Differential Diagnostic Methods Research Articles

The potential and limitations of standard electrocardiography for the differential diagnosis of wide QRS complex tachycardias

The possibility to identify potentially life-threatening ventricular arrhythmias by analysis of standard electrocardiography (ECG) parameters without the use of sophisticated and expensive diagnostic techniques, such as electrophysiological heart studies, has been an important achievement of the last decades. Current differential diagnostic methods for wide QRS complex tachycardias can be categorized into 4 groups: 1) identification the ECG signs diagnostic of ventricular tachycardia, such as atrioventricular dissociation and/or sinus captures and/or fusion QRS complexes; 2) analysis of the distinct morphological features of QRS complexes during wide QRS complex tachycardias; 3) analysis of the ECG characteristics in between wide QRS complex tachycardia attacks; 4) comparison of the morphological QRS features during wide QRS complex tachycardia and during sinus rhythm periods. The list of ECG algorithms for differential diagnosis of wide QRS complex tachycardias has been growing and updated year after year; however, all of them have their limitations. Most frequently, the differential diagnosis between ventricular and aberrant supraventricular tachycardias is based on the morphological criteria of wide QRS complexes developed by H.J. Wellens et al., P. Brugada et al., M. Griffith et al., K.E. Kindwal et al., A. Vereckei et al. At the same time, there is a continuous search for new algorithms or criteria that could be easily used without decreased specificity and/or sensitivity of the diagnosis of ventricular tachycardia. The aim of this review is to comprehensively analyze the literature data and results of our own studies on the potential and limitation of standard ECG for the differential diagnosis of ventricular and various aberrant supraventricular tachycardias.

Features of the Epidemiological Situation on Siberian Tick Typhus and other Tick-Borne Ricketsioses in the Russian Federation, Prognosis for 2019

The review presents an analysis of the epidemic situation on infections of rickettsial etiology, the causative agents of which are transmitted by Ixodidae ticks in the territory of the Russian Federation. The data obtained through molecular-biological verification allow to unite under the name of “tick-borne ricketsioses” a group of infections caused by R. sibirica subsp. sibirica, R. conorii, R. heilongjiangensis and other species of rickettsiae circulating in natural foci of various regions of Russia. Cases of tick-borne rickettsioses in Siberia and the Far East, caused by various species of rickettsiae, are registered under the name of “Siberian tick-borne typhus” due to the lack of available methods of differential laboratory diagnostics. The paper presents the assessment of the incidence of Siberian tick-borne typhus, indicating not only the varying degrees of epidemic hazard of endemic regions, but also changes in the distribution of risk areas, including the identification of new, epidemically significant foci. In accordance with the risk-oriented approach to prophylaxis, forecasting of epidemic situation on tick-borne rickettsioses was given and differentiation of the endemic territories of the Russian Federation as regards Siberian tick-borne typhus was carried out with distinguishing of epidemiological zones of low, medium, above average, high and very high risk of population infection.

Immunological methods for the diagnosis of oral mucosal diseases

Immunological methods, which have been widely used in autoimmune blistering diseases (AIBDs) of the oral mucosa, can also be adopted as auxiliary diagnostic tools in oral lichen planus (OLP) and discoid lupus erythematosus (DLE). AIBDs, characterized by autoantibodies against structural proteins of keratinocytes or the basement membrane zone, clinically present as blisters and erosions of the oral mucosa. When atypical lesions occur, OLP or DLE may be confused with AIBDs. The improvement of diagnostic accuracy is necessary due to the significant differences in treatment and prognosis among these diseases. A variety of immunological methods are used for qualitative and quantitative detection of target antigens and autoantibodies. These methods can evaluate efficacy of treatment, monitor diseases and guide treatment decisions. In this review, we discuss the application of immunofluorescence, biochemical tests, and protein microarrays for AIBDs, OLP and DLE, as well as the differential diagnostic methods using immunological tests.

The current understanding of overlap between characteristics of HIV-associated neurocognitive disorders and Alzheimer's disease.

