HIV INFECTION AS A RISK FACTOR OF TUBERCULOSIS IN CHILDREN

The article presents the results of three year follow-up over 96 HIV positive children registered in the AIDS Center. During 3 year follow up the infection with tuberculous mycobacteria was diagnosed in 27.3% (n = 23) of HIV positive children from the followed up group. The leading risk factor of tuberculosis is family exposure to a tuberculosis patient – 22.6% (n = 19). Compliance to follow-up and treatment, timely prescribed preventive anti-tuberculosis chemotherapy and highly active antiretroviral therapy enhanced prevention of development of local forms of tuberculosis in the followed up group of children

Secondary Specialized Educational Institutions of Tyumen in 1920—1930s

Issues related to the material and personnel aspects in the initial period of the formation of secondary specialized educational institutions in Tyumen in the 1920—1930s are considered. Attention is paid to the study of the process of creating a network of educational institutions, areas of student training are identified, and data on the dynamics of the number of students are given. The analysis results of the material base of technical schools formation are presented. The problems that students had to face in the learning process were identified. An assessment of the material and technical conditions of educational activities is made. The authors dwell on the study of the staff of secondary specialized educational institutions of the city. Attention is paid to the analysis of the level of education and qualifications of teachers. The material working conditions of the teaching staff are investigated. The authors note a certain dynamics in solving the material and personnel problems of technical schools in the period under study, despite the fact that the existing opportunities of educational institutions were significantly inferior to the needs of the population in obtaining professional education. The conclusion is made about the degree of provision of educational institutions of the city with teaching and administrative personnel. The impact of this problem on the quality of student training is assessed

X-ray diagnostics of tuberculosis in the screening of patients with HIV infection

Background. The main method of screening of patients with HIV infection to detect pulmonary tuberculosis is X-ray diagnostics. A comparative assessment of changes in lung tissue in different methods of X-ray diagnostics and at different levels of CD4+ cells seems relevant.The aim of the study. To compare plain radiography and computed tomography of the lungs as screening methods for detecting tuberculosis in patients with HIV infection at various stages of immunosuppression.Materials and methods. 396  patients with HIV registered at the AIDS Center were  examined using plain lung radiography (PLR) and computed tomography (CT). To search for mycobacterium tuberculosis, we used bacterioscopy of a smear with Ziehl – Neelsen staining; HAIN-GenoType MTBDRplus technique; inoculation of BACTEC MGIT 960 liquid media; inoculation of Löwenstein – Jensen dense medium. Statistical processing of numerical material was carried out using the Statistica 5.5 program with a significance level p ≤ 0.05; Pearson χ2 criterion was used for the analysis of qualitative featuresResults. When comparing the results of PLR and CT, the differences were found. When  using PLR, the focal lung lesions were described more often (χ2  =  40.79; p = 0.00001), according to CT data, they turned out to be fibrosis (χ2 = 2.33; p = 0.1269). When comparing the PLR and CT data, the differences were obtained in the description of pulmonary fibrosis (χ2 = 20.78; p = 0.00001), focal lung lesions (χ2 = 40.79; p = 0.00001), dissemination (χ2 = 9.16; p=0.0025).Conclusion. When screening HIV-infected patients (at the standard of using plain radiography twice a year) it should be taken into account that CT provides more precise differentiation of focal lung lesions and pulmonary fibrosis, earlier detection of dissemination syndrome and ground-glass, especially at severe immunodeficiency with a decrease in CD4+ T lymphocytes down to 200 cells and less. Timely appointment of CT study will improve the effectiveness of tuberculosis detection at the stage of screening in AIDS centers

Screening for tuberculosis of patients with HIV-infection. New possibilities

Background. Tuberculosis associated with HIV infection is becoming almost a new disease, where not only new approaches to treatment are being formed, but there is also a need to improve the quality and search for new means of early diagnosis of tuberculosis infection.The aim. To evaluate the diagnostic performance of the T-SPOT.TB test for the detection of latent tuberculosis infection and clinical forms of tuberculosis in patients with HIV infection.Materials and methods. 396 patients registered at the AIDS Center for more than a year were examined. Everyone underwent standard examinations for pulmonary tuberculosis using sputum bacterioscopy techniques with Ziehl – Neelsen staining; a molecular genetic method based on hybridization technology – HAIN-GenoType MTBDRplus; crops on liquid media in the automated BACTEC MGIT 960 system and on Löwenstein–Jensen dense medium. T-SPOT.TB was conducted as a screening for everyone. With positive T-SPOT.TB results, negative results of the MBT search, absence of specific changes on the X-ray a conclusion was made about latent tuberculosis infection. Statistical data processing was carried out using the software package Statistica 10 (StatSoft Inc., USA).Results. According to the results of a comprehensive examination, tuberculosis was diagnosed in 174 patients, verified using various methods of searching for Mycobacterium tuberculosis in 116 patients (66.6 %). Infiltrative (63.8 %) and disseminated (24.7 %) tuberculosis were more often diagnosed. Latent tuberculosis infection was diagnosed in 52 patients, 170 HIV-infected patients have no data for tuberculosis at this stage.Conclusions. T-SPOT.TB can be used in the diagnostic complex of monitoring patients with HIV infections – as a screening method to detect latent tuberculosis, for preventive chemotherapy

Overview of potential drugs for the treatment of new coronavirus Infection (COVID-19)

