Immunization against tuberculosis in children exposed to HIV.

The article deals with the issues of vaccination against tuberculosis of children born to women with HIV. The completeness of vaccination coverage against tuberculosis of HIV-exposed children and the reasons for the lack of vaccination were analyzed. According to the size of the vaccine scar and the results of the Mantoux test, the effectiveness of vaccination against tuberculosis was assessed.В статье рассмотрены вопросы вакцинации против туберкулеза детей, рожденных от женщин с инфекцией В20. Проанализированы полнота охвата прививками против туберкулеза ВИЧ- экспонированных детей и причины отсутствия вакцинации. По размеру вакцинального рубца и результатам пробы Манту проведена оценка эффективности вакцинации против туберкулеза

Long-term photometric monitoring of RR Lyr stars in M3

The period-change behaviour of 134 RR Lyrae stars in the globular cluster Messier 3 (M3) is investigated on the ~120-year time base of the photometric observations. The mean period-change rates (\beta \approx 0.01 d Myr^-1) of the subsamples of variables exhibiting the most regular behaviour are in good agreement with theoretical expectations based on Horizontal-Branch stellar evolution models. However, a large fraction of variables show period changes that contradict the evolutionary expectations. Among the 134 stars studied, the period-change behaviour of only 54 variables is regular (constant or linearly changing), slight irregularities are superimposed on the regular variations in 23 cases and the remaining 57 stars display irregular period variations. The light curve of ~50 per cent of the RRab stars is not stable, i.e., these variables exhibit Blazhko modulation. The large fraction of variables with peculiar behaviour (showing light-curve modulation and/or irregular O-C variation) indicate that, probably, variables with regular period changes incompatible with their evolutionary stages also could display some kind of instability of the pulsation light curve and/or period, but the available observations have not disclosed it yet. The temporal appearence of the Blazhko effect in some stars, and the 70-90 years long regular changes preceded or followed by irregular, rapid changes of the pulsation period in some cases support this hypothesis. [...] Abstract truncated due to the limitations of astroph. See full abstract in the paper.Comment: 22 pages, 14 figures, accepted for publication in MNRA

Professional risks of hemocontact infections for medical personnel (on the example of Sverdlovsk region)

In the dynamics from 2003 to 2016. the indicators of the frequency of accidents with exposure to blood (AEB) from medical personnel are presented. The characteristics of the AEB are given, taking into account the professional orientation of the employees, the age, medical experience, the time of occurrence of AEB during the week, the circumstances of the injury, etc. The conditions and nature of the specific prophylaxis performed in AEB with HIV-infected patients are analyzed taking into account the risk of possible infection. Recommendations are given to reduce the risks of emergencies.В динамике с 2003-го по 2016 год представлены показатели частоты аварий с экспозицией крови (АЭК) у медицинских сотрудников. Дана характеристика АЭК с учетом профессиональной ориентированности сотрудников, возраста, медицинского стажа, времени возникновения АЭК в течение недели, обстоятельствами получения травмы и др. Проанализированы условия и характер проводимой специфической профилактики при АЭК с ВИЧ-инфицированными пациентами с учетом степени риска возможного инфицирования. Даны рекомендации по снижению рисков возникновения аварийных ситуаций

Direct evidence of a sub-stellar companion around CT Cha

In our ongoing search for close and faint companions around T Tauri stars, we found a very faint (Ks=14.9mag, Ks_0=14.4mag) object, just ~2.67" northwest of the Chamaeleon star-forming region member CT Cha corresponding to a projected separation of ~440AU at 165+/-30 pc. We show that CT Cha A and this faint object form a common proper motion pair from data of the VLT Adaptive Optics (AO) instrument NACO taken in February 2006 and March 2007 and that the companion is by >=4 sigma significance not a stationary background object. Our AO integral field spectroscopy with SINFONI in J, and H+K bands yields a temperature of 2600+/-250K for the companion and an optical extinction of A_V=5.2+/-0.8mag, when compared to spectra calculated from Drift-Phoenix model atmospheres. We demonstrate the validity of the model fits by comparison to several other well-known young sub-stellar objects. Relative flux calibration of the bands was achieved using photometry from the NACO imaging data. We conclude that the CT Cha companion is a very low-mass member of Chamaeleon and very likely a physical companion to CT Cha, as the probability for a by chance alignment is <=0.01. Due to a prominent Pa-Beta emission in the J-band, accretion is probably still ongoing onto the CT Cha companion. From temperature and luminosity (log(Lbol/Lsun)= -2.68+/-0.21), we derive a radius of R=2.20+0.81-0.60 R_Jup. We find a consistent mass of M=17+/-6 MJup for the CT Cha companion from both its luminosity and temperature when placed on evolutionary tracks. Hence, the CT Cha companion is most likely a wide brown dwarf companion or possibly even a planetary mass object.Comment: 10 pages, 11 figures, accepted for publication in A&

The occupational risk factors of blood-contact infections among health care workers and risk-management

The occupational risk of healthcare workers blood-contact infections is usually implemented through invasive procedures. Biological factor is risk factor of healthcare workers. The hepatitis B, hepatitis С and HIV are prevalence in the population of healthcare workers. We are consider the management of healthcare workers occupational risks, such as vaccination and personal protective equipment.Риск заражения медицинских работников гемоконтактными инфекциями, как правило, реализуется при проведении инвазивных процедур, в связи с чем биологический фактор является ведущим из всех факторов, оказывающих влияние на здоровье медицинских работников. Наиболее актуальна проблема заражения медицинских работников вирусами гемоконтактных инфекций - гепатитов В, С и ВИЧ, что обусловлено их значительной распространенностью в популяции. В работе представлен материал по различным направлениям управления рисками: вакцинопрофилактика, антиретровирусная терапия и средства индивидуальной защиты