The advent of effective antiretroviral medications (ARVs) has led to an aging of the HIV population with approximately 50% of people with HIV (PWH) being over the age of 50years. Neurocognitive complications, typically known as HIV-associated neurocognitive disorders (HAND), persist in the era of ARVs and, in addition to risk of HAND, older PWH are also at risk for age-associated, neurodegenerative disorders including Alzheimer's disease (AD). It has been postulated that risk for AD may be greater among PWH due to potential compounding effects of HIV and aging on mechanisms of neural insult. We are now faced with the challenge of disentangling AD from HAND, which has important prognostic and treatment implications given the more rapidly debilitating trajectory of AD. Herein, we review the evidence to date demonstrating both parallels and differences in the profiles of HAND and AD. We specifically address similarities and difference of AD and HAND as it relates to (1) neuropsychological profiles (cross-sectional/longitudinal), (2) AD-associated neuropathological features as evidenced from neuropathological, cerebrospinal fluid and neuroimaging assessments, (3) biological mechanisms underlying cortical amyloid deposition, (4) parallels in mechanisms of neural insult, and (5) common risk factors. Our current understanding of the similarities and dissimilarities of AD and HAND should be further delineated and leveraged in the development of differential diagnostic methods that will allow for the early identification of AD and more suitable and effective treatment interventions among graying PWH.

Кохлеарная имплантация при отосклерозе с IV степенью тугоухости и глухотой

The article presents a literature review devoted to such pathology as otosclerosis with severe hearing loss and deafness. The article describes in details this pathology, research methods, analysis of statistical data and different methods of surgical treatment of otosclerosis with degree IV hearing loss, as well as their results. The article describes the present-day methods of diagnostics and differential diagnostics with other pathologies in the preoperative period in otosclerosis with severe hearing loss and deafness. The experience of various authors in preoperative preparation of patients with otosclerosis with severe hearing loss in cochlear implantation (CI). The detailed analysis of each CI technique, complexity and complications (intraoperative and postoperative), which significantly affects the results of rehabilitation in cochlear implantation in patients with otosclerosis with degree IV hearing loss and deafness. The problem of intraoperative diagnosis of this pathology remains unsolved. The authors suggest various ways of registration of reflexes, however, they are not effective in stapes ankylosis or after stapedoplasty. The article points out the unsolved problems in this pathology that need further development to improve the results of rehabilitation after CI.

Результаты хирургического лечения пациентов с кохлеарной формой отосклероза

Despite the progress in otosurgery, the efficient treatment of patients with the cochlear form of otosclerosis (according to the classification of N.A. Preobrazhensky, 1962) remains an important task. The authors have developed and implemented an advanced stapedoplasty method, providing the improvement of hearing in this category of patients. and described the methods of differential diagnostics for selection of patients according to the developed method. The article describes in details the early and long-term functional results of surgical treatment of 60 patients with cochlear and mixed II forms of otosclerosis, divided into the main and control groups. The main group is represented by 30 patients who underwent a cartilage-on-vein stapedoplasty according to the improved method. The control group included 30 patients, in which 18 people underwent a cartilage-on-vein stapedoplasty according to the method developed by Lenin Prize winner V. F. Nikitina, and 12 people who underwent V. T. Palchun’s piston stapedoplasty. The results demonstrate a statistically significant improvement of bone conduction in the main group in average by 15–20 dB throughout the entire tone scale (except for high frequencies in some patients) and the complete closure of the bone-air interval with subsequent preservation of the results. Based on the obtained data, the authors present the expediency and perspectivity of implementation of the advanced stapedoplasty method.

Refining methods of vibration diagnostics of wear of turbo-prop engine differential speed reduction unit gear teeth

The paper presents results of complex research of vibration behavior of the differential reduction gear unit of a turboprop engine on the basis of statistics of products with repaired reduction gears and those placed under repair. The conducted research made it possible to establish the source of resonant oscillations of the compressor design elements leading to their breakage. It is established that this source is determined by the kinematics of the reduction gear unit and is associated with the wear of its gear teeth. Standards for the intensity of the appropriate discrete component of the reduction gear vibration spectrum and those for the amount of permissible wear are substantiated and established on the basis of the work carried out. A complex of diagnostic parameters of wear based on intensity components of the auto-spectrum and the spectrum of maxima, the depth of amplitude modulation in some narrow-band processes, their characteristics based on the parameters of the current frequency and mutual characteristics was identified. It is shown that for the whole complex of the diagnostic parameters obtained their dependence on the wear value is satisfactorily approximated by a linear characteristic. The obtained results can serve as a basis for the development of a complex of methods of differential reduction gear vibration diagnostics.

