Volume 69, Nº 2 (2024)

Background: Respiratory distress syndrome plays an important role in the structure of pathologies that have a significant impact on the life and health prognosis in premature infants,. Among neonatal respiratory disorders, its frequency is up to 46%. Improvement of the disease prognosis, prevention of complications, and pathogenetically based therapy requires a detailed study of metabolic disorders in this group of children.

Aim: The study aimed to identify changes in the amino acid spectrum of cord blood plasma preceding respiratory distress syndrome in premature infants.

Materials and methods: The study was conducted from May 2023 to September 2024. Cord blood was collected during vaginal and operative deliveries of premature babies at ≤36 weeks of gestation, taking into account the mother’s informed consent and non-inclusion/exclusion criteria. The included children were followed up until discharge. A confirmed diagnosis of respiratory distress syndrome was recorded based on patient follow-up. Concentrations of amino acid in cord blood plasma were determined by capillary electrophoresis. Based on the patient follow-up and disease diagnosis, 2 groups were retrospectively formed: the comparison group included premature newborns who did not develop respiratory distress syndrome during the entire follow-up period (n = 49); the main group included patients with respiratory distress syndrome (n = 14).

Results: In the main group, respiratory distress syndrome was diagnosed within 24 hours after birth. Disease development was preceded by an increase in alanine concentration (by 61.1%), р = 0.007, and a decrease in relative levels of tryptophan (by 15.0%), histidine (by 12.1%), and citrulline (by 14.7%); p = 0.020, p = 0.007 and p = 0.016, respectively.

Conclusion: Intrauterine amino acid metabolism disorders in premature infants become the basis for the development of severe diseases in the first days after birth. This study demonstrates changes in the amino acid profile of cord blood plasma reflecting the role of metabolic disorders of ornithine cycle-related amino acid metabolites, heterocyclic amino acids, and energy metabolism disorders in the respiratory distress syndrome.

Background: We examined which clinical signs and symptoms are associated with human African trypanosomiasis (HAT), and assessed the performance of selected clinical presentations, of rapid diagnostic tests (RDT), and of reference laboratory tests on dried blood spots (DBS) for diagnosing HAT in Guinea.

Materials and methods: The study took place in 14 health facilities in Guinea, where 2345 clinical suspects were tested with RDTs (HAT Sero-K-Set, rHAT Sero-Strip, and SD Bioline HAT). Seropositives underwent parasitological examination (reference test) to confirm HAT and their DBS were tested in indirect enzyme-linked immunoassay (ELISA)/Trypanosoma brucei gambiense, trypanolysis, Loopamp Trypanosoma brucei Detection kit (LAMP) and m18S quantitative PCR (qPCR). Multivariable regression analysis assessed association of clinical presentation with HAT.

Results: The HAT prevalence, as confirmed parasitologically, was 2.0% (48/2345, 95% CI: 1.5–2.7%). Odds ratios (OR) for HAT were increased for participants with swollen lymph nodes (OR=96.7, 95% CI: 20.7–452.0), important weight loss (OR=20.4, 95% CI: 7.05–58.9), severe itching (OR=45.9, 95% CI: 7.3–288.7) or motor disorders (OR=4.5, 95% CI: 0.89–22.5). HAT Sero-K-Set, rHAT Sero-Strip, and SD Bioline HAT were respectively 97.5% (95% CI: 96.8–98.1%), 99.4% (95% CI: 99.0–99.7%) and 97.9% (95% CI: 97.2–98.4%) specific, and 100% (95% CI: 92.5–100.0%), 59.6% (95% CI: 44.3–73.3%) and 93.8% (95% CI: 82.8–98.7%) sensitive for HAT. The RDT’s positive and negative predictive values ranged from 45.2–66.7% and 99.2–100% respectively.

Conclusion: Diagnostic performances of HAT Sero-K-Set and SD Bioline HAT are sufficient for referring positives to microscopy. Trypanolysis on DBS may discriminate HAT patients from false RDT positives.

This article is a translation of the article by Camara O, Camara M, Falzon LC, et al. Performance of clinical signs and symptoms, rapid and reference laboratory diagnostic tests for diagnosis of human African trypanosomiasis by passive screening in Guinea: a prospective diagnostic accuracy study. Infect Dis Poverty. 2023;12(1):22. doi: 10.1186/s40249-023-01076-1

In the 1970s, the laboratory service was actively reorganized in the Union of Soviet Socialist Republics. One of the key specialists in this field was Victoria T. Morozova, Professor, Dr. Sci. (Medicine), Head of the Department of Clinical Laboratory Diagnostics of the Russian Medical Academy of Postgraduate Education.

In 1971, Morozova was appointed as Chief Consultant of the Ministry of Health of the USSR in Clinical Laboratory Diagnostics. Under her leadership, clinical and diagnostic laboratories were separated into independent departments within medical centers. This pioneered the introduction of modern educational technologies in the educational process.

Morozova also participated in the creation of the first educational film on clinical laboratory diagnostics—Methods of Gastric Secretion Examination. This film became a teaching aid for the USSR medical universities.

The clinical simulation experience acquired while watching the film was successfully used by the departmental team in the 2020s during a new coronavirus infection pandemic. It enabled rapid transition of the learning process to an online format with digital technology. Seminars, short-term training courses, audio and teleconferences for the Russian clinical diagnostic laboratory specialists were developed.