Latent tuberculosis and COVID-19 disease

Since the start of the COVID-19 pandemic in 2020, there has been chaos in the world. With the COVID-19 cases rising, many other medical diseases have been ignored and not prioritized. One of these crucial diseases is Tuberculosis (TB). TB is a highly infectious bacterial respiratory disease. Every year there are millions of cases that are registered all around the world. TB is seen in two forms, an active and a latent form. In both of the states, the individual with TB is immunocompromised. This is of great importance, as COVID-19 is known to readily infect individuals in an immunocompromised state more than those with a healthy immune system. Although a little investigation about coexisting infections with COVID-19 and TB is conducted, it is important to consider many factors that can be beneficial to help treat these patients with both conditions effectively and promptly. A few of these factors are pathophysiological relation, diagnostic measurements, effects of each condition on the other, and approaches to treatment. Through a literature review of available information, we summarized the knowledge regarding the correlation between Latent TB infection and COVID-19 infection. The main objective of this publication is to provide a brief overview of how the two conditions overlap with one another. The article also provides a clinical review of how to approach these two conditions in a scenario where an individual is found to be infected with both Latent TB and COVID-19.

The case of comorbidity of sinus node dysfunction and new coronavirus infection with Sjogren’s disease and Thompson’s myotonia

Coronavirus infection, according to modern data, poses a threat not only to the respiratory system, in more than 15% of patients it can lead to cardiovascular complications, including in young and middle-aged people. COVID-19 is probably the trigger of a detailed clinical picture of chronic diseases occurring in a latent form. The article considers the case of sinus node dysfunction and polyneuropathy in a young patient after coronavirus infection against the background of concomitant diseases such as Sjogrens disease and Thompsons myotonia. To observe the dynamics of the three diseases, the timely organization of a multidisciplinary approach is important. It is necessary to consider all three diseases in the paradigm of the main and concomitant in order to timely and adequate therapy. Further study of the clinical features, therapeutic approaches and complications in patients with COVID-19 is required.

Study of polysynaptic reflex excitability and somatosensory evoked potentials in patients with myofascial pain syndrome

Introduction. Myofascial pain syndrome (MFPS) is one of the most common pathologies of the musculoskeletal system that causes chronic pain. This type of pain reaches its peak in middle-aged people; women get sick 2,5 times more often than men. The disease leads to significant disability; it is not only a medical but also a social problem. Atthe same time, a number of authors still note the low clinical efficacy of the applied therapy regimens. In this situation there is in demand the further study of the MFPS pathogenesis, in particular, the clinical and electroneurophysiological characteristics of this pathology, in order to search for new, including pathogenetically proved, treatment methods.The aim of the research was to study the relationship between the indicators of the blinking reflex and somatosensory evoked potentials in patients with active and latent forms of MFPS.Materials and methods. In order to study the neurophysiological aspects of MFPS, a comprehensive clinical and electroneurophysiological examination was carried out in 92 patients of working age, including 78 women and 14 men, whose average age was 48,1±9,3) years, suffering from MFPS of the scapular area. The patients were subdivided into subgroups depending on the prevalence and severity of pain manifestations: the first subgroup — with an active form (58 people, 63 %), the second subgroup — with a latent form of MFPS (34 people, 37 %). The control group was formed from conditionally healthy volunteers in the amount of 35 people, comparable to the main group by age and sex.Results. The comparing of the study results, taking into account polysynaptic reflex excitability and the data of somatosensory evoked potentials, revealed the significant positive correlations of the indicators. The obtained results allowed to assess the excitability of spinal cord motor neurons as well as suprasegmental structures in MFPS, involved in the implementation of pain syndrome.Conclusion. The use of clinical electroneurophysiology methods makes it possible to assess the functional state of the CNS structures involved in the analysis of nociceptive afferentation. In the active form of MFPS, an increase in the excitability of stem and thalamic structures was mainly determined, which could potentially indicate the activation of adaptive processes on the one hand, and on the other hand, the predisposition of neuronal networks to a state of arousal. In the latent form of MFPS, a multidirectional change in reflex excitability was observed.

Variation in human herpesvirus 6B telomeric integration, excision and transmission between tissues and individuals

Human herpesviruses 6A and 6B (HHV-6A/6B) are ubiquitous pathogens that persist lifelong in latent form and can cause severe conditions upon reactivation. They are spread by community-acquired infection of free virus (acqHHV6A/6B) and by germline transmission of inherited chromosomally-integrated HHV-6A/6B (iciHHV-6A/6B) in telomeres. We exploited a hypervariable region of the HHV-6B genome to investigate the relationship between acquired and inherited virus and revealed predominantly maternal transmission of acqHHV-6B in families. Remarkably, we demonstrate that some copies of acqHHV-6B in saliva from healthy adults gained a telomere, indicative of integration and latency, and that the frequency of viral genome excision from telomeres in iciHHV-6B carriers is surprisingly high and varies between tissues. In addition, newly formed short telomeres generated by partial viral genome release are frequently lengthened, particularly in telomerase-expressing pluripotent cells. Consequently, iciHHV-6B carriers are mosaic for different iciHHV-6B structures, including circular extra-chromosomal forms that have the potential to reactivate. Finally, we show transmission of an HHV-6B strain from an iciHHV-6B mother to her non-iciHHV-6B son. Altogether we demonstrate that iciHHV-6B can readily transition between telomere-integrated and free virus forms.

