Українською | English
usaid banner

Issue. Articles

№1(1) // 2010

 

Обкладинка

 

1. Editorial

 

Tuberculosis is actual problem in Ukraine

V.F. Moskalenko, V.I. Petrenko, R.G. Protsyuk, D.G. Donets

Epidemic situation about tuberculosis was analyzed all over the world and in Ukraine. Morbidity of tuberculosis in Ukraine since 1992 till 2005 has been growing and increased during this period in 2.4 times (from 35.0 per 100 000 of population to 84.5 in 2005). Mortality rate during this period has increased in 2.7 times (from 9.5 causes in 1992 to 25.3 causes per 100 000 of population in 2005).
Since 2006 has been noticed slow decrease of morbidity and mortality during last 4 years. In 2009 morbidity of tuberculosis was 72.2 per 100 000 of population and it was for 13.6 % less comparing 2005, and mortality rate descended during this period for 28.1 % from 25.3 % per 100 000 of population in 2005 to 18.2 causes in 2009.

To download   
full version need login

2. Editorial

 

Problems of the co-infection tuberculosis/HIV in Ukraine

S.О. Cherenko, L.V. Scherbacov

Includes analysis of epidemic situation by co-infection tuberculosis/AIDS in Ukraine in dynamic 9 years, causes and terms of death from co-infection. Found out that major cause low quality collection epidemic sign and higher risk of lethality from co-infection tuberculosis/HIV are defects of dispensary control by the patients with AIDS centrals and not low cooperation besides phthisiology service and service of prophylactic and fight against AIDS on a regional level.

To download   
full version need login

3. Original research

 

The cellular reactions in broncho-pulmonary system in patients with chronic obstructive pulmonary disease

Ye.M. Neyko, P.R. Herych, М.М. Оstrovskyi, L.M. Tomashchuk, I.V. Hatayilo, L.D. Mygovych

The aim — to study cellular reactions in broncho-pulmonary system in patients with chronic obstructive pulmonary disease.
Materials and methods. On the basic of broncho-pulmonary fluid in 60 patients the cellular reactions in the bronchoalveolar complex in the exacerbation of chronic obstructive pulmonary disease (COPD) of the IInd and the III rd stages were studies. At the beginning of the pa examinations the patients were divided into two groups due to stages of a disease. The ammount of the cellular elements' content in broncho-pulmonary fluid, the phagocytic and biocidal activity of the alveolar macrophages in the peripheral blood the phagocytic and biocidal activity of the neutrophils were determined.
Results and discussion. The immune disorders developing in patients with COPD in the exacerbations were established. They correlate with both changes in the cellular content of the immune defense and in the functional stabe. The relapses of the exacerbations cause the increase of neutrophils in the broncho-pulmonary fluid and peripheral blood, the decrease of their functional activity (according to NBT tests and phagocytosis indexes) in the peripheral blood and in broncho-pulmonary fluid indicating the processes, which take place in the system of local broncho-pulmonary fluid defense.
Conclusion. The peculiarities of cellular structure of the local immunity in bronchoalveolar complex of patients with COPD depend on many factors including inflammatory processes and stages of the disease.

To download   
full version need login

4. Original research

 

The analysis of the efficacy of treatment the HIV-infected individuals and patients with AIDS in Ukraine using the results of cohort studies

N.M. Nizova, I.P. Kolesnikova, A.O. Bobrova, O.O. Kurpita, T.V. Stepanova, S.V. Ryabokon, A.V. Aleksandrin

The aim — to analyse cohorts of patients which began ART in Ukraine from the beginning of its large-scale introduction, and to define the statistical indexes of its efficiency of after 12 months of treatment.
Materials and methods. A cohort analysis and statistical method of processing of data, got during the periodic looking after the group of patients which began ART in Ukraine from August 2004 grammes was used.
Results and discussion. The summarized data on antiretroviral therapy outcomes for HIV/AIDS patients in Ukraine are presented in the publication based on cohort monitoring results of patients group who started antiretroviral therapy.
Conclusion. In 5 years from the beginning ART continue it to get practically 70 % patients,  from them 80 % have functional status «able» to work, that testifies to the positive social-economic model of accompaniment of patients on HIV/AIDS on the basis of command multidisciplinary approach, that harmoniously connects medical and non medic constituents.

To download   
full version need login

5. Original research

 

Регуляция специфического клеточного иммунитета у взрослых больных с впервые диагностированным туберкулезом легких

