scholarly journals The role of extragenital infectious pathology in the structure of maternal mortality in Moscow

2020 ◽  
Vol 9 (3) ◽  
pp. 34-42
Author(s):  
L.M. Mikhaleva ◽  
A.G. Konoplyannikov ◽  
Y.Y. Kudryavtseva ◽  
Y.G. Parkhomenko ◽  
A.S. Olenev ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Hiv Infection ◽  
Maternal Mortality ◽  
Molecular Genetic ◽  
Infectious Endocarditis ◽  
Medical Documentation ◽  
Icd 10 ◽  
Back Ground ◽  
Life Threatening ◽  
Report Data

Introduction. Diseases that are not directly related to obstetric pathology and childbirth fade into the back-ground and are not always included in the maternal mortality, but their significance can hardly be overes-timated. A special group of such pathologies comprises infectious diseases, the prevalence of which varies significantly in different countries. As a rule, these diseases are characterized by a severe course and are life-threatening for the mother and the child. The most relevant among them are HIV infection, tuberculosis, infectious endocarditis, and sepsis. The aim of the study was to consider the leading extragenital causes of maternal mortality and to assess the importance of infectious pathology based on the pathological findings. Materials and methods. The study included 38 pathological autopsies, 10 of which are described in more detail. Medical documentation, autopsy protocols for deceased pregnant women, women in labor, and women in childbirth were examined. Causes of death were classified according to the ICD-10 criteria. A clinical and morphological study was carried out, and supportive laboratory techniques were used (microbiological, histobacterioscopic, molecular genetic, serological, and cytological tests). Results. As it follows from the autopsy report data from 2013 to 2019 in Moscow, the extragenital pathology accounted for 38 lethal cases (46.9% of all maternal deaths), of which 10 (26.3%) cases were associated with infectious pathology. Conclusion. Extragenital pathology, although not a leading cause of maternal mortality, remains a crucial obstetric problem. Infectious diseases, primarily HIV infection, are the significant cause of extragenital morbidity. Keywords: maternal mortality, extragenital infectious pathology, tuberculosis, HIV infection, infectious endocarditis, drug addiction, Kaposi’s sarcoma

Obstetrical causes of maternal mortality. Results of pathoanatomical examinations

2020 ◽  
Vol 19 (4) ◽  
pp. 99-109
Author(s):  
L.M. Mikhaleva ◽  
◽  
A.G. Konoplyannikov ◽  
Ya.Yu. Kudryavtseva ◽  
A.S. Olenev ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Maternal Mortality ◽  
Massive Pulmonary Embolism ◽  
Medical Documentation ◽  
Morphological Examination ◽  
Complex Approach ◽  
Icd 10 ◽  
Leading Position ◽  
Causes Of Mortality ◽  
Postpartum Cardiomyopathy

Objective. To study the main causes of maternal mortality and to determine the role of obstetrical pathologies based on the findings of pathoanatomical autopsies. Materials and methods. The study included 42 autopsy findings, we studied medical documentation, autopsy records of deceased pregnant and parturient women. The most common causes of mortality (n = 29), according to the latest revision of ICD-10, were analyzed in detail. The general clinical and morphological examination was performed. Results. In Moscow, more than half of cases in the structure of maternal mortality refer to obstetrical pathologies. The most significant role belongs to preeclampsia and eclampsia (28.6%), they are in most cases characterised by an atypical clinical course and a specific pathomorphological picture. The second place is taken by massive pulmonary embolism (9.5%), the third place belongs to maternal shock during labour (7%) and the fourth place is shared by intrapartum infection (obstetrical sepsis), complications associated with obstetrical operative intervention and procedures, postpartum cerebral venous thrombosis, amniotic fluid embolism, postpartum cardiomyopathy (4.8%). Conclusion. The leading position in the structure of maternal mortality due to obstetrical causes belongs to preeclampsia and eclampsia. This pathology requires a complex approach to diagnosis and treatment, and postmortem verification of diagnosis should be confirmed by morphological examination with the use of immunohistochemical reactions. Key words: maternal mortality, obstetric pathology, preeclampsia and eclampsia, pulmonary embolism, maternal shock, obstetrical sepsis

scholarly journals Incidence of community-acquired pneumonia in HIV-infected people, depending on the level of immunodeficiency and viral load