The new coronavirus infection (SARS-CoV-2), better known as COVID-19, quickly evolved into a worldwide pandemic with a significant public health burden. Currently, there are no approved drugs or preventive therapeutic strategies to combat infection. Decisions about prescribing many medications are made based on the results obtained in in vitro studies, or expert opinions. Most of the drugs currently used to treat COVID-19 are approved antivirals or antibodies against other diseases. However, there are hundreds of clinical studies underway around the world to discover effective treatments for COVID-19. This article summarizes the results of clinical studies of potential therapeutic drugs used as COVID-19 therapy. Based on this review, it can be concluded that there is still no high-quality evidence to support any of the drugs described below. Until the unambiguous results of randomized controlled trials are available, the use of any of the following drugs is not clinically proven as an effective treatment for COVID-19

Global tests evaluating the functional condition of hemostasis

Control of effectiveness of global tests evaluation of the functional state regulation of blood aggregation provided an opportunity to obtain timely information about the I-II and III phases of hemostasis while using native substrate - whole blood. Ex vivo, registered during hemocoagulation of changing the viscous characteristics of whole blood, allowed to formulate the concept of fibrinogenesis permanence as in vivo existing process, defining proper hemostatic potential – integrative characteristic of the entire cycle of hemocoagulation, ensuring necessary blood fluidity and restricting extravasation of its components in case of defecting its permeability or damaging its vascular wall

Features of Hematological and Hemostasiological Parameters in Coronavirus Infection COVID-19 and Community-Acquired Pneumonia

Against the background of priority attention paid to the COVID-19 pandemic, there are also cases of community-acquired pneumonia of a different genesis. Identification of the features of lung lesions in such diseases is relevant during the spread of seasonal respiratory infections. The comparative study of the dynamics of hematological and hemostasiological parameters of blood in patients with pneumonia of various origins is of interest in terms of searching for predictors of the prognosis of the diseases development.Aim. To compare the features of clinical symptoms, hematological and hemostasiological parameters in patients with pneumonia caused by COVID-19 and in patients with community-acquired pneumonia.Materials and methods. During cross-sectional study two groups were formed: group 1 consisted of 92 patients diagnosed with moderate community-acquired pneumonia caused by COVID-19 infection; group 2 included 40 patients diagnosed with moderate community-acquired bilateral polysegmental pneumonia.Results. It was found that patients with COVID-19 had an older age (69 vs 39.3 years), a lower body temperature at admission (37.5 vs 38.85 °C), a lower percentage of reduced oxygen saturation (less than 89 % in 5.4 % of cases vs 10 % of cases). In most cases, the average values of some hematological parameters in patients with COVID-19 did not go beyond the reference range. Leukopenia (below 4 × 109 cells/l) and lymphopenia (below 1.1 × 109 cells/l) were observed in 26 % and 38 % of cases respectively; thrombocytopenia (less than 100 × 109 cells/l) – in 12.2 % of cases; hyperfibrinogenemia (more than 4 g/l) – in 65.3 % of cases. A direct correlation was found between platelet levels and leukocytes (R = 0.53; p < 0.001) and lymphocytes (R = 0.29; p = 0.06). Compared with the patients of the group 2,on average, patients with COVID-19 had significantly lower levels of leukocytes and lymphocytes (2.5 times each; p < 0.001) and an increased level of fibrinogen (by 45 %; p < 0.001).Conclusion. In patients with pneumonia caused by COVID-19, we revealed the particular features of clinical symptoms, hematological and hemostasiological blood parameters compared to community-acquired nonspecific pneumonia

Features of peripheral blood cellular immunity parameters in patients with lung damage up to 30 % in COVID-19

Background. The stability of human organism for different kind of infection, including SARS-CoV-2 is significantly defined by the immune system. The mechanisms of the cellular immunity to the SARS-CoV-2 are not exactly defined and are under study. The aim. To study the features of cell immunity parameters in patients with lung damage up to 30 % in COVID-19. Material and methods. 73 people were examined during the 2020–2021 pandemic. The study group consisted of 31 patients with lung damage up to 30 % with COVID-19, the comparison group consisted of 42 people not infected with SARS-CoV-2. A complete clinical blood count was carried out using a Medonic M20 hematological analyzer (Boule Medical, Sweden), the level of lymphocyte subpopulations was determined using a FACS Calibur cytometer (BD, USA) and FITC- and phycoerythrin-labeled monoclonal antibodies (Sorbent, Russia). Differences were considered statistically significant at p < 0.05. Results. Patients with COVID-19 with lung damage according to computed tomography (CT) ≤ 30 % before the treatment had a restructuring in the ratio of lymphocyte subpopulations in 67.7 % of cases. Lymphopenia (< 1.1 × 109 cells/l) was detected in 34.4 % of patients: a decrease in the absolute count of CD3+ lymphocytes by 30.8 %, CD3+CD4+ – by 35 %, CD3+CD8+ – by 6.7 % (p < 0.05), CD16+CD56+ natural killer (NK) cells – by 29.4 % (p = 0.009). The level of CD95+ lymphocytes in COVID-19 is 3.2 times higher than in healthy individuals. Elevated levels of HLA-DR+- (> 20 %) and CD3+ HLADR+ lymphocytes (> 6 %) are recorded in 60 % and 86.7 % of patients, respectively. Elevated levels of CD19+ B lymphocytes (> 17 %) in COVID-19 are 2.6 times more common than in healthy individuals. Correlation dependences of the count of NK cells with a wide range of T lymphocyte subpopulations were revealed. Conclusion. Cellular immunity indicators in COVID-19 have a number of features that can serve as predictors of the progression of the severity of the disease