CLINICAL COURSE OF HIV-ASSOCIATED TUBERCULOSIS IN THE PREGNANT WOMAN AND NEWBORN

The article describes the clinical case of TB/HIV coinfection in the pregnant woman and newborn. The discussion of the management tactics included main issues on which treatment success depended on: the right choice of chemotherapy regimen, correct decision on the time of delivery due to life-threatening conditions of the mother, timely diagnostics of tuberculosis in the newborn. It is necessary to develop cross-disciplinary guidelines by professional medical communities on the management of pregnant women with TB/HIV coinfection which will allow enhancing the quality of medical care to pregnant women and newborns at all stages of follow-up

СЛУЧАЙ ТЕЧЕНИЯ ВИЧ-АССОЦИИРОВАННОГО ТУБЕРКУЛЕЗА У БЕРЕМЕННОЙ И НОВОРОЖДЕННОГО

The article describes the clinical case of TB/HIV coinfection in the pregnant woman and newborn. The discussion of the management tactics included main issues on which treatment success depended on: the right choice of chemotherapy regimen, correct decision on the time of delivery due to life-threatening conditions of the mother, timely diagnostics of tuberculosis in the newborn. It is necessary to develop cross-disciplinary guidelines by professional medical communities on the management of pregnant women with TB/HIV coinfection which will allow enhancing the quality of medical care to pregnant women and newborns at all stages of follow-up.Представлен клинический случай коинфекции (ВИЧ-и/ТБ) у беременной и новорожденного. В обсуждение врачебной тактики рассмотрены основные вопросы, от которых зависит успех терапии: правильность выбранного режима химиотерапии; правильность принятия решения о проведении родоразрешения по жизненным показаниям со стороны матери; возможность своевременной диагностики туберкулеза у ребенка. Необходимо создание междисциплинарных рекомендаций от профессиональных сообществ по тактике ведения беременных с сочетанной патологией (ВИЧ-и/ТБ), что позволит повысить качество оказания медицинской помощи беременным и новорожденным на всех этапах наблюдения

Electrochemical Behavior of Chloramphenicol on Carbon-Containing Electrodes in a Microcell

The work is devoted to the study of the electrochemical behavior of chloramphenicol during the transition from a macro- to a microcell. The possibility of using the reduction of the nitro group as an analytical signal for the determination of CA in a microcell was shown.Работа выполнена при финансовой поддержке гранта МК-392.2022.1.3

STRUCTURING OF THE SENSOR RECEPTOR LAYER TO CHLORAMPHENICOL BY ELECTRODEPOSITION OF 3,6-BIS(ETHYNYL)-9Н-CARBAZOLE

In this work, the approach to structuring the receptor layer of the glassy carbon electrode by electropolymerization of 3,6-bis(ethynyl)-9H-carbazole through the acetylene fragment has been proposed. The use of immobilized molecule as an agent for selective detection of chloramphenicol was evaluated.Работа выполнена при финансовой поддержке гранта МК-392.2022.1.3

Fluorometric Determination of Chloramphenicol in Aqueous Solutions Using Derivatives of 9h-Carbazole

На сегодняшний день задачей экологического мониторинга является детектирование следовых количеств антибиотиков в объектах окружающей среды и продуктах питания. Настоящее исследование посвящено сравнительной оценке возможности применения замещенных и незамещенных карбазолов для флуорометрического определения хлорамфеникола в водно-органических растворах. Показано закономерное изменение интенсивности флуоресценции, обусловленное процессами взаимодействия исследуемых флуорофоров с аналитом. Наиболее перспективным соединением для аналитического применения является ацетиленпроизводное карбазола, продемонстрировавшее в широком линейном диапазоне (0,1-25 мкМ) высокую чувствительность Ksv=105425 M-1 с пределом обнаружения 2,8 мкМ.Today, the task of environmental monitoring is to detect trace amounts of antibiotics in environmental objects and food. The present study is devoted to a comparative assessment of the possibility of using substituted and unsubstituted carbazoles for the fluorometric determination of chloramphenicol in aqueous organic solutions. A regular change in the fluorescence intensity caused by the processes of interaction of the studied fluorophores with the analyte is shown. The most prospects compound for analytical use is the acetylene derivative of carbazole, showing in a wide linear range (0,1-25 μM) a high sensitivity of Ksv=105425 M-1 with a detection limit 2,8 μM

