Результаты апостериорного оценивания предоставляют важную информацию об эффективности преподавания преподавателю и учебному заведению.The question about the development and application of technology posterior estimation of teaching and educational activity of the students, is considered at the article. Posteriori estimation results provide important information about the performance of teaching and teacher education institutions

Application of Basophil Activation Test with Anthraxin for Laboratory ( <I>in vitro</I>) Diagnostics of Anthrax

Demonstrated is the possibility to use in vitro basophil activation test with anthraxin, with registration of the results by means of flow cytometry, for anthrax diagnostics. This approach seems promising as it provides quantitative assessment of sensitization of the organism and does not cause its additional allergization. The duration of the analysis is 1h. The test is suggested for application, as an express one, for early and retrospective laboratory diagnostics of anthrax, estimation of post-vaccinal immunity

STUDYING DEVELOPMENT OF POST-VACCINAL CELLULAR IMMUNITY AGAINST BRUCELLOSIS BY MEANS OF LYMPHOCYTE <i>IN VITRO</i> TESTS USING AN EXPERIMENTAL ANTIGENIC COMPLEX

Regulatory framework and methodological approaches to evaluation of immunological effects of vaccination against brucellosis are not established, and the degree of immunological post-vaccinal rearrangement is not yet developed. Due to leading role of cellular immunity in formation of immune protection against brucellosis, evaluation the cellular response in response to antigenic stimulation may be considered the most informative and objective approach to analysis of immune changes in the body during vaccination. In order to develop the most diagnostically informative methods for design of antigen-stimulation cell tests in vitro, a careful selection of a stimulating agent (antigen) is required, which should have a sufficient activating potential, thus providing specificity of reaction under in vitro conditions. The aim of the present study is to study the in vitro specific activity of a protein-polysaccharide antigenic complex from the Brucella abortus 19 BA strain (BrAg), and an opportunity of its application in order to assess the formation of post-vaccinal cellular immunity against brucellosis.The study was performed with white laboratory mice (n = 50) immunized with the Brucella abortus 19 BA strain. The control group (n = 50) consisted of laboratory mice that received a sterile saline solution in a volume of 0.5 ml. Blood samples were taken from immunized and control animals before vaccination, and 7, 14, 21, and 30 days after immunization. By means of flow cytometry, the activation molecules CD25, CD69, MHC II and CD95, expressed on T lymphocytes (CD3+CD69+, CD3+CD25+, CD3+CD95+, CD3+MHC+) were determined. To observe the development of immunity, the intensity of expression of T lymphocyte activation markers was calculated using the stimulation quotient. BrAg was used for specific in vitro stimulation of T lymphocytes. The liquid brucellosis allergen (brucellin) was used as an antigen for comparison, when studying opportunity of BrAg usage for assessing the postvaccinal immunity development.The following results were obtained: BrAg has pronounced specific activity, it did not cause non-specific in vitro reactions (activation) of T lymphocytes, thus enabling its application as a test antigen when evaluating development of adaptive vaccine immunity against brucella.Experimental testing of brucellosis antigen for carrying out the in vitro antigen-stimulated cellular reactions, aiming for evaluation of post-vaccinal immunity development against brucellosis, showed that the usage of BrAg promotes increase in diagnostic sensitivity of cellular reactions under in vitro experimental conditions. The applied experimental antigen is a quite promising tool for development of laboratory algorithms for brucellosis diagnostics, and assessment of actual vaccination efficiency in cohorts previously vaccinated against brucellosis

Using CAST-test to investigate human specific hypersensitivity to the anthrax pathogen

