Pleural pathology in HIV-infected patients: features of morphological diagnostics

Background. The progression of HIV infection is accompanied by the development of opportunistic diseases, including pleural effusions of various origins. Morphological examination of pleura tissue in cases of pleural effusion serves as the basis for establishing the etiology of the pathological process and, therefore, the final clinical diagnosis. Objective – analysis of results of morphological diagnostics of pleura lesions in HIV-infected patients in comparison with other laboratory tests and clinical diagnosis. Methods. 103 cases of pleurisy of various origins were studied. Pleural biopsies were obtained by various types of minimally invasive diagnostic interventions with subsequent morphological examination. Results were compared with the available data of microbiological and molecular genetic studies of pleural biopsies. Results. At the time of hospitalization the preliminary clinical diagnosis was pleurisy of unknown etiology in 96,1 % of cases. A combined disease was diagnosed – hepatitis C in a third of all observations according to the results of laboratory tests. Due to routine staining with hematoxylin and eosin, tuberculosis lesions of the pleura were diagnosed in 59,2 %, the second most frequent was the diagnosis of nonspecific pleurisy, 20,4 %. According to the duration of the process, acute pleural tuberculosis was established in 19,7 % of cases, the subacute form of tuberculosis pleurisy – in 54,1 % of cases, and chronic pleural tuberculosis was established in 22,9 % of cases. In 17,5 % of cases, in order to clarify the etiology of pleurisy, additional histochemical staining for infectious agents was performed. The results of microbiological and molecular genetic studies were established in 76,7 % of cases. The greatest number of M. tuberculosis detection was obtained during the culture study of the biopsy material and exudates. When comparing the final clinical diagnosis and the level of CD4 cells in peripheral blood, it was found that in most cases (74,5 %) pleural effusions developed at low counts of CD4 cells, less than 350/l. Conclusion. Tuberculosis predominates in the etiological structure of pleural effusions in patients with HIV infection. Pleural tuberculosis can be the main secondary disease or be combined with pulmonary tuberculosis. In second place in terms of frequency of occurrence, nonspecific pleurisy was diagnosed as a complication of the main secondary disease. Pleural effusions develop when CD4 cell counts are low. Morphological diagnostics of pleural lesions is the main research method in the diagnostic algorithm of cases of pleural effusions of unknown etiology against the background of HIV infection.

The advertisement call of Chiasmocleis (Syncope) carvalhoi (Nelson, 1975) (Anura: Microhylidae), with taxonomic remarks based on new morphological observations of specimens from Peruvian Amazonia

We quantitatively describe for the first time the advertisement call of Chiasmocleis (Syncope) carvalhoi using recordings of five specimens from northern Peruvian Amazonia. The advertisement call is characterized by a single, short, tonal, and high-pitched note. Call duration ranges between 0.03–0.06 s and its dominant frequency between 7.12–7.92 kHz. The lack of pulses within notes distinguishes C. (Syncope) carvalhoi from all congeneric species except C. (Syncope) antenori, C. (Syncope) parkeri and C. (Chiasmocleis) mantiqueira, which can be distinguished by the shorter duration of their notes and silent intervals (in C. (Syncope) antenori and C. (Syncope) parkeri) and by the lower dominant frequency (in C. (Syncope) parkeri and C. (Chiasmocleis) mantiqueira). In addition, based on our collected specimens, we report on and discuss about the variation of some external morphological characters and natural history of C. (Syncope) carvalhoi, including the absence of vocal slits and sacs. Our study reveals a potential association between the absence of vocal slits and sacs, and tonal calls in Chiasmocleis, as well as conflicting morphological diagnostics characters in the literature.

The incidence of lung cancer in the Moscow region from 1998 to 2018

This review discusses the main statistical indicators for lung cancer (LC) in the Moscow region over the past 20 years from 1998 to 2018. Methods. The analysis of basic statistics was carried out on the basis of official statistics of the Moscow region in the period from 1998 to 2018. Results. A decrease in the incidence was revealed. The five-year survival rate increased. The morphological diagnostics of LC improved. The detection of the disease in the early stages improved. In addition, mortality has decreased, both overall, and one-year. Conclusion. The reduction of morbidity and mortality, as well as the improvement of early detection of patients with LC in the Moscow Region was facilitated by the introduction of tobacco control measures, the implementation of programs to fight cancer, improving the quality of diagnostics and improving the equipment of clinics and hospitals, as well as the use of new modern treatment methods, such targeted and immunotherapy.