Tracing the Children in Contact of Sputum Smear Negative Adults is the Need of the Hour to Achieve WHO “Stop TB Strategy”

Tuberculosis has been a public health issue affecting a large number of population world wide. 1According to 2019 report, approximately 10 million of people fell ill by the disease around the globe. A considerable proportion of TB affected cases is constituted by paediatric patients solely. The WHO estimates that about 1 million children endure the disease each year of which a significant figure harbours the latent form of infection. Since, the accurate diagnostic test to confirm the tuberculosis in children has not been unrolled, a positive history of contact is regarded as the foremost feature for authenticating the diagnosis in children. A large proportion of children with tuberculosis lives under the same roof with sputum smear positive adults, tracing out the childhood TB cases in sputum smear negative contacts is equally important and needs to be diagnosed timely. This category of children left undiagnosed acts as a pool for further transmission of the disease from where new TB cases arise. Therefore, the early diagnosis of children of this group is the need of the hour and a challenge to “STOP TB Strategy”.

Algorithm for diagnosing the latent form of celiac disease in adults

The article presents a clinical case of the latent course of celiac disease with diagnosis in the adult period, reflects the role of trigger factors, the features of the clinical course, the formation of concomitant lactase deficiency and the need for all diagnostic stages for diagnosis.

AGEISM AS A LATENT FORM OF AGE DISCRIMINATION

. The article is devoted to the study of ageism as a form of age discrimination. The peculiarity of age discrimination is that anyone can become its object after reaching the appropriate age. The main thing is that ageism has a dual nature. The first is the level of perception and stereotypes and the second is the level of certain ones. At the same time, the influence on the change of stereotypes is possible only through the sphere of indirect influence - the formation of appropriate cultural norms that would be in opposite to such stereotypes. Also, discriminatory practices may be subject to the legal regulation. It is noted that some of these practices have a marginal origin, because they are on the border between actions that can be clearly defined as direct discrimination and actions that constitute covert discrimination. At the same time, both formalization and prevention of hidden discrimination are very complicated. The possibility of implementing special measures (affirmative actions) to reduce the impact of agediscriminatory practices is indicated in the article. The study of the problem of ageism emphasizes the special nature of discriminatory practices in the field of labor law. The practice of restricting the employment of persons who have reached a certain age is the most pronounced. Such limitations should be considered as discriminatory practices, except when they can be justified. However, such justification must be proven for each specific type of restriction. The concept of presumption of prohibition of age discrimination is offered. The article emphasizes the need of the problem of age discrimination for future researches, including through sociological means. Also, it is necessary to monitor and revise legislation and bills in terms of age restrictions on certain activities.

Variation in Human Herpesvirus 6B telomeric integration, excision and transmission between tissues and individuals

Human herpesviruses 6A and 6B (HHV-6A/6B) are ubiquitous pathogens that persist lifelong in latent form and can cause severe conditions upon reactivation. They are spread by community-acquired infection of free virus (acqHHV6A/6B) and by germline transmission of inherited chromosomally-integrated HHV-6A/6B (iciHHV-6A/6B) in telomeres. We exploited a hypervariable region of the HHV-6B genome to investigate the relationship between acquired and inherited virus and revealed predominantly maternal transmission of acqHHV-6B in families. Remarkably, we demonstrate that some copies of acqHHV-6B in saliva from healthy adults gained a telomere, indicative of integration and latency, and that the frequency of viral genome excision from telomeres in iciHHV-6B carriers is surprisingly high and varies between tissues. In addition, newly formed short telomeres generated by partial viral genome release are frequently lengthened, particularly in telomerase-expressing pluripotent cells. Consequently, iciHHV-6B carriers are mosaic for different iciHHV-6B structures, including circular extra-chromosomal forms that have the potential to reactivate. Finally, we show transmission of an HHV-6B strain from an iciHHV-6B mother to her non-iciHHV-6B son. Altogether we demonstrate that iciHHV-6B can readily transition between telomere-integrated and free virus forms.

DIAGNOSIS OF LIVER ENCEPHALOPATHY IN PATIENTS WITH LIVER CIRRHOSIS

Summary. Aim. Comparison of methods for diagnosis of hepatic encephalopathy in patients with cirrhosis. Matherials and Methods. We observed 95 patients with LC who were hospitalized from 2018 to 2020 in the Department of Anesthesiology and Intensive Care, Surgical and Gastroenterological Departments of the Transcarpathian Regional Clinical Hospital. Andriy Novak (Uzhhorod). Neurological status, state of mental and cognitive functions in patients with LC were assessed before and after the course of therapy with psychometric testing, as well as electroencephalographic (EEG) study. The severity of LE was determined by West-Haven criteria. Results. Signs of LE were not diagnosed in 8.4 % of patients with LC. In 13.8 % of patients found a latent form of LE. This was most often observed in the III century. (in 25.2 % of patients), LE II. diagnosed in 22.1 % of patients with LE and Art. — in 17.9 % of examined patients, and in 12.6 % of examined — LE IV. In patients with LC, alpha waves on the EEG are most often registered in the latent form of LE, and with the increase of clinical signs of LE there is a decrease in the frequency of alpha waves, instead of pathological delta and theta waves. Conclusions. According to the MMSE scale, the highest scores are observed in patients of group I (29.9 ± 3.4). The most pronounced disorders of intelligence were determined in patients with LC of group III from the IV century. LE (15.1 ± 3.3). The level of personal anxiety in patients with LC was higher than normal in patients with LE II-IV centuries. surveyed groups with maximum values in group III (55.5 ± 8.2). At patients with LC the expressed cognitive frustration are observed. Signs of LE were not diagnosed in 8.4 % of patients with LC. In 13.8 % of patients found a latent form of LE. This is most often observed in the III century. (in 25.2 % of patients), LE II. diagnosed in 22.1 % of patients with LE and Art. — in 17.9 % of examined patients, and in 12.6 % of examined — LE IV.