We present the results of applying functional cytometric test of antigen-stimulated activation basophils to assess specific immunological reactivity in the people with anthrax, and immunized with anthrax vaccine. As a criterion for antigen-specific basophil activation, we measured expression of the CD63 membrane receptor, which reflects the process of anaphylactic basophil degranulation. To determine spontaneous and antigen-induced activation of basophils (CCR3+CD63+), a FlowCAST reagent kit (Buhlmann laboratories AG, Switzerland) was used. Anthraxin, an experimental anthrax allergen (a hydrolysate the Bacillus anthracis STI-1 strain), manufactured by the Stavropol Anti-Plague Institute, was used as a specific antigen. As based on clinical and experimental data, a threshold value of &gt; 10% of anthraxin-activated (CCR3+CD63+) basophils was accepted for the in vitro immunodiagnostic CAST test, as a laboratory criterion for the subjects exhibiting specific immune response, i.e., IgE-mediated sensitization. It was shown that, in anthrax patients within one week after onset of the disease (3-7 days), a positive CAST result was obtained in 92.3% cases; the levels of specific basophil activation with anthraxin averaged 37.9% (12.01 ÷ 78.9%). Immunological examination of individuals three weeks (21 days) after vaccination against anthrax revealed CAST-positivity in all the vaccinated persons. Intensity of anthraxin-induced basophil activation the vaccinated subjects was ranged from 10.87 to 30.03%, averaging 17.86%. The overall values of spontaneous and specific activation ranged within 12.39 ÷ 41.46%. The study opens prospectives for implementation of basophil antigenic activation test in the Flow CAST format in diagnostics of anthrax and to identify specific immune rearrangements after vaccination in humans, as an index of actual vaccination rates. Usage of CAST test with anthraxin makes it possible to identify anthrax patients at the early stages (2-4 days after onset of the disease) including, among patients with an increased CCR3+CD63+ background values, evaluation of immunological efficiency in the cohorts at risk for vaccination. At the same time, it was found that a significant decrease in diagnostic sensitivity of CAST test could be observed in the patients immune to anthrax pathogen who received intensive antibacterial and pathogenetic therapy at the early stages of infection, including glucocorticosteroids (anti-inflammatory drugs) and desensitizing agents that inhibit the degree of hypersensitivity development and its expression

Analysis of Epizootiological-Epidemiological Situation on Brucellosis in the Russian Federation in 2018 and Forecast for 2019

Presented is the analysis of brucellosis incidence among humans and animals in the Russian Federation in 2018. Epizootiological situation in the regions of developed animal husbandry remains reasonably tense. In 2018, as in previous years, the foci of bovine cattle and small ruminant brucellosis were registered in the North Caucasian, Southern Federal Districts, Volga and Siberian Federal Districts, the share of which made up to more than 90% of all registered in Russia potentially hazardous as regards brucellosis areas and cases of the disease in animals. Against the background of long-term unfavorable epizootic condition, the incidence of brucellosis over the past three years was, on average, 14 % lower than the average long-term indicators. The greatest number of cases (94.1 % of the overall Russian incidence) is registered in the administrative subjects of the North Caucasus Federal District, Southern Federal District and Siberian Federal District, which have the maximum levels of brucellosis incidence in cattle (88.9 %) and small ruminants (95 %). In 2019, persistence of epidemiological problems in regard to brucellosis in the subjects of the North Caucasus Federal District (primarily the Republic of Dagestan, Stavropol Territory), the Southern Federal District (the Republic of Kalmykia, Volgograd and Astrakhan Regions), and the Siberian Federal District (the Tuva Republic, the Omsk and Tyumen Regions) is predicted. The number of human cases of brucellosis may be within the range of 290–310 cases (intensive incidence rate per 100 thousand population – 0.21)

Brucellosis: Trends in the Development of Situation in the World and Forecast for 2022 in the Russian Federation

An analysis of trends in the development of situation on brucellosis in the world over past decade and the data on the main risk factors for the occurrence of epidemiological complications regarding this infection in various regions of the world are provided in the paper. An expert assessment of the current epizootiological and epidemiological situation on brucellosis, the coverage of population and animals with immunization in the Russian Federation is given. Over 9 months of 2021, 210 potentially hazardous as regards brucellosis in cattle areas and 24 sites – as regards brucellosis in small ruminants – were registered in Russia. Compared to the same period in 2020, there was a decrease in the number of newly identified hazardous sites for bovine brucellosis by 35.8 % (117 areas). However, long-term upward trend in epizootiological adversity for bovine brucellosis in Russia persists. The epidemiological situation on brucellosis in the country for the period of 2012–2021 is characterized as unfavorable. Decrease in the number of newly detected human brucellosis cases (by 25.1 % of long-term average values) is observed against the background of persistent unfavorable epizootic conditions for brucellosis among epidemiologically significant species of small ruminants and cattle in regions with developed animal husbandry. In 2021, clusters of human cases were registered in the Republic of Dagestan and Penza Region. In the Republic of Dagestan, against the background of aggravation of epizootiological and epidemiological situation on brucellosis, there was also an alarming trend towards prevalence of a relatively high incidence among minors. The proportion of cases of brucellosis among children under the age of 17 in the Republic amounted to 60.3 % of the total number of minors with newly diagnosed brucellosis in Russia over the past 10 years. Taking into account current epizootic, epidemic situations and the long-term dynamics of the development of situation on  brucellosis in the Russian Federation, the incidence of brucellosis among the population  is predicted to be 10–15 % lower than the average long-term values – 0.18–0.20 per 100000 of the population – in 2022. The number of human cases of brucellosis can range from 250 to 300

