Bosonic Excitations in Random Media

We consider classical normal modes and non-interacting bosonic excitations in disordered systems. We emphasise generic aspects of such problems and parallels with disordered, non-interacting systems of fermions, and discuss in particular the relevance for bosonic excitations of symmetry classes known in the fermionic context. We also stress important differences between bosonic and fermionic problems. One of these follows from the fact that ground state stability of a system requires all bosonic excitation energy levels to be positive, while stability in systems of non-interacting fermions is ensured by the exclusion principle, whatever the single-particle energies. As a consequence, simple models of uncorrelated disorder are less useful for bosonic systems than for fermionic ones, and it is generally important to study the excitation spectrum in conjunction with the problem of constructing a disorder-dependent ground state: we show how a mapping to an operator with chiral symmetry provides a useful tool for doing this. A second difference involves the distinction for bosonic systems between excitations which are Goldstone modes and those which are not. In the case of Goldstone modes we review established results illustrating the fact that disorder decouples from excitations in the low frequency limit, above a critical dimension $d_c$, which in different circumstances takes the values $d_c=2$ and $d_c=0$. For bosonic excitations which are not Goldstone modes, we argue that an excitation density varying with frequency as $\rho(\omega) \propto \omega^4$ is a universal feature in systems with ground states that depend on the disorder realisation. We illustrate our conclusions with extensive analytical and some numerical calculations for a variety of models in one dimension

Causes of death in HIV-infected patients in a large tuberculosis hospital of Kemerovo region

The aim was to study the causes of death in HIV patients in the Novokuznetsk tuberculosis dispensary in 2016 (population is 550 thousand people; about 2% of population are HIV-positive). Materials and methods: Protocols of all autopsies of HIV-infected patients (n=221) performed in 2016 in the Novokuznetsk tuberculosis dispensary. Results: The mean age of the deceased was 37±6,9 years. HIV and tuberculosis (TB) co-infection was in 83,3% of patients (n=184), HIV/TB and other opportunistic or severe somatic diseases - in 10,4% (n=23), non-tuberculous opportunistic diseases - in 6,3% (n=14). The new tuberculosis cases were in 71,1% (n=147), relapses - in 7,2% (n=15), chronic tuberculosis cases - in 21,7% of patients (n=45). Disseminated form prevailed among the cases of respiratory tuberculosis; generalized tuberculosis (3 and more localizations) occurred in 87,0% (n=180), tuberculosis meningitis was found in 17,9% (n=37). Positive fluorescent sputum microscopy was in 72.5%, sputum cultures on Loewenstein-Jensen medium - in 78,3% with HIV/TB. Primary multidrug resistance was detected in 60,7% (including in 5,8% of them with primary extensively drug resistance). Severe opportunistic infections or malignancies were in 9,2% of HIV/TB (n=19) and in 78,7% of non-TB patients (n=11). Data on the CD4 level was known in 68,8% of cases (n=152): the median count was 75,5 cells/μl; 38,9% of new TB cases (n=46) were diagnosed with HIV in time of TB detecting. Antiretroviral therapy was performed only 13% of patients (n=29). Conclusion: There is a need for the optimization of HIV detecting approaches and early initiation of antiretroviral therapy before the appearance of incurable opportunistic diseases, as well as for comprehensive TB prevention

Causes of death in HIV-infected patients in a large tuberculosis hospital of Kemerovo region

