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There is given an expert evaluation of medical response and release efforts during the recent disasters in Arzamas, Sverdlovsk, Armenia and Bashkiria. Special attention is paid to the movable medical units activity, to the work of psychiatric, forensic medicine service. The attention is focused on the problem of establishing national disaster medical system.
In four studied Dermacentor species at preimaginal phases sexual dimorphism hardly reveals itself in body size and mass of individuals. The formation of sexual distinctions at the nymphal phase concerns different characters as in different species so in populations of one species. In D. niveus male and female nymphs differ in the length of II-III palpal joints and width of gnathosoma, in D. ushakovae in the length of scutum and its proportions, in the width of gnathosoma and hypostome and in the diameter of peritreme. The sex of D. silvarum nymphs can be identified by the width of gnathosoma, length of hypostome and diameter of peritreme. Female and male nymphs of D. marginatus from the Stavropol Territory and Armenia differ in the scutum proportions and populations from the western Pamirs in the length of scutum and gnathosoma.
Antibiotic sensitivity of 91 strains of the plague microbe isolated in Armenia, Azerbaijan, Daghestan, Georgia, Kabardino-Balkaria and the Stavropol region in 1977-1979 from the rodents and their ectoparasites was studied with the method of serial dilutions in the Hottinger agar. The following antibiotics were tested: streptomycin, erythromycin, tetracycline, methicillin, gentamicin, levomycetin, monomycin, lincomycin, ristomycin, rifampicin, kanamycin, doxycyclin and polymyxin M. All of the strains irrespective of their nature were resistant to methicillin, erythromycin, lincomycin, ristomycin and polymyxin M. The sensitivity levels of the strains to other antibiotics were different. The studies showed that with respect to the effect on the plague microbe streptomycin may be replaced by tetracycline, gentamicin, kanamycin or monomycin. The blood levels of these antibiotics in humans treated with their average therapeutic doses were several times higher than the minimum inhibitor concentration determined in the experiments.
The purpose of this study was to determine the polymorphism of insertion segment 6110 (IS6110) in strains of Mycobacterium tuberculosis isolated from Colombian patients as well as the current status of resistance to antituberculosis drugs in the department of Quindío, Colombia. To this end, a prospective study was performed with a consecutive sample of 59 patients who sought care at local health centers and hospitals in rural and urban areas of Quindío from March to July 1993. The patients in the sample had symptomatic pulmonary tuberculosis confirmed by bacteriologic inspection of sputum, with and without a history of treatment, and were participants in the Tuberculosis Control Program of the Sectional Health Institute of Quindío in Armenia, Colombia. Sputum cultures and drug sensitivity tests were done. Later, restriction fragment length polymorphisms (RFLP) of IS6110 were analyzed in accordance with the protocols of van Soolingen et al. (1992). Cases were classified by treatment history, applying the criteria of WHO (1991). The results showed 44 cultures positive for M. tuberculosis and one positive for M. africanum. Primary drug resistance was found in 4 of 42 cultures, or 9.5% (CI 95%: 0.6 to 18); 4.8% were resistant to isoniazid (INH) and 4.8% to isoniazid and streptomycin (INH-SM). Acquired resistance was found in two of three cultures, or 66% (to isoniazid, rifampicin, and streptomycin [INH-RM-SM] and to isoniazid, ethambutol, rifampicin, and streptomycin [INH-EMB-RM-SM]). In 27 strains submitted to RFLP analysis, the number of copies of IS6110 varied from 6 to 17. Similarity coefficients revealed five distinct groups.(ABSTRACT TRUNCATED AT 250 WORDS)
According to WHO questionnaire data, reports of national ministries of health, medical associations and other medical institutions, tuberculosis morbidity in the majority of the East European countries and CIS surpasses that for the West Europe. In 1990-1992 it varied from 18 to 80 cases per 100,000 people. The lowest morbidity was recorded in the Czech Republic, the highest in Roumania and Kazakhstan. In Estonia, Latvia, Lithuania, Russia and Ukraine tuberculosis morbidity tends to a slow reduction, while in Armenia, Kyrgyzstan, Latvia, Lithuania, Moldova, Roumania, Turkmenistan mortality rates constantly grow. Antituberculous therapeutic and prophylactic policy in the East Europe and CIS should be aimed at finding the resources for adequate supply of the population with antituberculous medications, introduction of WHO-recommended short course of chemotherapy. On demand, health care system should be restructured and new educational programs for specialists and the population introduced.
The phenomenon of autogenity has been examined by means of different criteria both in nature and in laboratory in 25 blood-sucking species of the genus Culicoides, which were collected in Russia, Uzbekistan, Azerbaijan, Armenia, Georgia and Kazakhstan during 1979-1990 years. An autogenetic maturation of eggs has been observed in 6 species, and the absence of this phenomenon has been observed in 19 species. It is suggested, that autogenity or non-autogenity is a species characteristic of blood-sucking midges. The processus of autogenetic vitellogenesis takes the time from later pupa (more than 2 days of this stage) to earlier imago (lesser than 2-3 days of this stage).