2021 ◽  
Vol 13 (2) ◽  
pp. 62-65
Author(s):  
V. I. Sergevnin ◽  
K. V. Ovchinnikov ◽  
E. V. Sarmometov ◽  
A. A. Kirshina
Keyword(s):  
Viral Load ◽  
Infectious Diseases ◽  
Hiv Infection ◽  
Average Duration ◽  
Community Acquired Pneumonia ◽  
Medical Documentation ◽  
Infected People ◽  
Regional Center ◽  
Secondary Disease ◽  
Cd4 Lymphocytes

The aim of the study was to study the timing and frequency of community — acquired pneumonia in HIV-infected people, depending on the level of immunodeficiency and viral load.Materials and methods. Based on the materials of the Perm regional center for the fight and prevention of AIDS and infectious diseases, medical documentation was studied for 396 patients with HIV-associated pneumonia who died in 2014–2018 the frequency of community-acquired pneumonia (EAP) was estimated depending on the level of immunodeficiency and viral load.Results and discussion. It turned out that in most cases, EAP in relation to HIV infection is a secondary disease. The average duration of EAP after HIV infection was 4,6±3,7 years. With increasing immunodeficiency and viral load, the incidence of VP increases. Most often, VP is registered with CD4+ lymphocytes less than 200 cells/μl and viral load of 10 000–100 000 copies/ml.

Renal Phosphate Handling in Antiretroviral-naïve HIV-infected Patients

2020 ◽  
Vol 20 ◽  
Author(s):  
Tewogbade Adeoye Adedeji ◽  
Simeon Adelani. Adebisi ◽  
Nife Olamide Adedeji ◽  
Olusola Akanni Jeje ◽  
Rotimi Samuel Owolabi
Keyword(s):  
Hiv Infection ◽  
Plasma Phosphate ◽  
Cross Sectional ◽  
Phosphate Retention ◽  
Significant Difference ◽  
Immunodeficiency Virus ◽  
Life Threatening ◽  
Moderate Chronic Kidney Disease ◽  
One Year ◽  
Sectional Analysis

Background: Human immunodeficiency virus (HIV) infection impairs renal function, thereby affecting renal phosphate metabolism. Objectives: We prospectively estimated the prevalence of phosphate abnormalities (mild, moderate to life-threatening hypophosphataemia, and hyperphosphataemia) before initiating antiretroviral therapy (ART). Methods: A cross-sectional analysis was performed on 170 consecutive newly diagnosed ART-naïve, HIV-infected patients attending our HIV/AIDS clinics over a period of one year. Fifty (50) screened HIV-negative blood donors were used for comparison (controls). Blood and urine were collected simultaneously for phosphate and creatinine assay to estimate fractional phosphate excretion (FEPi %) and glomerular filtration rate (eGFR). Results: eGFR showed significant difference between patients’ and controls’ medians (47.89ml/min/1.73m2 versus 60ml/min/1.73m2, p <0.001); which denotes a moderate chronic kidney disease in the patients. Of the 170 patients, 78 (45.9%) had normal plasma phosphate (0.6-1.4 mmol/L); 85 (50%) had hyperphosphataemia. Grades 1, 2 and 3 hypophosphataemia was observed in 3 (1.8%), 3 (1.8%), and 1(0.5%) patient(s) respectively. None had grade 4 hypophosphataemia. Overall, the patients had significantly higher median of plasma phosphate than the controls, 1.4 mmol/L (IQR: 1.0 – 2.2) versus 1.1 mmol/L (IQR: 0.3 – 1.6), p <0.001, implying hyperphosphataemia in the patients; significantly lower median urine phosphate than the controls, 1.5 mmol/L (IQR: 0.7 -2.1) versus 8.4 mmol/L (IQR: 3.4 – 16), p <0.001), justifying the hyperphosphataemia is from phosphate retention; but a non-significantly lower median FEPi% than the controls, 0.96 % (IQR: 0.3 -2.2) versus 1.4% (IQR: 1.2 -1.6), p > 0.05. Predictors of FEPi% were age (Odds ratio, OR 0.9, p = 0.009); weight (OR 2.0, p < 0.001); CD4+ cells count predicted urine phosphate among males (p = 0.029). Conclusion: HIV infection likely induces renal insufficiency with reduced renal phosphate clearance. Thus, hyperphosphataemia is highly prevalent, and there is mild to moderate hypophosphataemia but its life-threatening form (grade 4) is rare among ART-naïve HIV patients.

scholarly journals Primary Care Guidelines for the Management of Persons Infected With HIV: 2013 Update by the HIV Medicine Association of the Infectious Diseases Society of America