The aim was to study the causes of death in HIV patients in the Novokuznetsk tuberculosis dispensary in 2016 (population is 550 thousand people; about 2% of population are HIV-positive). Materials and methods: Protocols of all autopsies of HIV-infected patients (n=221) performed in 2016 in the Novokuznetsk tuberculosis dispensary. Results: The mean age of the deceased was 37±6,9 years. HIV and tuberculosis (TB) co-infection was in 83,3% of patients (n=184), HIV/TB and other opportunistic or severe somatic diseases - in 10,4% (n=23), non-tuberculous opportunistic diseases - in 6,3% (n=14). The new tuberculosis cases were in 71,1% (n=147), relapses - in 7,2% (n=15), chronic tuberculosis cases - in 21,7% of patients (n=45). Disseminated form prevailed among the cases of respiratory tuberculosis; generalized tuberculosis (3 and more localizations) occurred in 87,0% (n=180), tuberculosis meningitis was found in 17,9% (n=37). Positive fluorescent sputum microscopy was in 72.5%, sputum cultures on Loewenstein-Jensen medium - in 78,3% with HIV/TB. Primary multidrug resistance was detected in 60,7% (including in 5,8% of them with primary extensively drug resistance). Severe opportunistic infections or malignancies were in 9,2% of HIV/TB (n=19) and in 78,7% of non-TB patients (n=11). Data on the CD4 level was known in 68,8% of cases (n=152): the median count was 75,5 cells/μl; 38,9% of new TB cases (n=46) were diagnosed with HIV in time of TB detecting. Antiretroviral therapy was performed only 13% of patients (n=29). Conclusion: There is a need for the optimization of HIV detecting approaches and early initiation of antiretroviral therapy before the appearance of incurable opportunistic diseases, as well as for comprehensive TB prevention

Бактериовыделение у пациентов с ВИЧ-инфекцией и туберкулезом

Objective. To analyze the rate of bacterial excretion among new-onset patients with HIV infection concurrent with tuberculosis (HIV/TB) in Novokuznetsk. Materials and methods. The rate of sputum TB pathogen detection using fluorescence microscopy and cultures on dense nutrient media was studied in all new-onset patients with respiratory TB and HIV infection who had been registered in Novokuznetsk in 2013-2014 (n = 362). 77.0% were men and 23.0% were women. Their mean age was 34.8 ± 8.1 years. Results. Data on CD4 lymphocyte counts were available in 294 (79.0%) patients; the median CD4 lymphocytes were 185 cells/ßl. Fluorescence sputum smear microscopy and cultures on dense nutrient media gave positive results in 58.6% and 64.1%, respectively. Bacterial excretion was more frequently recorded in severe immunosuppression (CD4 lymphocytes < 200 cells/ßl; p < 0.05). The rate of primary multidrug resistance was 51.9%, and its presence did not depend on the degree of immunosuppression. Fatal outcomes were significantly more common in patients with sputum smear-positive bacterial excretion results (46.7%) than in those with negative ones (30.1%;p < 0.005). Conclusion. Sputum TB pathogen was found by at least one of the phenotypic methods in 72.1% of the HIV-infected patients with new-onset respiratory TB. Bacterial excretion was more frequently found in patients with CD4 lymphocytes < 200 cells/ßl. The primary multidrug resistance rate was 51.9%.Цель исследования. Анализ частоты бактериовыделения среди впервые выявленных больных с сочетанием ВИЧ-инфекции и туберкулеза (ВИЧ/ТБ) в Новокузнецке. Материалы и методы. Изучали частоту обнаружения возбудителя ТБ в мокроте методом люминесцентной микроскопии и посевов на плотные питательные среды у всех впервые выявленных пациентов с ТБ органов дыхания и ВИЧ-инфекцией, зарегистрированных в Новокузнецке в 2013-2014 гг. (n = 362). Мужчины составляли 77,0%, женщины - 23,0%. Средний возраст - 34,8 ± 8,1 года. Результаты. Сведения о количестве СБ4-лимфоцитов имелись у 294 (79,0%) больных, медиана CD4-лимфицитов - 185 клеток/мкл. Люминесцентная микроскопия мазка мокроты дала положительный результат в 58,6% случаев, посевы на плотных питательных средах - в 64,1%. Бактериовыделение чаще регистрировали при выраженной иммуносупрессии (количество CD4-лимфоцитов < 200 клеток/ мкл; р < 0,05). Уровень первичной множественной лекарственной устойчивости составил 51,9%, а ее наличие не зависело от степени иммуносупрессии. Смертельные исходы среди больных, у которых по мазку мокроты было установлено бактериовыделение, встречались достоверно чаще (46,7%), чем при его отсутствии (30,1%; p < 0,005). Заключение. Возбудитель ТБ был обнаружен в мокроте как минимум одним из фенотипических методов у 72,1% больных ВИЧ-инфекцией с впервые выявленным ТБ органов дыхания. Бактериовыделение чаще встречалось у пациентов с количеством CD4-лимфоцитов < 200 клеток/мкл. Уровень первичной множественной лекарственной устойчивости составил 51,9%

