Current study was aimed at investigating prevalence of overt and occult hepatitis B infection in HIV-positive individuals as well as molecular-epidemiological characteristics of the circulating hepatitis B virus (HBV) strains in the Far Eastern Federal District (FEFD). A total number of 297 blood serum/plasma samples obtained from HIV-positive patients residing in the FEFD were enrolled in the study. The first control group included 351 blood serum/plasma samples of general population without indication on HIV and HBV-infection that underwent laboratory check up at the Centers for AIDS Prevention and Control. After evaluating the group of HIV-positive patients 20 HIV-HBV positive samples were selected for further detailed analysis. The second control group included 43 patients with chronic hepatitis B. All groups were age and gender-matched. The research included serological and molecular-genetic (real-time PCR, positive for HBV DNA samples underwent clonal sequencing of PCR-amplified HBV P/S gene) assessment of the biological material followed by a phylogenetic analysis of the HBV sequences. Our research revealed that HIV-positive patients are exposed to a higher risk of HBV infection compared to general population enrolled in the study, which is evident from the prevalence of anti-HBcAg antibodies in the groups examined. HIV-positive vs. first control group was positive for anti-HBcAg antibodies at higher rate (35.02%, CI 95: 29.5940.45% versus 22.22%, CI 95: 17.8726.57%, p = 0.0003). Abundance of ongoing HBV-infection markers was also higher in HIV-positive individuals compared to general population (6.73%, CI 95: 3.889.58% versus 0.85%, CI 95: 01.81%, p = 0.0001, respectively). Should be noted, that HBsAg-negative HBV infection in HIV-positive patient cohort comprised 1.01% (CI 95: 02.15%) whereas in general population this index was as low as 0.28% (CI 95: 00.84%). Virus hepatitis С and D were revealed at higher rate in HIV-positive individuals compared to patients with HIV-negative chronic HBV infection (p = 5.84 107 and p = 0.000001 respectively). HCV and HDV prevalence rates comprised 50.0% (CI 95: 27.4677.46%) and 40.0% (CI 95: 17.9762.03%) in HIV-positive patients. Similar indices in control group were 4.65% (CI 95: 010.94%) and 4.65% (CI 95: 010.94%), respectively. The phylogenetic analysis of the six isolated HBV sequences showed that the five samples belonged to genotype D, with dominant subtype D2 (verified in 4 cases). Further, HBV genotype С was detected only in one case. The obtained data indicate a necessity for further in-depth diagnostic examination of viral hepatitis in HIV-positive patients to lower a risk of developing life-threatening complications as well as preventing hepatitis spread in human population.
Epilepsy is a chronic brain disease and one of the most common neurological diseases in the world, manifested by sudden seizures due to increased paroxysmal activity of neurons. There are no published studies aimed at assessing the dynamics of motor development in young children suffering from epilepsy with motor disorders.Purpose. The paper aimed at studying the dynamics of motor function indicators in patients with epilepsy on the background of movement disorders during three courses of rehabilitation treatment.Material and methods. We studied 123 young children with epilepsy and motor disorders. Age ranged from 9 months to 24 months. All patients were divided into 3 groups: group 1 patients who received only general massage, group 2: patients who received Vojta therapy, group 3: patients who received massage and Vojta therapy. The duration of remission for clinical seizures in all groups was at least 3 months, remission for video EEG monitoring in all patients was 23 months. Three courses of medical rehabilitation were carried out with an interval of 2 to 5 months for 1015 sessions of 2530 minutes daily. The dynamics of motor development of patients and the effectiveness of medical rehabilitation were assessed using the GMFCS scale, before and after each course of medical rehabilitation.Results. After the first course of rehabilitation, almost no improvement was observed and was unreliable, while after the second course there was a significant positive trend, especially pronounced in group 3. At the same time, the growth of the scale indicators in the period from the end of the first course to the end of the third was almost linear.Conclusion. The data obtained indicate the presence of a certain rigidity of the motor system of such patients, which determines the minimum dynamics after the first course of rehabilitation. Only starting from the second course, we begin to notice a linear improvement in the indicators of motor functions. The preferred duration of the interval between courses, in our opinion, is not less than two and not more than three months.
Enuresis as an independent pathology in children over 5 years old occurs quite often, and amounts to 5–17% depending on the age. For a long time, the focus of research into this pathology has been on monosymptomatic enuresis, which is both a symptom and the main manifestation of the disease (nighttime urination incontinence). In-depth study into the problem of enuresis was initiated more than 20 years ago by prof. E.L. Vishnevsky in the Moscow City Center of Pathology of urination at the Speransky Children's City Clinical Hospital № 9. As a result of the work carried out jointly at several Russian centres in Moscow, Petrozavodsk, Sevastopol and Anadyr by children’s urologists, neurologists, nephrologists and paediatricians, a conclusion was reached on encuresis as a manifestation of comorbid conditions. The article presents the results of of the clinical studies in children with attention-deficit/hyperactivity disorder (ADHD), overactive bladder (OAB), metabolic nephropathies, and other somatic pathologies in which enuresis was a manifested clinical syndrome. Differential diagnosis and effective treatment tactics in such cases require more thorough research using clinical, neurophysiological and instrumental methods, which makes it possible to establish a diagnosis in a timely manner and administer an adequate therapy.
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