2013 ◽  
Vol 58 (1) ◽  
pp. e1-e34 ◽  
Author(s):  
Judith A. Aberg ◽  
Joel E. Gallant ◽  
Khalil G. Ghanem ◽  
Patricia Emmanuel ◽  
Barry S. Zingman ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Hiv Infection ◽  
Healthcare Providers ◽  
Health Problems ◽  
Antiretroviral Drugs ◽  
New Information ◽  
Immunodeficiency Virus ◽  
Care Guidelines ◽  
Evidence Based Guidelines ◽  
Specific Health

Abstract Evidence-based guidelines for the management of persons infected with human immunodeficiency virus (HIV) were prepared by an expert panel of the HIV Medicine Association of the Infectious Diseases Society of America. These updated guidelines replace those published in 2009. The guidelines are intended for use by healthcare providers who care for HIV-infected patients. Since 2009, new antiretroviral drugs and classes have become available, and the prognosis of persons with HIV infection continues to improve. However, with fewer complications and increased survival, HIV-infected persons are increasingly developing common health problems that also affect the general population. Some of these conditions may be related to HIV infection itself or its treatment. HIV-infected persons should be managed and monitored for all relevant age- and sex-specific health problems. New information based on publications from the period 2009–2013 has been incorporated into this document.

scholarly journals Application of the real-time PCR in veterinary practice

2020 ◽  
Vol 2020 (2) ◽  
pp. 5-12
Author(s):  
Maksim Doronin ◽  
Dmitriy Lozovoy ◽  
Aleksey Scherbakov ◽  
Vladimir Makarov
Keyword(s):  
Infectious Diseases ◽  
Real Time ◽  
Quantitative Pcr ◽  
Biological Material ◽  
Molecular Genetic ◽  
The Body ◽  
Suspected Infection ◽  
Virus Content ◽  
Wide Range ◽  
Pathogenic Agents

To date the molecular genetic methods of analysis are widely used for laboratory diagnostic tests in various infectious diseases of animals. This discourse reflects information about the history of the invention of real-time polymerase chain reaction (PCR-RV), the nature of the processes that occur during this reaction, the main stages of the reaction, the preparation of biological material for research in PCR-RV. The spectrum of possibilities of using the PCR-RV method for a qualitative study of biological material in cases of suspected infection of animals with certain viral and bacterial agents, as well as a quantitative assessment of the virus content in tissues, organs or in the body by analogy with conventional methods for titrating infectiousness without direct manipulation with pathogenic agents, is presented. . A quantitative PCR-RV option allows veterinarians to evaluate the pathogenetic dynamics of the development of the disease, monitor the effect of antiviral and antibacterial therapy, and monitor the emergence of pathogen variants with high resistance to the drugs used. Thanks to the development of ARRIAH, the qualitative and quantitative PCR-RV method can now be used in domestic veterinary science and laboratory practice for the diagnosis of a wide range of animal infectious diseases.

scholarly journals Difficulties in primary diagnosis of HIV infection at the stages of health care settings

2020 ◽  
Vol 25 (1) ◽  
pp. 11-17
Author(s):  
Elena V. Esaulenko ◽  
Kseniya E. Novak ◽  
Thierry Ingabire ◽  
Sof’ya A. Semenova ◽  
Aleksandra O. Nikiforova
Keyword(s):  
Infectious Diseases ◽  
Hiv Infection ◽  
Primary Care Physicians ◽  
Sexual Transmission ◽  
Laboratory Data ◽  
Primary Diagnosis ◽  
Newly Diagnosed ◽  
Hiv Diagnosis ◽  
Rapid Tests ◽  
First Time

Aim: to demonstrate the difficulties and timeliness of HIV diagnosis by primary care physicians, to carry out a clinical and epidemiological analysis of newly diagnosed cases of HIV infection. Materials and methods: The study evaluated the routing of diagnosis and analyzed the epidemiological and clinical and laboratory data of 85 patients with a newly diagnosed HIV infection hospitalized in the St. Petersburg Clinical Infectious Diseases Hospital named after S. P. Botkin during the period from November 2018 to October 2019. To confirm positive results, ELISA and western blot were used. Results: Among the observed patients, 71.3% were women and 28.7% were men. The average age was 39.3 2 years. Upon admission to the infectious diseases hospital with an established diagnosis of HIV infection, 49.5% were hospitalized in specialized departments (n = 42). Of them, nine (9) were referred by the polyclinic with an established diagnosis, in 20 patients the diagnosis was established in somatic hospitals, and emergency room doctors newly diagnosed HIV infection in 13 more patients. The remaining 50.5% (n = 43) were hospitalized in various departments with other diagnoses. Clinical and laboratory analysis of these patients showed that for the first time in life, an established diagnosis of HIV infection corresponded to both early (15.3%) and late (84.7%) stages of the disease with dominance of sexual transmission of the virus (43.6%). Conclusion: HIV infection at both early and late stages can manifest under the guise of various other diseases, which makes it necessary to expand testing of patients for HIV infection, including using rapid tests.