WAYS TO ELIMINATION OF MOTHER-TO-CHILD TRANSMISSION OF HIV

Aim. The article addresses the progress in elimination of mother-to-child transmission of HIV in the Russian Federation. The authors reviewed the available data on the current situation and identified opportunities to reduce the risk of mother-to-child transmission of HIV. Materials and methods. The basic HIV statistics for 2017 from the federal public health watchdog Rospotrebnadzor and the Russia's ministry of health were analysed. The findings included several important aspects. Results. In 2017, women constituted a substantial proportion of population living with HIV, both among all cases and among new HIV infections (37%-38%). The number of new HIV cases among women was growing every year and by 2017 increased 62% compared to 2010. In 28 regions of the Russian Federation, more than 1% of pregnant women were HIV positive. Across the whole monitoring period (from 1987), 177,663 pregnancies complicated by HIV infection and ended in delivery were registered in Russia by the end of 2017, including 14,969 such pregnancies in 2017 alone. In 2017, 91.0% of pregnant women living with HIV took ART during pregnancy, 94.7% received it in labour. 98.7% of new-borns were given antiretroviral therapy as prevention. However, a three-stage chemoprophylaxis was provided to only 89.1% of mother-child pairs. It was revealed that 1,635 motherchild pairs (10.9%) missed at least one of prevention stages. The main reason for incomplete prevention was the late diagnosis of HIV infection in mothers. The viral load before delivery was not suppressed in 25.8% of HIV-positive pregnant women whose pregnancies were completed in 2017 (2,527 women were tested for viral load and 1,342 did not take antiretroviral drugs during pregnancy). 708 children born to HIV-positive mothers were diagnosed HIV positive in 2017 of whom, however, only 235 were born that year. Calculations showed that in 2017 the risk of vertical HIV transmission amounted to 2.3%, which were 348 new-born babies. A significant number of children (35,579 born in different years) did not undergo a final HIV test. 3.9% of all HIV-infected children born to HIV-positive women had contracted HIV through breastfeeding. There was also a trend towards increasing the number of HIV transmissions this way. The article reveals that in the cohort of children born women, the death rate is higher. So in 2017 mortality among infants born to HIV-positive mothers was 1.5 times higher, while perinatal mortality was twice as high as in the general population. Conclusion. The study showed that in order to improve the situation concerning vertical transmission of HIV, it is necessary to solve a number of tasks related to low threshold programmes aimed at access to surveillance, treatment and retention in care for women, especially those of at-risk of HIV. The ways to achieve the goal are early infant HIV diagnosis in first two months of new-borns' life, urgent final laboratory examination of older children exposed to HIV at birth, determination and elimination of factors leading to increased infant mortality, breast-feeding counselling, as well as improvements in statistical methods

ОСОБЕННОСТИ ТЕЧЕНИЯ БЕРЕМЕННОСТИ, ПЕРИНАТАЛЬНЫЕ ИСХОДЫ И РЕЗУЛЬТАТЫ ЛЕЧЕНИЯ ТУБЕРКУЛЕЗА В ПОСЛЕРОДОВОМ ПЕРИОДЕ У КОИНФИЦИРОВАННЫХ (ВИЧ+ТБ) ЖЕНЩИН