Бактериовыделение у пациентов с ВИЧ-инфекцией и туберкулезом

Objective. To analyze the rate of bacterial excretion among new-onset patients with HIV infection concurrent with tuberculosis (HIV/TB) in Novokuznetsk. Materials and methods. The rate of sputum TB pathogen detection using fluorescence microscopy and cultures on dense nutrient media was studied in all new-onset patients with respiratory TB and HIV infection who had been registered in Novokuznetsk in 2013-2014 (n = 362). 77.0% were men and 23.0% were women. Their mean age was 34.8 ± 8.1 years. Results. Data on CD4 lymphocyte counts were available in 294 (79.0%) patients; the median CD4 lymphocytes were 185 cells/ßl. Fluorescence sputum smear microscopy and cultures on dense nutrient media gave positive results in 58.6% and 64.1%, respectively. Bacterial excretion was more frequently recorded in severe immunosuppression (CD4 lymphocytes < 200 cells/ßl; p < 0.05). The rate of primary multidrug resistance was 51.9%, and its presence did not depend on the degree of immunosuppression. Fatal outcomes were significantly more common in patients with sputum smear-positive bacterial excretion results (46.7%) than in those with negative ones (30.1%;p < 0.005). Conclusion. Sputum TB pathogen was found by at least one of the phenotypic methods in 72.1% of the HIV-infected patients with new-onset respiratory TB. Bacterial excretion was more frequently found in patients with CD4 lymphocytes < 200 cells/ßl. The primary multidrug resistance rate was 51.9%.Цель исследования. Анализ частоты бактериовыделения среди впервые выявленных больных с сочетанием ВИЧ-инфекции и туберкулеза (ВИЧ/ТБ) в Новокузнецке. Материалы и методы. Изучали частоту обнаружения возбудителя ТБ в мокроте методом люминесцентной микроскопии и посевов на плотные питательные среды у всех впервые выявленных пациентов с ТБ органов дыхания и ВИЧ-инфекцией, зарегистрированных в Новокузнецке в 2013-2014 гг. (n = 362). Мужчины составляли 77,0%, женщины - 23,0%. Средний возраст - 34,8 ± 8,1 года. Результаты. Сведения о количестве СБ4-лимфоцитов имелись у 294 (79,0%) больных, медиана CD4-лимфицитов - 185 клеток/мкл. Люминесцентная микроскопия мазка мокроты дала положительный результат в 58,6% случаев, посевы на плотных питательных средах - в 64,1%. Бактериовыделение чаще регистрировали при выраженной иммуносупрессии (количество CD4-лимфоцитов < 200 клеток/ мкл; р < 0,05). Уровень первичной множественной лекарственной устойчивости составил 51,9%, а ее наличие не зависело от степени иммуносупрессии. Смертельные исходы среди больных, у которых по мазку мокроты было установлено бактериовыделение, встречались достоверно чаще (46,7%), чем при его отсутствии (30,1%; p < 0,005). Заключение. Возбудитель ТБ был обнаружен в мокроте как минимум одним из фенотипических методов у 72,1% больных ВИЧ-инфекцией с впервые выявленным ТБ органов дыхания. Бактериовыделение чаще встречалось у пациентов с количеством CD4-лимфоцитов < 200 клеток/мкл. Уровень первичной множественной лекарственной устойчивости составил 51,9%