IgG4-RELATED DISEASE. CLINICAL NOTES

IgG4-related diseases are a new nosological entity that encompasses a few previously known diseases. IgG4-related systemic disease is diagnosed if two or more affected organs are detected. This group of diseases has two similar signs: serological (elevated serum IgG4 subclass concentrations) and histological (organ and tissue infiltration from plasmo-cytes secreting IgG4, and eosinophils, and the development of fibrosclerosis and phlebitis obliterans). The paper describes two cases. In one case, a multisystemic disease was observed virtually at its onset whereas in the other this lesion was diagnosed several years after the natural course of the disease

Analysis of Brucellosis Incidence and Molecular-Genetic Characteristics of Brucella Population in the Territory of the Russian Federation

An analysis of brucellosis incidence in Russia in 2013–2022 and the data on genetic diversity of Brucella melitensis and Brucella abortus populations isolated in Russia in 1939–2022 are provided in the review. Over the past decade, the epidemiological situation in Russia has been characterized as unstable against the background of persistent unfavorable conditions for brucellosis in cattle and small ruminants. During the period of 2013–2022 (9 months), 4298 epizootic foci as regards brucellosis in cattle (89164 sick animals) and 371 as regards brucellosis in small ruminants (13569) were registered. The largest number of epizootic brucellosis foci was recorded in the North-Caucasian and Southern Federal Districts. In 2013–2022, on average, 327 cases of brucellosis among people were registered annually, the incidence rate per 100 000 of the population was 0.24. Up to 70–90 % of brucellosis cases were detected in the south of the European part of the country. A trend towards deterioration of the situation on brucellosis in Volga (Penza and Samara Regions) and Central (Smolensk, Voronezh and Tula Regions) Federal Districts is observed. There is a connection between the intensity of epidemic manifestations of brucellosis and the level of anthropurgic enzooty of territories. In 2022, 467 cases of brucellosis were reported (0.32 per 100 000 of the population), which is 42.8 % higher than annual average values over 10 years. In 2023, a measure of stability of incidence rates, by 20–25 % above average long-term values, is to be expected. Incidence of brucellosis in humans will be within the range of 380–410 cases (0.26–0.28 per 100 000 of the population). The results of genotyping of B. melitensis strains point to an increase in the proportion of isolates with an MLVA-profile characteristic of strains from enzootic as regards brucellosis countries of Middle East and North Africa over past 20–25 years, which can indicate importation (introduction) of the infection from these territories to Russia through small ruminants and/or biomaterial from them

Дифференциальная диагностика плазматических дискразий в ревматологической практике