The characteristics of pregnancy and parturition, the perinatal outcomes, and the results of therapy for tuberculosis were analyzed based on findings related to 24 women coinfected with HIV and TB who were followed up at Krasnoyarsk Regional TB Dispensary № 1 in 2010-2014. Eight women continued psychoactive drug abuse during pregnancy. Abortions were made upon patient’s agreement with medical panel advice in four cases of seven associated with the progression of coinfection during the second trimester. Pregnancy ended with parturition in 13 cases. One infant died within the antenatal period. Among twelve mother-and-child pairs, eight passed through three-stage preventive interventions against perinatal HIV transmission. One infant still contracted the coinfection and died of it at six months of age. Three women died, including two cases that occurred in the early postpartum period and one case that occurred in 20 months, its causes being unrelated to TB or HIV Radiological examinations revealed TB progression during the early and late postpartum period in seven and four women, respectively. With account of forced combined therapy and resulting multiple drug interactions and of high risks of adverse outcomes for both, women and fetuses, HIV-infected women coinfected with TB should be strongly advised to use contraception.Приведен анализ особенностей течения беременности, родов, перинатальных исходов и результатов лечения туберкулеза у 24 коинфицированных женщин (ВИЧ+ТБ), наблюдавшихся в Красноярском краевом противотуберкулезном диспансере № 1 с 2010 по 2014 год. Восемь женщин сохраняли активное наркопотребление в период беременности (33,3%). Прерывание беременности по желанию женщины произошло в 4 случаях, по решению врачебного консилиума по причине прогрессирования коинфекционного процесса в 7 случаях в срок от 17 до 26 недель. Беременность закончилась родами у 13 женщин. Антенатально погиб один ребенок. Живые дети родились у 12 женщин, из 12 пар мать-ребенок 8 получили трехэтапную профилактику перинатальной передачи ВИЧ. Перинатально инфицирован один ребенок, который умер от коинфекции (ВИЧ+ТБ) в возрасте 6 мес. Три женщины умерли: две в раннем послеродовом периоде и одна через 20 мес от причин, не связанных с туберкулезом и ВИЧ-инфекцией. При лучевом обследовании в раннем послеродовом периоде прогрессия туберкулеза в виде отрицательной рентгенологической динамики отмечена у 7 из 11 женщин, а в позднем послеродовом периоде у 4 из 12 женщин. Учитывая вынужденную полипрагмазию, широкий спектр лекарственных взаимодействий, высокие риски неблагоприятного исхода беременности, как для женщины, так и для плода, ВИЧ-инфицированным женщинам в период лечения туберкулеза настоятельно рекомендована контрацепция

PATHOMORPHOLOGY OF PLACENTA IN WOMEN WITH PRETERM BIRTHS AT DIFFERENT AGE OF GESTATION

The aim: to identify pathological characteristics of placenta in women with preterm labor according to the gestational age.Materials and methods. The study involved 55 women who gave birth prematurely: 21 women with gestational age from |22 to 32 weeks (group 1) and 34 women with gestational age from 32 to 37 weeks (group 2). All the women had spontaneous singleton pregnancies followed by preterm spontaneous births. We conducted a comparative analysis of the social, clinical and amnestic information, as well as a histopathological study of the placentas; the latter included macroscopic description, organometry and microscopic morphology. The analysis aimed to identify the placental factors associated with the premature delivery occurred before and after 32 weeks of gestation.Results. The study revealed a number of anamnestic and clinical factors associated with preterm births. At a gestational age up to 32 weeks, the placentas showed hypoplasia with a mass deficit of more than 30% in combination with proliferative vylusitis, post-inflammatory hypovascularization, abnormal differentiation of the vascular-stromal component of the villi, and insufficient compensatory and adaptive reactions. After 32 weeks of pregnancy the placenta characteristics included chronic disorders of the maternal and fetal blood circulation, compensatory hyperplasia of the terminal villi, capillaries and their syncytia capillary membranes.Conclusion. There is a need for individual rehabilitation programs for women with the history of preterm births that would include their clinical and anamnestic background together with the pathomorphological characteristics of their placentas. Such a program is expected to help these women to be better prepared prior to their subsequent pregnancy