ТУБЕРКУЛЕЗ У ПАЦИЕНТОВ С РАЗЛИЧНЫМ ВИЧ-СТАТУСОМ НА ПРИМЕРЕ Г. НОВОКУЗНЕЦКА

Goal. To study the results of treatment for newly diagnosed tuberculosis in patients with different HIV status. Materials and methods. A retrospective study of all new TB cases among adults (n = 1036) registered in 2013-2014: 664 patients with HIV-free tuberculosis (TB) and 372 patients with HIV (HIV) and TB. Results. The average age of the patients was 39 ± 13 years; of men was 63.8% (n = 661). The median number of CD4-lymphocytes was 185 cells / jl (0-2064 cells / jl). most patients with HIV and (69.8%, n = 260) did not receive antiretroviral therapy. TB in HIV-1 and more often than in patients without HIV and was detected by treatment (74.7%, n = 278 vs. 49.4%, n = 328) (P <0.001), and among the clinical forms more often disseminated TB (43.1%, n = 156 vs 15.8%, n = 103) (P <0.001). Bacteriovenectomy by any of the methods for HIV and / or TB was detected more often than in patients without HIV without TB (72.1%, n = 261 vs 54.7%, n = 356) (P <0.0001), including number when sowing on dense nutrient media (64.1%, n = 232, vs 46.0%, n = 299) (P <0.001). For HIV and TB with preserved drug sensitivity, it was less common (31.9%, n = 67 vs 50.9%, n = 137) (P <0.001), and with primary multidrug resistance (MDR) 1.5 times more often than with monoinfection (51.4% and 33.5%, respectively) (P <0.001). In the absence of data on drug resistance, patients were treated with drugs of the main series. Treatment of MDR TB was conducted 64.4% (n = 58) in patients with TB and 42.6% (n = 46) with HIV and / or TB patients; in the remaining cases, MDR preparations of the reserve were not assigned because of refusal, lack of commitment or obtaining information about drug resistance after death. Cure for HIV / TB was less frequent than with monoinfection of TB (38.2% vs 61.7%) (P <0.001), and the share of deaths from all causes in HIV-TB was significantly higher (40.9% % vs 12.1%) (p <0.001). The conclusion. In patients with HIV, tuberculosis in most cases was detected during treatment, they were more often registered with bacterial excretion and primary MDR, and the effectiveness of treatment for HIV and / or TB was significantly lower than in patients with negative HIV status, mainly due to high mortality.Цель. Изучить результаты лечения впервые выявленного туберкулеза у больных с различным ВИЧ-статусом. Материалы и методы. ретроспективное исследование всех новых случаев тБ среди взрослых (n=1036), зарегистрированных в 2013-2014 гг.: 664 больных с туберкулезом (ТБ) без ВИЧ-инфекции и 372 пациента с ВИЧ-инфекцией (ВИЧ-и) и ТБ. результаты. Средний возраст пациентов составил 39±13 лет; мужчин было 63,8% (n=661). Медиана количества CD4-лимфоцитов составляла 185 кл./мкл (0-2064 кл./мкл.); большинство больных ВИЧ-и (69,8%, n=260) не получали антиретровирусной терапии. ТБ при ВИЧ-и чаще, чем у пациентов без ВИЧ-и выявлялся при обращении (74,7%, n=278 vs 49,4%, n=328) (P<0,001), а среди клинических форм чаще диагностировали диссеминированный ТБ (43,1%, n=156 vs 15,8%, n=103) (P<0,001). Бактериовыделение любым из методов при ВИЧ-и/тБ обнаруживали чаще, чем у больных ТБ без ВИЧ-и (72,1%, n=261 vs 54,7%, n=356) (P<0,0001), в том числе при посевах на плотные питательные среды (64,1%, n=232, vs 46,0%, n=299) (P<0,001). При ВИЧ-и ТБ с сохраненной лекарственной чувствительностью встречался реже (31,9%, n=67 vs 50,9%, n=137) (P<0,001), а с первичной множественной лекарственной устойчивостью (МЛУ) - в 1,5 раза чаще, чем при моноинфекции (51,4% и 33,5% соответственно) (P<0,001). В отсутствие сведений о лекарственной устойчивости пациенты получали лечение препаратами основного ряда. Лечение МЛУ ТБ проводилось 64,4% (n=58) больным с ТБ и 42,6% (n=46) больным ВИЧ-и/тБ; в остальных случаях МЛУ препараты резерва не назначались из-за отказа, отсутствия приверженности или получения сведений о лекарственной устойчивости после смерти. Излечение при ВИЧ-/тБ достигали реже, чем при моноинфекции ТБ (38,2% vs 61,7%) (р<0,001), а доля летальных исходов от всех причин у ВИЧ-и/тБ была значительно выше (40,9% vs 12,1%) (р<0,001). Заключение. У больных ВИЧ-и туберкулез в большинстве случаев выявлялся при обращении, у них чаще регистрировали бактериовыделение и первичную МЛУ, а эффективность лечения ВИЧ-и/тБ была существенно ниже, чем у пациентов с негативным ВИЧ-статусом, преимущественно за счет высокой летальности

