We analysed 193 results of a microbiological study of sputum with culture typing in HIV-infected patients. The data obtained are compared with the existing clinic picture of infectious lesions of the respiratory system. Four groups were formed: 1st group — patients with bacterial microflora + Streptococcus (S.) viridans + pneumonia clinical picture (n = 25), 2nd — S. viridans + clinical picture of pneumonia (n = 114), 3rd — Mycobacterium tuberculosis + S. viridans + clinical picture of pneumonia (n = 19), 4th — S. viridans without clinic picture of pneumonia (n = 35).
In the studied groups, statistically significant differences in immunological status (number of CD4+ lymphocytes), localization of inflammatory changes in the lung tissue, the degree of contamination of S. viridans and fungi of the genus Candida in sputum were observed. In HIV-infected patients with S. viridans verification and a clinical picture of pneumonia, radiographic changes in the lower left lobe and unilateral hydrothorax were more common. The massive growth of S. viridans was observed in patients with bacterial pneumonia, pulmonary tuberculosis, as well as in the group with an unspecified etiological agent of lung tissue damage.
The data obtained during the study can be used in practice in the differential diagnosis of lower respiratory tract infections in HIV-infected patients.
Operational bioptic material of thyroid gland tumors taken from 55 children and adolescents 8-17 years old was investigated. Taking into account the new classification of tumors (WHO, 2017), tumors of the follicular structure were verified in 21 patients: follicular cancer (FC, n = 7), follicular variant of papillary cancer (FV PC, n = 7), follicular adenoma (FA, n = 4), noninvasive follicular thyroid neoplasm with nuclei of papillary type (NFT, n = 2), follicular thyroid tumor of uncertain malignant potential (n = l). The conducted study indicates a low incidence of noninvasive follicular thyroid neoplasm with nuclei of papillary type in children and adolescents — 4% of cases. The peculiarities of benign and malignant tumors with nuclei of papillary type are the following: smoothing of sexual differences, frequently combined with autoimmune diseases of the thyroid gland, the increase of karyometric parameters as compared with follicular adenomas and carcinomas. Ultrastructural analysis showed that the tumor cells with nuclei of papillary type (FV PC, NFT) distinguish themselves by expressed polymorphism. At the same time, cells with signs of neuroendocrine differentiation prevail in a NFT neoplasm with nuclei of papillary type in contrast to FV PC, in which cellular forms with the loss of secretory activity and organospecificity predominate.
The study of the quality of life of patients with occupational chronic obstructive pulmonary disease (COPD), involved occupational COPD patients exposed to toxic gases/liquid aerosols (n = 55) or inorganic dust (n = 101). The comparison group consisted of patients with COPD due to tobacco smoking (n = 103). The diagnosis of COPD was established on the basis of the GOLD 2011-2018 criteria. Quality of life was assessed according to the St. George’s Respiratory Questionnaire. We revealed a predominant decrease in the quality of life of patients with occupational COPD due to the effects of toxic gases/liquid aerosols on account of the impact on physical activity and social functions. The quality of life of patients with COPD is reduced to a greater extent than in COPD due to smoking.
To identify risk factor for unfavorable outcome of the disease in patients with HIV-associated tuberculosis the study including 459 cases of HIV-associated tuberculosis was conducted: 248 cases with an unfavorable outcome of the disease constituted the main group (MG) (186 males and 62 females, mean age 35.0 ± 1.5 years), the comparison group (CG) — 211 cases with a favorable outcome (160 males and 51 females; mean age — 37.0 ± 2.3 years). To assess the risk factors, the odds ratio (OR) and the 95% confidence interval in the binary logistic regression module were calculated.
The statistically significant risk factors for the unfavorable outcome of tuberculosis in HIV-infected patients are revealed: 1) risk factors associated with the peculiarities of the tubercular process — the presence of a widely extended, with the damage of two lung lobes and more, bilateral tubercular process, with lung tissue patholysis and the shedding of multidrug-resistant mycobacterium tuberculous to anti-tuberculous drugs, the generalization of tuberculosis with the lesion of 2 organs and more; 2) risk factors associated with characteristics of the course of HIV infection — the presence of immunodeficiency clinical signs, a comprehensive clinical picture of EBV (Epstein — Barr virus) infection, the intensity of the viral load is over 100 000 RNA copies HIV/ml, 3) a pre-term cessation of chemotherapy for tuberculosis, refusal of antiretroviral therapy, 4) Charlson comorbidity index > 8 points. The obtained results are the evidence of the need to reconsider the existing algorithms for the management of HIV-associated tuberculosis co-infected patients in terms of the identified risk factors for an unfavorable outcome of the disease.
The aim of the work is to study the pharmacokinetic profile of the antiplatelet drug of indolinone series (GRS) in the blood plasma of rats and rabbits. GRS was administered once to rats and repeatedly to rabbits intragastrically as a suspension in 0.5% aqueous solution of carboxymethyl cellulose. The study of the predictability of systemic exposure growth in response to dose increase was carried out as part of a study of the linearity of pharmacokinetics in doses of 10, 20 and 40 mg/kg in rats. To assess the absolute bioavailability GRS was injected into the vein in rats at a dose of 1 mg/kg as a solution in 50% polyethylene glycol — 400. Blood from rats after administration was taken at points of 10, 20, 30, 45 min, 1, 2, 4, 8 and 24 h (5 rats per point). To study the possible accumulation of rabbits GRS was orally repeatedly (1 time per day for 10 days) administered, blood was taken after 1, 5 and 10 administration at points of 30, 45 min, 1, 2, 4, 8 and 24 h.
