The aim: Is to study the efficacy of influenza vaccination for individuals with polymorphism Arg753Gln of TLR-2 gene, Leu412Phe of TLR-3 gene, and Asp299Gly of TLR-4 gene. Materials and methods: 66 people with mutant genotypes and normal distribution of alleles of TLR-2, TLR-3, TLR-4 genes, aged 18-63, were inoculated with anti-influenza vaccine. The genotyping of Arg753Gln polymorphic site of TLR-2, Asp299Gly of TLR-4, and Leu412Phe of TLR-3 gene was carried out by polymerase chain reaction with oligonucleotide primers usage. The immunological efficacy of vaccination was evaluated by seroconversion, seroprotection, and dynamics of mean geometric titers of antibodies. Results: It has been established that individuals with mutant genotypes Arg/Gln of TLR-2, Leu/Phe, Phe/Phe of TLR-3, Asp/Gly of TLR-4 genes have a vaccinal response to administering anti-influenza vaccine at the level of subjects with normal distribution of TLR alleles, as evidenced by the growth in dynamics of mean geometric titers of antibodies to vaccine strains, the level of seroprotection and seroconversion. Clinical and epidemiological efficacy of vaccination in this category of people is characterized by: reduction of ARI cases in the postvaccinal period by 2,0-3,0 times; prevention of pneumonia in all vaccinated subjects; decrease in the frequency of bronchitis by 2,5-3,8 times. Conclusions: Effectiveness of influenza vaccination in individuals with Arg573Gln polymorphism of TLR-2, Leu412Phe of TLR-3, Asp299Gly of TLR-4 genes by immune and clinical epidemiological parameters is determined at the level of vaccinated subjects with normal distribution of TLR-2, TLR-3, TLR-4 alleles. Specific influenza immunization of people with polymorphic modified genotypes of TLR-2, TLR-3, TLR-4 genes can prevent the development of pneumonia and reduce the incidence of bronchitis.
The paper is devoted to developing a methodology for failure mode and effects analysis on the example of assessment of defects that occur during production and operation of polymer composite materials and industrial products from them. The paper uses the Ishikawa method to illustrate and further analyze the cause of defects in reinforced polymer composite material. The Ishikawa diagram was constructed and analyzed using the method of causal analysis. The types and consequences of failures and defects for polymer composite materials are analyzed. For each type of defect, the value of the priority number of risks is calculated. For the most critical defect, measures to reduce potential defects are proposed. Suggestions for improving the detected defective zones in the structures of polymer composites in the analysis process are given.
The aim of the research was to determine clinical and genetic predictors and to create a prognostic model for the rapid hepatic fibrosis progression in men with chronic hepatitis C. Materials and methods. А cross-sectional study which included 111 male patients with chronic hepatitis C was conducted. The patient examination program included: assessment of complaints and anamnestic data, physical examination, complete blood count, biochemical test, the stages of hepatic fibrosis according to METAVIR аnd genetic studies (detecting carriers alleles 11Gln or 11Leu of TLR7 gene in the genome of the examined men). Results. It was determined that informative predictors of rapid hepatic fibrosis progression in men with chronic hepatitis C are: ethanol use in a dose of more than 40 g/day (ОR = 2.40, P = 0.042), presence of chronic cholecystitis in past history (ОR = 2.94, P = 0.013), ALT level above 3 upper limit of normal (ОR = 2.49, P = 0.031), the levels of AST, GGT exceeding upper limit of normal (ОR = 6.94, P < 0.001 and ОR = 4.02, P = 0.001 respectively), hyperbilirubinemia (ОR = 3.13, P = 0.010) and carrier state of allele 11Gln of TLR7 gene in the genome (ОR = 3.62, P = 0.036). In order to optimize the prognosis of rapid hepatic fibrosis progression in men with chronic hepatitis C a model that demonstrated statistical significance (χ² = 44.73, P < 0.001) and high operational characteristics (sensitivity-76.8 %, specificity-74.5 %, the total number of correct predictions-75.7 %, AUC of the ROC-curve-0.828), which indicates the feasibility of its practical use, was proposed. Conclusions. An effective clinical and genetic prognostic model has been created and allows us to predict the probability of rapid hepatic fibrosis progression in men with chronic hepatitis C with high accuracy and to form a group of patients who need high priority antiviral therapy.
HIV-infection is a relevant issue of the modern healthcare system due to socio-medical and demographic significance. The problem of correlation between clinico-laboratory characteristics and immunological indexes in people living with HIV-infection and obtain ART remains relevant, and the solution may help to expand the knowledge about predictors of the disease in the future. The aim of our research was to analyze the clinical and immunological characteristics of HIV-infection in dynamics against the background of ART considering the initial level of CD4+ T-lymphocytes. Patients and methods. We conducted a cohort study of 181 people living with HIV-infection – 127 male and 54 female patients, aged from 21 to 55 years (the average age 34.6±0.6 years), who underwent dispensary observation at Poltava Regional HIV/AIDS Prevention and Control Center during 2003-2017, for the purpose of evaluation of clinical and immunological characteristics of HIV-infection in dynamics against the background of ART. Results of the research and their discussion. We found that among people living with HIV, young people (90.0%) predominated; among them – males (70.2%); patients who injected drugs at the time of referral to medical care (49.2%); with bad habits (smoking – 49.2%, alcohol abuse – 14.4%) and had experience of incarceration (26.5%). They were diagnosed with opportunistic infections inherent to III and IV clinical stages of HIV-infection, including bacterial (37.0%), fungal (44.2%), viral (35.4%) and parasitic (6.6%) infections. Moreover, 24 (13.3%) patients developed the CD4+ T lymphocytes level ≥350 cells/µl. Examination of HIV-infected patients in dynamics showed that there was a clinical progression of HIV-infection against the background of ART background in 72 (39.8%) out of 181 patients, 21 of them (30%) with CD4+ T lymphocytes ≥350 cells/μl.
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