scholarly journals Tuberculosis and HIV mortality in Russia

2020 ◽  
Vol 98 (6) ◽  
pp. 15-21
Author(s):  
E. B. Tsybikovа ◽  
I. M. Son ◽  
A. V. Vlаdimirov
Keyword(s):  
Mortality Rate ◽  
Infectious Diseases ◽  
Hiv Infection ◽  
Causes Of Death ◽  
Age Groups ◽  
Young Age ◽  
Federal State ◽  
Statistical Monitoring ◽  
Hiv Mortality ◽  
Leading Position

The objective: to study changes in the structure of mortality from tuberculosis and HIV infection in Russia from 2000 to 2017.Subjects and methods. The data of the Federal State Statistics Service on the mortality of the Russian population from tuberculosis and HIV infection (standardized ratio per 100,000 population) for 2000-2017 were studied. Data on the structure of patients with TB/HIV co-infection were obtained from Form no. 61 of the federal statistical monitoring for 2017.Results. In Russia, there has been a steady decrease in the mortality rate from tuberculosis, the value of which in 2017 reached 5.9 per 100,000 people. At the same time, the average values of the mortality rate from tuberculosis have shifted towards the older age groups reaching maximum values in the age group of 45 years and older. On the contrary, the analysis of mortality from HIV infection (2006-2017) detected its unprecedented increase from 1.6 to 12.6 per 100,000 population. The maximum concentration of mortality from HIV infection was observed in young age groups (35-44 years old). The increase in mortality from HIV infection was accompanied by a change in the structure of mortality from infectious diseases: the proportion of tuberculosis decreased from 79.1% (2000) to 27.4% (2017), and the proportion of HIV infection increased from 0.1% ( 2000) to 57.2% (2017). Currently, in Russia, mortality from HIV infection in young age groups has taken a leading position in the structure of causes of death from infectious diseases, displacing mortality from tuberculosis.

scholarly journals PREVALENCE AND MOLECULAR GENETIC PECULIARITIES OF PARENTERAL VIRAL HEPATITIS B AND C AMONG HIVPOSITIVE CITIZENS OF THE FAR EASTERN FEDERAL DISTRICT, INCLUDING THOSE PERSONS SENTENCED TO DEPRIVATION OF FREEDOM

2019 ◽  
pp. 51-55
Author(s):  
E.A. Bazykina ◽  
V.B. Turkutyukov ◽  
O.E. Trotsenko ◽  
V.O. Kotova ◽  
L.A. Balakhonsteva ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Hiv Infection ◽  
Viral Hepatitis ◽  
Molecular Genetic ◽  
Federal District ◽  
Biological Research ◽  
Hiv Positive ◽  
Healthy Population ◽  
Genetic Characteristics ◽  
Viral Hepatitis B

We conducted a comparative analysis of the parenteral viral hepatitis B and C (HBV and HCV) prevalence and their molecular genetic characteristics among prisoners of persons diagnosed with HIV infection (41 samples), HIV-positive free citizens (187 samples) and «conditionally healthy population» with the lack of information about the presence of a diagnosis of chronic viral hepatitis of any etiology and HIV infection (231 samples). Immunological and molecular biological research methods were used. Obtained data analysis showed that the prevalence of infection markers with viruses of parenteral hepatitis was significantly higher in the groups of HIV-positive individuals (imprisoned and freemen). The HBsAg-negative form of the disease was determined among the HIV-positive free population and in the «conditionally healthy population». Over the past 10 years (2009–2018), the proportion of HIV-positive prisoners in custody of people with HCV monoinfection doubled, HBV was increased in 8.7 times. Significant decrease in the combined infection of HBV and HCV of this contingent was found. Given this decrease in the penitentiary system in HIV-positive individuals, the overall burden of HBV infection (both in mono form and coinfection with HCV) significantly (5.3 times) decreased , which can be attributed to successful widespread vaccination against hepatitis B in Russia. The most common HCV genotypes among HIV-positive individuals were 1b and 3a, genotypic structure of HBV prevailed genotype D.

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