Distinctive pattern of AHNAK methylation level in peripheral blood mononuclear cells and the association with HBV-related liver diseases.

The purpose of this study was to investigate the correlation between AHNAK methylation level in peripheral blood mononuclear cells (PBMC) and the progression of hepatitis B virus (HBV)‐related liver disease. Bioinformatics methods were applied to evaluate the AHNAK methylation level in PBMC and T cells at different stages of HBV related liver disease, to investigate the correlation between AHNAK methylation and clinical features, as well as to compare the methylation site of AHNAK in cancer tissues and adjacent tissues. Subsequently, the differentially expressed gene analysis technique was used to analyze the liver disease‐related genes and immune‐related pathways in hepatitis B patients with different pathological changes. Finally, promoter methylation and mRNA expression of AHNAK gene in liver cancer and adjacent tissues were determined by quantitative polymerase chain reaction (Q‐PCR), and the diagnostic value of AHNAK methylation level in hepatopathy was evaluated by receiver operating characteristic (ROC) curve. The promoter methylation level of AHNAK gene in PBMCs decreased with the progression of HBV‐related liver disease, and showed significant difference among the patients with various HBV‐related liver diseases (P = 0.0001). The AHNAK methylation level in PBMCs and T cells was negatively associated with age, white blood cell count, CREA, drinking, and positively associated with APTT and HbsAg. Higher mRNA expression of AHNAK was found in liver cancer tissues than that of adjacent tissues (P < 0.001), and the methylation level in PBMC decreased with the progression of hepatitis B‐related liver disease. The area under the ROC curve (ROC) was 0.883 (P < 0.001) in diagnosis of chronic hepatitis B (CHB), 0.885 (P < 0.001) in diagnosis of compensatory liver cirrhosis, 0.955 (P < 0.001) in diagnosis of decompensated liver cirrhosis, 0.981 (P < 0.001) in diagnosis of hepatocellular carcinoma. Our results revealed that AHNAK methylation level in peripheral blood decreases with the progression of hepatitis B‐related liver disease. This provided a potential differential diagnostic method for HBV‐related hepatopathies, and thus an early detective tool for liver cancer.

Identification of two novel fowl adenovirus C-specific B cell epitopes using monoclonal antibodies against the capsid hexon protein.

The diseases associated with fowl adenovirus (FAdV) infection, such as inclusion body hepatitis (IBH), hepatitis-hydropericardium syndrome (HPS), and gizzard erosion (GE), were first reported in Pakistan in 1987, and subsequent outbreaks have been reported worldwide, especially in China, where severe outbreaks of HPS with high mortality from 30 to 100% were recently reported and resulted in significant economic losses to the poultry industry. The diagnosis methods of FAdVs were mostly limited to the nucleotide sequence of hexon by PCR and DNA sequencing. The aim of this study was to generate B cell epitope maps of the species- and serotype-specific hexon L1 using monoclonal antibodies (mAbs) and bioinformatics tools for the development of novel diagnostic methods. In this study, the hexon L1 (230 amino acids) was expressed and used to generate 10 mAb-expressing hybridoma cell lines against the relative protein peptide. Subsequently, we defined the linear peptide epitopes recognized by these mAbs using a series of partially overlapping peptides derived from the FAdV-C hexon protein amino acid sequence to map mAbs reactivity. Finally, a common B cell epitope (31PLAPKESMFN40) for all species FAdVs and two FAdV-C-specific epitopes (79KISGVFPNP87 and 181DYDDYNIGTT190) were identified. These mAbs and their defined epitopes may support the development of the universal or species-specific differential diagnostic methods of FAdVs.