Over the period 1961-89 a total of 1,713,057 cases of cholera were reported to WHO from 117 countries in all continents. The course of the epidemic fell into three periods: in period I (1961 to 1969), 24 countries (predominantly in Asia) reported about 419,968 cholera cases; in period II (1970 to 1977), 73 countries from Asia, Africa, Europe, and the Americas reported 706,261 cases; and in period III (1978 to 1989), 83 countries reported 586,828 cases. The global epidemic was at its most severe in 1967-74. Subsequently morbidity declined and up to 1989 had remained high and stable, with 44,000-52,000 cases per annum. In the USSR 10,723 cholera cases and carriers were reported between 1965 and 1989 from 11 republics (but not Latvia, Lithuania, Estonia, or Armenia). In 1965 and 1970-74 large-scale outbreaks of imported cholera were characteristic of the epidemic in the USSR. Thereafter morbidity declined, and sporadic cases were reported along with environmental, predominantly nontoxigenic strains of cholera vibrio. Most of the outbreaks in the 1970s were waterborne, and virulent strains containing the vct-gene were isolated from samples of water. Large-scale outbreaks continued that were associated with seafood and dairy produce that were contaminated with cholera vibrio. Clinical cases of cholera as well as a considerable number of carriers of avirulent nontoxigenic strains were reported. The epidemiological situation in the USSR is unstable, with cases of cholera and virulent strains from surface water being reported every year.(ABSTRACT TRUNCATED AT 250 WORDS)
In order to study polymorphisms of the DNA insertion sequence 6110 (IS6110) in Mycobacterium tuberculosis strains isolated from Colombian patients, together with resistance to antituberculous medications in the Department of Quindío, Colombia, a prospective study was conducted using a consecutive sample of 59 patients with symptomatic pulmonary tuberculosis whose cases had been confirmed by bacilloscopy, both with and without a history of treatment. The patients, who were participating in the Tuberculosis Control Program of the Regional Health Institute of Quindío in Armenia, included all individuals attending local health centers and hospitals between March and July 1993 who were referred to the regional institute. Sputum specimens from each patient were cultured and subjected to drug sensitivity tests. Subsequently, restriction fragment length polymorphisms (RFLP) of IS6110 from 27 patients were analyzed. The patients' treatment histories were used to classify their cases according to WHO criteria. Forty-five cultures were found positive, 44 for M. tuberculosis and 1 for M. africanum. Initial drug resistance was observed in 4 of 42 new cases, or 9.5% (95% CI: 0.6, 18), 2 showing resistance to isoniazid (INH) and 2 to isoniazid plus streptomycin (INH-SM). Acquired resistance was observed in 2 of the 3 chronic cases and relapses, the bacteria being resistant to isoniazid, rifampicin, and streptomycin (INH-RM-SM) in one case and to isoniazid, ethambutol, rifampicin, and streptomycin (INH-EMB-RM-SM) in the other. In those 27 strains subjected to RFLP analysis, the number of copies of IS6110 ranged from 6 to 17. Similarity coefficients revealed five distinct groups of strains. Overall, the RFLP analysis permitted most of the strains to be distinguished from one another, implying that the polymorphisms involved are sufficient to permit effective employment of this technique, which appears to have considerable potential for use in epidemiologic studies and in work designed to provide a basis for tuberculosis control program decision-making.
Comparison of Sindbis virus strains isolated in different regions of the world (in Africa, Australia, and Europe, including Russia and its nearest neighbors) in the polymerase chain reaction (PCR) by the primary gene structure of proteins NSP1 and E1 and in the neutralization test showed the greatest similarity between geographically close strains isolated in Northern Europe (KFL, Karelia, 1381 and 1388, Estonia). Sindbis strains AR339 and Babanki isolated in Africa were similar to each other and to strains from Northern Europe by the examined gene sites but different from the Northern variants in the neutralization test. Geographically remote strains F-720 (Armenia and Southern Europe) and Whataroa (New Zealand) were close to Sindbis virus from Africa and Northern Europe by only one of the genes examined (F-720 by NSP1 and Whataroa by E1). PCR was carried out using oligonucleotide primers containing nucleotide sequences identical to genes NSP1 and E1 sites of Sindbis strains HRSP, Okelbo, and KFL, but different from gene sites of other known representatives of alphaviruses by at least 5 positions. PCR analysis showed that the appurtenance of the geographic variants to Sindbis group can be ascertained only after investigating the homology of at least two genes coding for the replicative and structural proteins. Such a procedure of PCR permits the detection of Sindbis viruses of different geographic origin with changes in their primary structure and allows the differentiation between Sindbis viruses and Western equine encephalomyelitis viruses within the serological complex.
UNLABELLED: A 12-year old boy from Armenia presented with chronic permanent ventricular tachycardia (150/min) and reduced left ventricular shortening fraction (< 30%). Tachycardia was present > 20 h/day on several 24-h Holter monitorings. Diagnosis of ventricular tachycardia could be established on surface ECG by identification of atrioventricular dissociation and a right bundle branch block pattern with a R/S ratio < 1 in lead V6. Antiarrhythmic therapy with mexiletine and sotalol alone or in combination did not influence the presence of the dysrhythmia. During electrophysiological study, the dysrhythmia could not be terminated by administration of adenosine, ventricular extrastimuli, overdrive stimulation or direct current cardioversion. Endocardial mapping identified a region on the left ventricular surface of the anterior upper interventricular septum as the origin of the dysrhythmia. At this location stimulation at a cycle length shorter than the tachycardia produced a QRS complex nearly identical to the tachycardia QRS complex. Local ventricular electrogram preceded the onset of the tachycardia QRS complex on surface ECG by 23 ms. Radiofrequency current application with 30 W for 30 s resulted in permanent termination of the tachycardia. No complications occurred. Six months after the intervention, the boy is still in normal sinus rhythm. Left ventricular function normalized. CONCLUSION: Radiofrequency catheter ablation should be considered in young patients with drug-refractory chronic permanent ventricular tachycardia.
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