Late presentation for HIV care has important individual and population implications. The objective of this study was to explore the problem of late presentation in the country of Georgia. Data on adult persons newly diagnosed with HIV in Georgia between 2012 and 2015 were extracted from the national AIDS Health Information System. Late presenter was defined as a person diagnosed with HIV with a CD4 cell count <350 cells/mm3 or an AIDS defining illness regardless of the CD4 cell count in the six months after HIV diagnosis. Late presenter with advanced disease was defined as a person diagnosed with HIV with a CD4 cell count <200 cells/mm3 or an AIDS defining illness, regardless of CD4 cell count in the six months after HIV diagnosis. Among 2267 adults diagnosed with HIV in Georgia in 2012–2015, 1987 (87.6%) had CD4 cell count measured within 6 months of HIV diagnosis and were included in the analysis. Among them 1260 (63.4%) patients were classified as late presenters and 870 (43.8%) as late presenters with advanced disease. The proportion of late presenters declined from 71.1% in 2012 to 55.5% in 2015 (p<0.0001), while presentation late with advanced disease decreased from 56.6% in 2012 to 34.5% in 2015 (p<0.0001). Late presentation was most common among people who inject drugs (77.7%). Overall 186 patients died over the studied period. Mortality was higher both among late presenters (6.74 per 100 person-years vs. 1.08 per 100 person-years, p<0.0001) and late presenters with advanced disease (8.93 per 100 person-years vs. 1.34 per 100 person-years, p<0.0001). High prevalence of late presentation in Georgia reflects insufficiency in HIV testing services. Better testing strategies are needed to improve earlier diagnosis and disease outcomes.

In the article, the questions of pectin extraction from citrus fruits are discussed. The research was carried out on the extracts obtained after squeezing the juice from citrus fruits: lemon (Georgian and Meer), Washington-Navel orange (Georgia and Turkey), Unshiu mandarin and the largest citrus fruit pomelo (China). Fruits collected in April-December were morphologically divided into flavedo, albedo, and tissue of fruit lobes, from which pectin isolates were obtained. The dependence of the production of isolates on the ratio of components of the hydromodule (acid: water), the type of acid (HCl, HNO 3 , H 2 SO 4 , H 2 C 2 O 4 and C 6 H 8 O 7 ), the duration of the process (1, 2, 3, 4, 5 and 24 hours) and the extraction temperature (20°) was investigated., 60°, 80°С), the type and time of fruit ripening, as well as the type of precipitation reagent pectin (AlCl 3 , CaCl 2 , 95% C 2 H 5 OH, isopropanol) and its concentration, duration of extraction (2h, 8h, 12h, 24h) and temperature (20, 40, 60, 70, 80°С). A technological scheme for obtaining pectin extracts was developed. Established: extraction of pectin depends on the type and time of fruit collection, temperature and duration of extraction, type of extractant; the ratio of water and acid in the hydromodule (Н 2 О : acid) should be 1:10; isolate should be extracted with HCl, H 2 SO 4 or lemon acid; рН of the hydromodule of the isolate should be 1.8-2.0; Extraction of pectin should be carried out with 95% C 2 H 5 OH, during 24 hours, with a module of 1:3 at room temperature. Identification of pectin isolates and obtained samples was carried out by the method of high-efficiency liquid chromatography. Obtained: practically all samples contain pectin and galacturonic acid and do not contain polygalacturonic acid, which indicates the complete extraction of pectin.

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Tumors of the pancreatic head commonly consist of carcinomas whereas other entities are rare exceptions. Extrapulmonary sarcoidosis is well-known but is extremely rare when detected as a mass in the pancreatic head. In general the diagnosis of sarcoidosis requires histologic examination with verification of non-caseous, epithelioid cell-like granulomas. Systemic therapy consists of steroids when the patient exhibits symptoms or in the case of progression of the disease. However, in some cases extended abdominal resections are also required to confirm the diagnosis and/or to treat symptoms.