Label-Free Quantitative Proteomics Identifies Novel Plasma Biomarkers for Distinguishing Pulmonary Tuberculosis and Latent Infection.

The lack of effective differential diagnostic methods for active tuberculosis (TB) and latent infection (LTBI) is still an obstacle for TB control. Furthermore, the molecular mechanism behind the progression from LTBI to active TB has been not elucidated. Therefore, we performed label-free quantitative proteomics to identify plasma biomarkers for discriminating pulmonary TB (PTB) from LTBI. A total of 31 overlapping proteins with significant difference in expression level were identified in PTB patients (n = 15), compared with LTBI individuals (n = 15) and healthy controls (HCs, n = 15). Eight differentially expressed proteins were verified using western blot analysis, which was 100% consistent with the proteomics results. Statistically significant differences of six proteins were further validated in the PTB group compared with the LTBI and HC groups in the training set (n = 240), using ELISA. Classification and regression tree (CART) analysis was employed to determine the ideal protein combination for discriminating PTB from LTBI and HC. A diagnostic model consisting of alpha-1-antichymotrypsin (ACT), alpha-1-acid glycoprotein 1 (AGP1), and E-cadherin (CDH1) was established and presented a sensitivity of 81.2% (69/85) and a specificity of 95.2% (80/84) in discriminating PTB from LTBI, and a sensitivity of 81.2% (69/85) and a specificity of 90.1% (64/81) in discriminating PTB from HCs. Additional validation was performed by evaluating the diagnostic model in blind testing set (n = 113), which yielded a sensitivity of 75.0% (21/28) and specificity of 96.1% (25/26) in PTB vs. LTBI, 75.0% (21/28) and 92.3% (24/26) in PTB vs. HCs, and 75.0% (21/28) and 81.8% (27/33) in PTB vs. lung cancer (LC), respectively. This study obtained the plasma proteomic profiles of different M.TB infection statuses, which contribute to a better understanding of the pathogenesis involved in the transition from latent infection to TB activation and provide new potential diagnostic biomarkers for distinguishing PTB and LTBI.

Tumors of thymus gland: clinical features, diagnosis, treatment

Main aspects of histogenesis, morphology and classification of tumors of the thymus, the current state of their diagnosis and treatment are submitted. Clinical manifestations of thymomas are dependent on their endocrine activity, pace and nature of growth, size and relationship with surrounding structures of mediastinum. Hormonal tumors of thymus are often accompanied by the development of generalized myasthenia gravis. Spiral computed and magnetic resonance tomography are recognized as the leading methods of diagnostics and differential diagnostics of the tumors of thymus gland. However, frequency of diagnostic errors can reach 10-30% of observations. The main method of treatment is surgical, as providing radical and the best long-term results. An adequate volume of surgical treatment of tumors of the thymus gland is thymomthymectomy- enblock removal of a tumor and the entire gland tissue along with fatty tissue and lymph nodes of anterior mediastinum. Various «open» and endovideosurgical approaches to thymus removal have been proposed. Minimally invasive endovideoscopic removal of thymus has a number of advantages over traditional, «open» thymectomy and is characterized by a much smaller intraoperative blood loss and duration of drainage of the pleural cavities, early activization of a patient and a shorter hospital stay. The implementation of endovideosurgical intervention is prescribed with the removal of thymoma I-II stage of cancer progression, as well as in some cases of combined operational benefits at stage III. However, international experience is not sufficient for making decisions regarding the selection of an optimal surgical approach in each case. In invasive tumors of thymus, combined treatment with the inclusion of radiation and chemotherapy is recommended. However, the choice of components of a treatment, modes and sequence remain controversial.