Plasma cell dyscrasias (PCD) present certain difficulties in differentially diagnosing with autoimmune rheumatic diseases (RD) as they have some clinical and laboratory manifestations that are characteristic of the latter. Objective: to generalize the experience in diagnosing PCD at the Research Institute of Rheumatology (RIR), Russian Academy of Medical Sciences (RAMS). Subjects and methods. Nineteen patients admitted to the RIR, RAMS, for rheumatological referral diagnoses were diagnosed as having different types of PCD, both PCD in the presence of RD (n = 10) and primary PCD without RD (n = 9). Immunochemical studies of serum and urinary proteins and bone marrow trepanobiopsy were performed in all the patients. Histological studies were made of the minor salivary glands (n = 12), lymph nodes (n = 3), parotid salivary glands - PSG (n = 5), spleen (n = 1), cranial bones (n = 2) and humerus (n = 1). The immunophenotype of tumor lymphocytes in the biopsy and trepanobiopsy specimens were determined by an immunoflurenscence method with standard monoclonal antibody panels and the paraffin sections of biopsy specimens were examined by an immunoperoxidase technique. Biopsy and trepanobiopsy speciments and myelograms were assessed by the researchers of the N.N. Blokhin Russian Cancer Research Center, RAMS. Results. Over 10 years of follow-up, 19 patients (13 females and 6 males) were diagnosed as having different types of PCD: multiple myeloma (MM) (n = 9), extramedullary plasmacytoma of lymph nodes (n = 2), solitary plasmacytoma (SP) of bone (n = 2), Bence-Jones myeloma (BJM) (n = 2), primary amyloidosis (PA) (n = '), lymphoplasmacytic lymphoma (n = '), Waldenström's macroglobulinemia (WM) (n = 2). In the presence of RA, '0 patients with PCD developed Sjogren's disease (SD) (n = 7), rheumatoid arthritis (RA) + SD (n = 2), RA (n = '); and 9 patients had primary PCD (MM (n = 5), BJM (n = '), WM (n = '), SP (n = '), and PA (n = ')). These 9 patients with different rheumatological diagnoses were long followed up and referred to the RIR, RAMS, to specify these. One third of the patients had recurrent conjunctivitis, enlarged PSG and xerostomia (55%). Arthralgias, arthritis of minor and large joints, flexion contractures of hands, ossalgias, and pains in the lumbar spine and ribs were present in '0-45% of the patients. Vascular lesions, such as Reynaud's phenomenon, recurrent purpuras, lower extremity ulcerative lesions, and toe gangrenes, were observed in '0-35% of the patients with PCD. Lesions in the reticuloendothelial system, such as lymphadenopathy, splenomegaly ('5%), hepatomegaly (45%), and fever (25%), were also detected. Conclusion. Many clinical and laboratory manifestations of primary PCD and RD are similar and only the absence of classical laboratory markers of autoimmune disease, as well as the presence of serum monoclonal immunoglobulins and urinary Bence Jones protein suggest the presence of PCD, both primary PCDs and those with RD.Плазматические дискразии (ПД) представляют определенные трудности для дифференциальной диагностики с аутоиммунными ревматическими заболеваниями (РЗ), так как имеют некоторые клинические и лабораторные проявления, присущие последним. Цель исследования - обобщить опыт диагностики ПД в НИИ ревматологии РАМН. Материал и методы. У 19 пациентов, поступивших в НИИ ревматологии РАМН с направительными диагнозами РЗ, диагностированы различные варианты ПД, как на фоне имеющегося РЗ (у 10), так и первичные ПД без признаков РЗ (у 9). Всем больным проводили иммунохимическое исследование белков сыворотки крови и мочи, трепанобиопсию костного мозга. Выполняли гистологическое исследование малых слюнных желез (у 12), лимфатических узлов (у 3), околоушных слюнных желез - ОСЖ (у 5), селезенки (у 1), костей черепа (у 2) и плечевой кости (у 1). Иммунофенотип опухолевых лимфоцитов в биоптатах и трепанобиоптатах определяли им-мунофлюоресцентным методом со стандартными панелями моноклональных антител, а парафиновые срезы биоптатов изучали им-мунопероксидазным методом. Биоптаты, трепанобиоптаты и миелограммы оценивали сотрудники РОНЦ им. Н.Н. Блохина РАМН. Результаты исследования. За '0лет наблюдения у 19 больных (13 женщин и 6 мужчин) диагностированы различные варианты ПД: множественная миелома (ММ) - у 9, внекостная плазмоцитома лимфатических узлов (ВП) - у 2, солитарная плазмоцитома костей (СП) - у 2, миелома Бенс-Джонса (МЫ) - у 2, первичный амилоидоз (ПА) - у 1, лимфоплазмоцитарная лимфома (ЛПЛ) - у 1, макроглобулинемия Вальденстрема (МВ) - у 2. У 10 больных ПД развились на фоне РЗ: болезни Шёгрена - у 7, ревматоидного артрита (РА) + синдрома Шёгрена - у 2, РА у - 1, и у 9 больных ПД были первичными (ММ - у 5, МЫ - у 1, МВ - у 1, СП - у ', ПА - у '). Эти 9 больных длительно наблюдались с различными ревматологическими диагнозами и были направлены в НИИ ревматологии РАМН для уточнения таковых. У трети больных присутствовали рецидивирующие конъюнктивиты, увеличение ОСЖ и ксеростомия (у 55%). Артралгии, артрит мелких и крупных суставов, сгибательные контрактуры кистей, оссалгии, боли в поясничном отделе позвоночника и в ребрах имелись у '0-45% больных. Сосудистые поражения: феномен Рейно, рецидивирующие пурпуры, язвенные поражения нижних конечностей и гангрена пальцев стоп наблюдались у '0-35% больных ПД. Выявлены также поражение ретикулоэндотелиальной системы: лимфаденопатия, спленомегалия ('5%), гепатомегалия (45%) и лихорадка (25%). Заключение. Многие клинико-лабораторные проявления первичных ПД и РЗ являются сходными и только отсутствие классических лабораторных маркеров аутоиммунного заболевания, а также наличие моноклональных Ig в сыворотке крови и белка BJ в моче позволяет предположить наличие ПД, как первичных, так и на фоне РЗ