Chronic obstructive pulmonary disease in patients infected with human immunodeficiency virus [Хроническая обструктивная болезнь легких у больных, инфицированных вирусом иммунодефицита человека]

The aim of the study was to examine the role of COPD in the structure of respiratory diseases in HIV patients and the course of these comorbidities among hospitalized patients with HIV infection. Methods. A continuous longitudinal retrospective study was conducted in the Holy Great Martyr George the Victorious Novokuznetsk City Clinical Hospital No.2 and included all HIV patients with respiratory diseases (n = 185) hospitalized in the therapeutic department in 2017 - 2018. About 2% of population in the Kemerovo region (with the population 2.7 million people) is known to be HIV-infected. The regional COPD incidence is 124.7/100 000. Results. COPD was diagnosed in 19 (10.3%) of all HIV patients hospitalized with respiratory diseases. 73.7% of patients with COPD were aged ≤ 40 years, the mean age was 37.6 ± 5.0 years. All patients (100.0%) were known to have smoking and intravenous drug use as potential risk factors for the development and progression of COPD. The ART coverage was low (21.1%). 68.5% of patients with COPD had severe bronchial obstruction with a decrease in FEV1 &lt; 50% of predicted values (GOLD grades III - IV). 73.7% of the patients were assigned to COPD group B, the rest 26.3% - to group D. In 31.6% of patients, the main cause of hospitalization was COPD itself, in 68.4% - COPD combined with other lung diseases (community-acquired pneumonias, septic embolism, tuberculosis and pneumocystosis). The CD4-lymphocyte count in cases of COPD combined with other respiratory diseases (median 214.0 cell/μl) was lower than in COPD as the only respiratory disease (median 495.5 cells/μl) (p = 0,014). Conclusion. The socio-economic significance of both HIV-infection and COPD argues the further study of the course and treatment of COPD in persons with HIV-infection. © 2021 Medical Education. All rights reserved

Tuberculosis in patients with hiv infection in a therapeutic hospital in a region with high hiv prevalence

Objective. To analyze the role and character of tuberculosis (TB) among all respiratory diseases in HIV-infected patients treated in a therapeutic hospital Patients and methods. This longitudinal retrospective study included all consecutive HIV-positive patients with respiratory diseases (n = 185) treated in the Therapeutic Department of the City Hospital No 2 in Novokuznetsk in 2017–2018. Results. TB was diagnosed in 50 HIV-infected patients (27.0%) admitted to hospital. Median CD4 count was 124 cells/µL. Only 14.3% of patients were adherent to antiretroviral therapy. Sputum smear microscopy in TB dispensary was positive twice as often as in the therapeutic hospital (54.4% vs 23.4%). Abdominal lymphadenopathy was detected in 52.8% of patients examined, regardless of the pulmonary lesion pattern (p >0.05); 25.0% of patients were diagnosed with endobronchial TB. The main radiological syndromes of TB in the HIV-infected population included dissemination (52.0%), infiltration (26.0%), and intrathoracic lymphadenopathy (10.0%). Pleural lesions were identified in 28% of participants with TB and HIV coinfection. Conclusion. TB was the only cause of focal dissemination (100.0%, p < 0.001), while pleural lesions and intrathoracic lymphadenopathy were significantly more common in TB patients than in individuals with non-tuberculosis diseases (11.6% and 0.8%, respectively, p < 0.05). Hospital mortality rate among TB patients in a therapeutic hospital was 8.0%. © 2020, Dynasty Publishing House. All rights reserved