Principles of drug therapy for acute bacterial rhinosinusitis: from evidence-based medicine to practice

The problem of treatment of acute rhinosinusitis (ARS) is extremely important due to high prevalence of the disease. According to statistical data the ARS affects from 6% to 15% of population and does not show any tendency to reduction. These figures are associated with a high rate of acute respiratory viral infection (ARVI) which directly leads to rhinosinusitis. But, however, despite the fact that practically every individual experiences from 2 to 5 episodes of ARVI every year, only 0.5-2% of them are complicated with acute bacterial rhinosinusitis (ABRS). Despite this low percentage of bacterial infection, in 80% of cases systemic antibacterial treatment is prescribed which further worsens the problem of bacterial resistance in the world. The main difficulty in determination of therapeutic approach to ABRS is associated with absence of reliable methods of differential diagnostics of viral and bacterial etiology of the disease. Because of low sensitivity and specificity, none of additional visualization methods of ABRS diagnosing such as radiography, ultrasonography, computed tomography, can be used as a routine laboratory method. Thus, the main method of differential diagnostics of viral and bacterial ARS remains analysis of clinical data which leads to a high rate of diagnostic errors and to polypragmacy.&#x0D; Nowadays there exists a wide range of medications for treatment of ABRS in the pharmacological market. The choice of therapeutic approach by our international colleagues is mostly based on the requirements of evidence-based medicine. Russian scientists, besides evidence-based medicine principles take into account the pathogenesis of the disease.&#x0D; In this article different groups of medications for treatment of ABRS are presented. Some of them do not meet the requirements of evidence-based medicine so far, but they are included to the Russian standards and are used for management of ABRS.

Principles of drug therapy for acute bacterial rhinosinusitis: from evidence-based medicine to practice

The problem of treatment of acute rhinosinusitis (ARS) is extremely important due to high prevalence of the disease. According to statistical data the ARS affects from 6% to 15% of population and does not show any tendency to reduction. These figures are associated with a high rate of acute respiratory viral infection (ARVI) which directly leads to rhinosinusitis. But, however, despite the fact that practically every individual experiences from 2 to 5 episodes of ARVI every year, only 0.5-2% of them are complicated with acute bacterial rhinosinusitis (ABRS). Despite this low percentage of bacterial infection, in 80% of cases systemic antibacterial treatment is prescribed which further worsens the problem of bacterial resistance in the world. The main difficulty in determination of therapeutic approach to ABRS is associated with absence of reliable methods of differential diagnostics of viral and bacterial etiology of the disease. Because of low sensitivity and specificity, none of additional visualization methods of ABRS diagnosing such as radiography, ultrasonography, computed tomography, can be used as a routine laboratory method. Thus, the main method of differential diagnostics of viral and bacterial ARS remains analysis of clinical data which leads to a high rate of diagnostic errors and to polypragmacy.&#x0D; Nowadays there exists a wide range of medications for treatment of ABRS in the pharmacological market. The choice of therapeutic approach by our international colleagues is mostly based on the requirements of evidence-based medicine. Russian scientists, besides evidence-based medicine principles take into account the pathogenesis of the disease.&#x0D; In this article different groups of medications for treatment of ABRS are presented. Some of them do not meet the requirements of evidence-based medicine so far, but they are included to the Russian standards and are used for management of ABRS.

ОПРАЦЮВАННЯ РІЗНИХ МЕТОДИК ВИКЛАДАННЯ ДИФЕРЕНЦІЙНОЇ ДІАГНОСТИКИ ЕСЕНЦІАЛЬНОЇ РЕЗИСТЕНТНОЇ ТА ПСЕВДОРЕЗИСТЕНТНОЇ АРТЕРІАЛЬНОЇ ГІПЕРТЕНЗІЇ ДЛЯ ЛІКАРІВ-ІНТЕРНІВ ЗІ СПЕЦІАЛЬНОСТІ “ЗАГАЛЬНА ПРАКТИКА – СІМЕЙНА МЕДИЦИНА”