A new model of the organization of medical care on the example of the polyclinic №5 children’s hospital №11

The new model of the organization of primary care is one of the priority projects of the Ministry of Health aimed at improving the quality of polyclinics, which was approved by the Presidium of the Presidential Council for Strategic Development and Priority Projects on July 26,2017. Since August 2017, Polyclinic No. 5 of the Main Educational Institution “DGKB No. 11" has entered the “Lean Polyclinic” project in order to increase the availability and quality of medical care to the population. Repair work was carried out, and then optimization of the work of medical personnel by eliminating obvious losses. Work was carried out on 5 projects: 'Open Registry, 'Improving the quality of patient care in the district doctor's office', 'Optimizing the work of the vaccination room', 'Organizing routine check-ups for minors in organized teams on the principles of a continuous flow of patients', 'Optimizing preventive examinations of unorganized patients \ All projects were effective, showed a decrease in the time of the process (in some projects by 2-3 times). As a result, the satisfaction of the population increased to 85%, the waiting time in queues decreased from 1 hour to 10 minutes, the quality of patient care improved.Новая модель организации первичной медицинской помощи [5] - один из приоритетных проектов Министерства здравоохранения. направленный на качественное улучшение работы поликлиник, который был утвержден президиумом Совета при Президенте Российской Федерации по стратегическому развитию и приоритетным проектам 26 июля 2017 года. С августа 2017 года в проект «Бережливая поликлиника» вступила поликлиника №5 МАУ «ДГКБ №11» с целью повышения доступности и качества медицинской помощи населению. Были проведены ремонтные работы, а затем оптимизация работы медицинского персонала за счет устранения явных потерь. Проведена работа по 5 проектам: «Открытая регистратура», «Улучшение качества обслуживания пациентов в кабинете участкового врача», «Оптимизация работы прививочного кабинета», «Организация профилактических осмотров несовершеннолетних в организованных коллективах на принципах непрерывного потока пациентов», «Оптимизация профилактических осмотров неорганизованных пациентов». Все проекты оказались результативными, показали снижение времени протекания процесса (в некоторых проектах в 2-3 раза). В итоге выросла удовлетворенность населения до 85%. уменьшилось время ожидания в очередях с 1 часа до 10 минут, улучшилось качество обслуживания пациентов

Modern practices of immunizing children exposed to HIV and HIV-infected

The purpose of the study is to adjust the tactics of immunization of children exposed to HIV and HIV-infected people on the basis of studying modern vaccination practices within the framework of the National Calendar of Preventive Vaccinations (NCPV).Materials and methods. According to the information in the patient's outpatient card, the card of preventive vaccinations and the history of the child's development, the completeness and timeliness of immunization of 216 children exposed to HIV and 198 HIV-infected children were analyzed. The control group consisted of 100 children born to mothers with negative HIV status. In order to study adherence to vaccines, a survey was conducted among 160 parents of children registered in the dispensary for HIV infection.Results. It was established that, despite the delayed immunization, the coverage of vaccination against the major infections from NCPV among children ranged from 94.4% to 97.5%. The greatest difficulties in the implementation of the NCPV arose when immunizing children under 2 years of age. The “missed opportunities” during immunization subsequently led to a violation of the calendar terms of vaccinations and their implementation at an older age. The number of “missed vaccinations” in the study cohort did not exceed the criteria recommended by WHO (10%) and amounted to 5.8% for certain types of vaccines (DTP and polio).The proportion of children vaccinated against tuberculosis in the maternity hospital in the HIV-exposed group was 2 times less compared to the control group, however, there were no differences in the incidence of vaccine induced allergy.During the vaccination of children with HIV on the highly active antiretroviral therapy (HAART), the number of CD4 lymphocytes corresponded to the parameters of the age norm. Compared to baseline data, no changes in the immune status of vaccinees were recorded.Organizational omissions in immunizing children with HIV infection were the use of live polio vaccine, a 3-dose vaccination schedule against viral hepatitis B in children at risk, and vaccination against tuberculosis in the absence of a three-stage chemoprevention of mother-to-child transmission of HIV.When assessing parental vaccine adherence, it was found that 85% of respondents considered vaccination necessary for the prevention of infectious diseases, 11.3% found it difficult to answer, due to the possible risk of vaccine reactions and the lack of guaranteed protection, and 3.8% were against vaccination, citing own opinion.The most authoritative source of information for most respondents, both positive for vaccination and those who doubted its need, was medical workers (98.5 and 72.7%, respectively). In 33.3% of those who are negatively related to vaccines, health workers were also a source of information.Conclusion. The analysis of the completeness and timeliness of vaccinations in a cohort of HIV-infected and exposed to HIV revealed the most problematic issues regarding vaccinations within the time periods regulated by the NCPV. Children with HIV infection who have the 1st category of immune disorders on the background of HAART are subject to vaccination in the framework of the National calendar of vaccinations to full extent. The use of combined vaccines will make it possible to reduce the manipulation load in this cohort, overcome the identified inconsistencies and optimize the vaccination calendar