It was found that GRS is rapidly absorbed from the gastrointestinal tract with a maximum concentration at 1 h and has an absolute bioavailability of 23%. The value of the system AUC exposure increases linearly with increasing doses from 10 to 20 mg/kg, increasing the dose to 40 mg/kg does not lead to a corresponding increase in AUC, which goes to the plateau. Repeated (10-fold) intragastric administration of GRS to rabbits does not lead to a significant change in the value of the system exposure.
The aim of this study was to compare the dynamics of the clinical picture, morphofunctional parameters of the myocardium and adherence to treatment against the background of optimal medical therapy (OMT), including drugs that improve the prognosis, and percutaneous coronary intervention (PCI) in combination with OMT in patients with stable coronary heart disease during prospective observation. The study included 125 men aged 50-75 years. The main group (PCI with stenting + OMT) consisted of 78 people aged 61.5 ± 8.5 years; the comparison group (OMT) consisted of 47 people aged 63.5 ± 7.1 years. By age and frequency of the main cardiovascular risk factors patients did not differ significantly. Patients of both groups with a frequency of more than 90% had arterial hypertension (AH) with a history of 10.3 ± 2.5 years. Also patients of both groups did not differ significantly in functional class of angina pectoris, duration of ischemic history, frequency of myocardial infarction and functional class of chronic heart failure. After a year of observation there were no significant differences in the dynamics of morphometric and functional parameters of myocardium in both groups against the background of the treatment. The main reason for low treatment adherence was the lack of understanding of the need for taking medications (primarily statins) with good health.
The factors associated with non-alcoholic fatty liver disease/steatohepatitis in patients with ulcerative colitis (UC) and Crohn’s disease (CD) were studied. A high incidence of non-alcoholic fatty liver disease/steatohepatitis was revealed in patients with inflammatory bowel disease (IBD). In patients with IBD, non-alcoholic fatty liver disease was associated with age and the presence of metabolic risk factors, as well as high disease activity. In patients with CD, an association of non-alcoholic fatty liver disease with the extraintestinal manifestations of the basic disease was observed. In patients with CD without metabolic risk factors, non-alcoholic fatty liver disease was associated with hospitalization rates. The presence of Epstein — Barr virus and cytomegalovirus in the mucous membrane of the large intestine is not associated with non-alcoholic fatty liver disease/steatohepatitis.
In a study on the assessment of dental status in patients with a rare form of diabetes — MODY, 9 people were involved (3 women and 6 men). The diagnosis of MODY was based on the results of molecular genetic research. In patients with different subtypes (2, 6 and 12) of MODY a high intensity of caries, inflammatory periodontal diseases and dental anomalies was detected, which did not significantly affect the quality of life of the patients. In the oral cavity of patients with MODY subtype 2 there were no pronounced specific manifestations of disorders of carbohydrate metabolism, which probably can be associated with good diabetes compensation. Clinical descriptions of MODY subtype 2 in representatives of two generations — father and son — is also presented.
In order to study the functional state of the left atrium in individuals exposed to organic solvents of the aromatic series, 80 women working at an industrial enterprise in the profession of a painter and contacting with paints of various names on the basis of organic solvents of the aromatic series were examined, the main of which were: toluene, xylene, acetone, butyl acetate, ethyl acetate, butanol, which were intensively released into the air of the working area during the painting works. The control group was represented by healthy women — 20 people, an average age 39.3 ± 4.1 years; comparison group was represented by the individuals with vegetative-dishormonal cardiomyopathy (VDC) — 30 people, an average age 40.5 ± 3.4 years, who had no contact with toxic substances and patients with mild iron deficiency anemia (IDA) — 25 people, an average age 39.68 ± 3.3 years. All individuals underwent echocardiography.
It was revealed that depending on the length of service, there is a change in the activity of the left atrium, which is expressed in the formation of the mechanism of regulation of the left ventricular myocardial function by the сontracting atrium. This atrial mechanism begins to form in the groups of medium- and high-level painters with VDC. Hyperfunctional mode of the left atrium is noted in painters with anemic cardiomyopathy. In general, the state of the contractile function of the left heart in painters with secondary cardiomyopathy reflects the complex mechanism of interaction between the ventricle and the atrium, which occurs with the activation of their compensatory and adaptive resources, aimed at maintaining the heart function at the optimal level for the body in conditions of prolonged exposure to damaging factors.
Ischemic heart disease is the leading cause of mortality in the developed countries; accordingly the study of various aspects of this disorder is a crucial medico-biological task. Cardiac muscle of the left ventricle taken from 37 individuals suddenly deceased from acute forms of ischemic heart disease (as a result of acute coronary insufficiency and acute myocardial infarction at prenecrotic stage) served as the material for the conducted study. The control group included the cardiac muscles taken from 5 individuals deceased from traumatic brain injury. Besides light and polarized investigation of myocardial sections the immunohistochemical analysis, permitting to evaluate the intensity of cellular protein expression: actin, desmin, connexin 43, was used. The use of immunohistochemical staining of the cardiac muscle allows assessing the status of the macromolecular structure of the myocardium by the expression of actin, desmin and connexin 43 and can be applied for morphological diagnostics of acute focal myocardial injuries in forensic-medical or pathological practice in cases of sudden cardiac death.