Мета роботи – оцінити ефективність засвоєння лікарями-інтернами удосконаленої нами методики диференційної діагностики есенціальної РАГ та ПРАГ у порівнянні з загальноприйнятою методикою.Основна частина. У дослідження було включено 120 пацієнтів (чоловіків – 68 (56,7 %); жінок – 52 (43,3 %); середній вік – (55±8,8) року) з гіпертонічною хворобою. Всі пацієнти мали вихідний рівень артеріального тиску (АТ) вище за 140/90 мм рт. ст. при прийомі 3-х та більше антигіпертензивних препаратів (АГП), один із яких діуретик. Лікарі-інтерни першого року навчання були розподілені на дві групи: І група – контрольна (30 інтернів) – опрацьовувала традиційну методику диференційної діаг­ностики есенціальної РАГ та ПРАГ; ІІ група (30 інтернів) – навчалась нової методики диференційної діагностики есенціальної РАГ та ПРАГ.Строки проведення диференційної діагностики РАГ та ПРАГ запропонованою нами методикою склали (3,9±2,6) дня, у порівнянні з традиційною методикою – (16,4±6,8) дня (p&lt;0,01). Впровадження запропонованої методики дозволило лікарям-інтернам основної групи краще орієнтуватись у причинах вторинних форм РАГ – 25 ((83,3±6,8) %), у порівнянні з контрольною групою – 14 ((46,7±9,1) %) інтернів (p&lt;0,01). Внаслідок проведеної роботи збільшилась кількість інтернів, які опанували методику диференційної діагностики РАГ та ПРАГ, з 12 ((40,0±8,9) %) до 24 ((80,0±7,3) %) в основній групі (p&lt;0,001), та з 14 ((46,7±9,1) %) до 18 ((60,0±8,9) %) інтернів контрольної групи (p&gt;0,5).Висновок. Удосконалена нами методика викладання знань і навичок диференційної діагностики есенціальної РАГ і ПРАГ дозволяє значно скоротити строки її проведення та достовірно покращити засвоєння знань і практичних навичок у лікарів-інтернів зі спеціальності “Загальна практика – сімейна медицина”.

BILATERAL OVULATIONS FOR THE DAIRY BREEDS: DIAGNOSTICS, PREVALENCE, PRACTICAL VALUE

Results of monitoring research of morphological features of ovaries of cows of dairy breeds in 0th day of a follicular phase of a sexual cycle are presented. By differential manual technic diagnostic method one significantly established that the frequency of cases of bilateral ovulations of follicles is influenced by the level of milk production: amongst cows, that have milk production lower, than 5 thousand, this phenomenon was found in 12,88% of cycles, and among highly productive cows (6 000–10 000 kg) – only in 4,34% of cases. Significantly more frequent prevalence of bilateral ovulations was found amongst thoroughbred cows (7,34% of cycles) in comparison with local cattle (0,82% of cycles). Genetic influence on the frequency of bilateral ovulations is significantly established by the statistical analysis of data: amongst cows of red and red-and-white breeds – 10,96% of cycles were with bilateral ovulations, and amongst black-and-white cattle, respectively – 6,57%. For the first time the biological value of bilateralism of development of the dominating cow follicles is experimentally established. Among females with double ovulations after insemination the pregnancy was fixed by 1,5–6,4 times more often, than among cows with single ovulations (respectively, for the herds of Ukrainian Red Dairy and Ayrshire breeds). Pair gonads of cows are key bodies in dairy cattle reproduction, therefore studying of ovary morphogenesis and identification of biological resources of reproduction are important tasks in herd reproduction problem solving under the conditions of industrial milk production technologies.

NBI-endoscopy as an advanced method of early differential diagnostics of larynx tumors

The article provides information about significance and efficacy of NBI-endoscopy in early differential diagnostics of various larynx tumors which makes it possible to detect pathologically changed areas of mucosa and identify a specific vascular pattern characteristic of neoplasms. Based on the study conducted in the Phoniatrics Department of Clinical Research Centre of Otorhinolaryngology of the Federal Medico-Biological Agency of the Russian Federation and the analysis of literature, the authors describe advisability and prospects of NBI-endoscopy implementation in the practice of otorhinolaryngologists.

