Within the WHO framework of genomic epidemiological surveillance of tuberculosis, we have developed a panel of primers and TaqMan probes for PCR-based identification of SNPs in major epidemiological genotypes of Mycobacterium tuberculosis responsible for the spread of MDR/XDR strains in North Eurasia. Validation was performed on a dataset of 590 randomly selected strains circulating in the Krasnoyarsk Krai and Irkutsk region in 2021-2025. We identified 308 and 164 Beijing (L2) strains in the Krasnoyarsk and Irkutsk regions, respectively. The identified Beijing (L2) genotypes included B0/W148 (19 and 76); Central Asian (85 and 47) and its Central Asian Outbreak subtype (12 and 25); and orphan L2 genotypes (14 and 16). We also revealed 88 and 30 Euro-American (L4) strains in the Krasnoyarsk Krai and Irkutsk region, respectively. The identified L4 genotypes included Haarlem (9 and 6); LAM (35 and 7); Ural (19 and 5); S (2 and 0); and orphan L4 genotypes (15 and 12). We developed an approach employing two PCR to discriminate the principal M. tuberculosis genotype set into L2 and L4 lineages covering over 99% of all tuberculosis strains circulating in Russian Federation and other North Eurasian countries. Within the proposed framework, the required and sufficient number of PCR for genotyping and in-depth subtyping does not exceed eight. The feasibility of developing tests for further subtyping of epidemiological M. tuberculosis genotypes is discussed.
Background. The placement of intrauterine contraceptive devices rarely gives rise to complications. However, a failure to observe the procedure technique, lack of control, untimely diagnosis of possible device migration can create life-threatening conditions, including the long-term period after the manipulation.The aim. To report the case of fistulas of bladder and small intestine caused by perforation with intrauterine contraceptive device placed 17 years ago, and to discuss management tactics.Case presentation. A 39-year-old woman presented with an external purulent fistula after opening an abdominal abscess caused by dislocation of the intrauterine device 17 years after its placement. The intrauterine device produced pressure ulcers to the cervical wall and to the neck of the bladder, then migrated to the pelvis, where fixed the ileum to the bladder wall with the subsequent abscess formation. After opening the abscess, a purulent fistula of the abdominal wall formed. Multispiral computed tomography detected foreign body. It caused perforation of the ileum wall, abscess development, and formation of a tubular intestinal fistula. The contraceptive device was removed, the ileum was resected and the defect in the bladder wall was sutured.Conclusion. Dislocation of the intrauterine device into the bladder with its chronic inflammation over the period of 13 years resulted in the development of bladder and small intestine fistulas, abdominal abscess, which required surgical intervention with extensible approach. Awareness of patients and doctors about possible complications of this type of contraception allows them to prevent and timely diagnose hazard aftereffects.
Introduction: Efficacy of rabies immunoprophylaxis has been convincingly proven, but establishing the links between vaccination coverage and changes in rabies incidence in practice can be difficult if epizootics continue. Objective: To identify associations between animal and human vaccination and rabies incidence at the regional level. Materials and Methods: We conducted a retrospective descriptive epidemiological study for the years 2011 to 2024 using data from the veterinary service and the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor) on confirmed rabies cases (n = 326), vaccination coverage, and emergency department visits for animal bite injuries. We compared the periods before and after the introduction of oral fox vaccination (2011–2018 vs 2019–2024). The chi-square test, Spearman correlation, and confidence intervals for p < 0.05 (95 % CI) were used in the statistical data analysis while the Natural Earth electronic map and QGIS 3.2.1 software were used for mapping. Results: Until 2011, only dogs were vaccinated. Following the onset of epizootics among foxes (Vulpes vulpes), vaccination coverage was expanded to include farm, pet, and wild animals. Compared to 2011–2018, the growth rate of the number of doses of vaccines for various purposes was +167.3 % in 2019–2014. At the same time, the number of rabies cases decreased at a rate of –59.5 %. The share of farm animals decreased to 13–45 %, while that of wild animals increased to 45–68 %. Rabies in dogs and cats remained sporadic. A high posterior probability (p < 0.001) was demonstrated for the relationship between animal rabies and vaccination coverages of livestock and wild animals. Mapping revealed a reduction in the area of rabies-affected areas. We observed that 5,700 people received post-exposure prophylaxis annually, and 3,600 people received preventive vaccination. The incidence of animal bites ranged from 266.4 to 338.6 per 100,000 population. No cases of human rabies were registered. Conclusion: A significant correlation was established between increased vaccination coverage and the spread of rabies among animals. A change in the type of epizootics and systematic vaccination of the population contributed to the decreased risk of human rabies.
ABSTRACT INTRODUCTION. Orphan diseases are of particular interest in clinical neurology. At the present stage, the available genetic diagnostic methods make it possible to reasonably verify the hereditary diagnosis. This is especially relevant in the presence of comorbid pathology, which complicates the diagnostic search. Spinobulbar muscular atrophy, also known as Kennedy's disease, is one of the types of rare nosologies manifested by a complex of neurological and comorbid manifestations. AIM. To analyze the clinical manifestations of endocrine pathology, bulbar syndrome and peripheral paresis of the proximal muscles of the extremities in a patient with Kennedy's disease. Identify typical clinical symptoms and present the importance of accurate genetic diagnosis of the disease based on the presented clinical case. MATERIALS AND METHODS. The article presents a clinical case of a 43-year-old patient with a typical CAG mutation. RESULTS AND DISCUSSION. The description of this clinical history will allow specialists to include Kennedy's disease in the differential diagnostic series when examining a patient with suspected neuromuscular pathology with extraneural disorders. CASE PRESENTATION. Our own observation of spinobulbar muscular amyotrophy (Kennedy's disease) with the detection of a CAG mutation in the androgen receptor gene is presented. The article examines a clinical case demonstrating the manifestations of this disease. A special feature of the clinical case is the beginning of a diagnostic search with urological pathology for problems in the reproductive sphere. CONCLUSION. A detailed medical history combined with neurological status data, electromyography, and hormonal profile studies (decreased testosterone levels) make it possible to suspect Kennedy's disease. The diagnosis is verified by molecular genetic analysis of the androgen receptor gene. The description of the given clinical case will allow specialists of different specialities to obtain uptodate information about this pathology and to choose the correct diagnostic and therapeutic algorithm in the management of such patients. KEYWORDS: Kennedy's disease, spinobulbar muscular atrophy, molecular genetic analysis, CAG
On March 19, 2026, in Moscow, an international interdisciplinary Expert Council convened during the III National Congress of Pediatric Neurologists to address the treatment of comorbid conditions associated with ADHD in children. It was observed that comorbid disorders, such as anxiety, sleep disturbances, and heightened nervous excitability, affect at least 70% of patients, exacerbating clinical symptoms of ADHD and diminishing treatment efficacy. The experts evaluated the evidence supporting the use of multicomponent low-dose formulations derived from plant extracts and minerals, specifically Nervoheel (for children aged 3 years and older) and Neurexan (for those aged 12 years and older). These formulations are approved in the Russian Federation as medical products and have demonstrated effectiveness in alleviating neurotic manifestations, anxiety, and sleep disorders, as well as improving focus and compliance. Following the Expert Council's statement, these medications received a favorable evaluation regarding their effectiveness in managing anxiety, sleep disorders, and nervous. They were recommended for inclusion in the Ministry of Health of the Russian Federation's clinical guidelines, with a strength of recommendation of C and a quality of evidence rating of 3.