INNOVATIONS IN THE MANAGEMENT OF CHILDREN’S NEUROINFECTIONS

The article describes some topical problems of neuroinfections in children and the ways of their solutions on the basis of the experience of a leading institution — Pediatric Research and Clinical Center for Infectious Diseases. There are introduced some innovation approaches of diagnostics and therapy of bacterial purulent meningitis tested at the institution. There are described diagnostic markers of meningitis in children, method of ultrasound evaluation monitoring of the condition of kidneys, renal blood flow, adrenal glands in the patients with a fulminant course of generalized form of meningococcal infection, and innovation therapeutic approach by recombinant interleukin-2 — roncoleukin introduction to the complex therapy. There is reflected an innovation method of differential diagnostics by the determination of acute-phase protein haptoglobin in cerebrospinal fluid. There are presented the tested methods to diagnose sensorineural deafness in children with bacterial purulent meningitis, critical condition polyneuropathy, and inflammatory polyneuropathy by the technique of rehabilitation potential evaluation.

Differential Diagnostics of Neoplastic and Inflammatory Processes in the Brain by Modifications NMDA Receptor Activity in Blood Cells with Verapamil and Ketamine.

For the development of methods of additional differential diagnostics of gliomas of various grades of malignancy and gliomas and local inflammatory processes in the CNS we studied the intensity of aggregation of peripheral blood cells under the influence of channel blockers ketamine and verapamil. In in vitro experiments, verapamil and ketamine in various dilutions (from 10 to 100,000 times) were added to blood samples and the effects of these dilutions on the intensity of blood aggregation in patients with gliomas of different degree of malignancy, traumatic brain injuries, and other types of neurosurgical pathologies were studied. A correlation was revealed between the decrease in surface charge of blood cells and the type of neurosurgical pathology. The use of functional properties of potential-dependent inotropic NMDA receptors and calcium channels allowed indirect estimation of their activity via parameters of blood cell aggregation induced by channel blockers ketamine and verapamil.

Practical Approaches for Post-Operative and Post-Traumatic Lymphoedemas

Swelling of the extremities is frequently observed after traumatic lesions and poses differential diagnostic challenges. Causes include seromas, haematomas and thromboses, as well as lymphostatic oedemas, which may become chronic if left untreated. These are characterized by a high percentage of protein and, over the long term, they can lead to considerable impairment and complications such as recurrent erysipelas as a result of fibrotic tissue rearrangement. Usually a clinical diagnosis is made, which presupposes that the symptoms are known. The most important treatment option is complete decongestive therapy, with manual lymphatic drainage and lymphological multicomponent bandaging being applied at least on a daily basis. Surgical intervention is only possible in individual cases. Because their chronic progression can lead to disablement, post-traumatic lymphoedemas are often the subject of assessments in private and statutory accident insurance proceedings. This paper explains the formation mechanism of post-traumatic lymphoedemas and provides an overview of differential diagnostic methods and current treatment recommendations. The authors also touch on insurance-related aspects.

Loop-mediated isothermal amplification assay targeting the mpb70 gene for rapid differential detection of Mycobacterium bovis.

Loop-mediated isothermal amplification (LAMP) is a highly sensitive, rapid, cost-effective nucleic acid amplification method. Tuberculosis (TB) is widely popular in the world and it is difficult to cure. The fundamental treatment is to clear the types of TB pathogens such as Mycobacterium bovis (M. bovis), Mycobacterium tuberculosis (M. tuberculosis). In order to detect and diagnose TB early, we constructed the differential diagnostic method of TB. In this study, we used LAMP for detection of M. bovis, based on amplification of the mpb70 gene which is a unique gene in M. bovis strain. The LAMP assay was able to detect only seven copies of the gene per reaction, whereas for the conventional PCR, it was 70 copies. The LAMP was evaluated for its specificity using six strains of five Mycobacterium species and 18 related non-Mycobacterium microorganism strains as controls. The target three Mycobacterium strains were all amplified, and no cross-reaction was found with 18 non-Mycobacterium microorganism strains. TB was detected by two methods, LAMP and conventional PCR (based on mpb70 gene); the positive rates of the two methods were 9.55 and 7.01%, respectively. Our results indicate that the LAMP method should be a potential tool with high convenience, rapidity, sensitivity and specificity for the diagnosis of TB caused by M. bovis. Most importance is that the use of LAMP as diagnostic method in association with diagnostic tests based on mpb70 gene would allow the differentiation between M. bovis and other Mycobacterium in humans or animals. The LAMP method is actually in order to detect human TB, and it can be used for differential diagnosis in this paper.