В.И. Петренко, Ю.А. Варченко

Цель работы — изучить количественное распределение интерлейкинов (ИЛ-2, γ-ИФН, ФНО-α), IgE и показателей специфического иммунитета у больных с впервые диагностированным туберкулезом легких в зависимости от клинической формы туберкулеза легких в сравнении со здоровыми донорами с негативной и гиперергической реакцией на пробу Манту.
Материалы и методы. В статье проанализированы уровни иммунорегуляторных интерлейкинов в сыворотке крови: ИЛ-2, γ-ИФН, ФНО-α и уровень IgE с помощью иммуноферментного анализа, а также содержание лимфоцитов (CD2+), Т-лимфоцитов (CD3+), Т-лимфоцитов-хелперов (CD4+), Т-лимфоцитов киллеров/супрессоров (CD8+), НK-клеток (CD16+), активированых
В-лимфоцитов (CD22+) методом определения популяций лимфоцитов (CD) с помощью моноклональниых антител, у больных с впервые диагностированным (ВДТБЛ) очаговым (5 человек), инфильтративным (42 человека) и диссеминированным (4 человека) туберкулезом легких в сравнении со здоровыми донорами с негативной (15 человек) и позитивной реакциями на пробу Манту (12 человек).
Результаты и обсуждение. Клиническая картина туберкулеза сопровождается общими иммунологическими признаками, независимо от формы ВДТБЛ, а именно: снижением уровня γ-ИФН, относительного числа лимфоцитов (CD2+) и повышением содержания НK-клеток. Сочетание вышеуказанных иммунных изменений соответствует картине очагового ВДТБЛ. Инфильтративный
ВДТБЛ характеризируется активацией специфического гуморального иммунитета, что сопровождается повышением активированных В-лимфоцитов (СD22+). Диссеминированный туберкулез характеризируется резким угнетением всех показателей специфического иммунитета (снижением числа Т-лимфоцитов киллеров/супрессоров и активированных В-лимфоцитов). Общим признаком для здоровых лиц с гиперергической реакцией на пробу Манту и больных с ВДТБЛ является снижение продукции γ-ИФН. Повышение продукции IgE у больных с инфильтративным и диссеминированным ВДТБЛ, вероятно, связано с угнетением антагонистического влияния γ-ИФН на ИЛ-4, который активирует выработку IgE.
Выводы. Пусковым механизмом нарушения специфического клеточного иммунитета является снижение продукции γ-ИФН, что происходит до появления клинической картины туберкулеза еще на этапе инфицирования. Более тяжелой, распространенной клинической форме ВДТБЛ соответствуют более выраженные изменения показателей специфического клеточного иммунитета.

To download   
full version need login

6. Original research

 

Analytic epidemiology use in tuberculosis observation

Yu.G. Pustovyy, M.G. Dolynska, N.A. Gritsova, V.V. Baranova

The aim. Present-day trends of epidemiology development dictate the changes into tuberculosis surveillance focusing on risk factors. Tuberculosis development seems to be contributed by both infectious and non-infectious epidemiology laws.
Methods. The analysis of risk group prevalence among tuberculosis patients has been performed. According to classic epidemiologic regards absolute (R), relative (RR), attributable (AR) and population attributable risk (PAR) has been assessed for main tuberculosis risk factors.
Results. Low income and unemployment were the strongest social risk factor (52.3—69.1 % patients were exposed). HIV infection (2.4—3.5 %) and diabetes mellitus (1.7—3.2 %) were the most frequent among medical ones. Obtained data proved that so-called social risk factors are much more potent than medical ones, at least in Lugansk region. However relative and attributable risk of the HIV-infection being the main current medical risk factor is also high: RR was about 30.7, i.e. morbidity was 30.7 times as high in HIV-positive as in HIV-negative people; AR was 0.97 i. e. it’s just HIV which determined tuberculosis in 97 % of HIV associated TB cases.

To download   
full version need login

7. Original research

 

Study of changes psychoemotional status of patients with tuberculosis and its relationship with effective tuberculosis therapy for stationary phase

О.K. Asmolov, N.A. Gerasimova, A.V. Kaprosh, О.A. Baburina

The aim — to study the relationship between changes in the neuro-mental health patients with tuberculosis (ТB) and the course of disease and the effectiveness of TB therapy.
Materials and methods. Were observed 100 patients with tuberculosis who were divided into 4 groups of 25 persons each (group 1 — tubercular meningitis; group 2 — the first time diagnostic pulmonary tuberculosis, non proliferation; group 3 — TB on a background of chronic alcoholism; group 4 — against tuberculosis injecting drug use). In the 2 group of patients, together with conventional survey techniques, used a psychological test (the test LOBI).
Results and discussion. According to the survey in all groups of patients were allocated 2 basic types of violations: psychoses and neuro-psychiatric disorders neurotic registry. In the 2 group, according to tests conducted by the LOBI decreased the number of patients with a harmonic type of attitude towards their illness and treatment (from 56.2 % to 37.3 %) and increased the number of patients with apathetic type (from 1.1 % to 10.3 %), with a euphoric type (from 0 % to 21 %) and anozognozic type (from 2.2 % to 16.7 %).
Conclusion. The data obtained allow to recommend in order to enhance the effectiveness of treatment of patients with tuberculosis, as a pathogenetic treatment of psychological adjustment through various methods of psychotherapy.

To download   
full version need login

8. Original research

 

Indicators of the bone mineral density of tuberculosis, sarcoidosis and lung cancer patients

M.M. Savula, N.S. Kravchenko

The aim — comparative analysis of the state of mineral closeness of bone tissue (BMD), taking into account the factors of risk of osteoporosis for patients on tuberculosis, sarcoidosis and cancer of lungs.
Material and methods. 108 is inspected patients (30 patients with  a tuberculosis of lungs, 43 — with disease of Besnier-Boeck-Schaumann, 35 — with the cancer of lungs). Densitometria of lumbar department of spine is conducted by a x-ray photography doublephoton densytometr ДРХ-А (Lunar Corp., the USA).
Results and discussion. The changes BMD prevail in case of lung cancer (85.7 % ) and tuberculosis (83.3 %). Reduced BMD mostly was noticed in case of tuberculosis (70.0 %), but the mostly expressed reduction of BMD was in case of lung cancer (48.6 %). In case of sarcoidosis mostly with chronic course of process was noticed considerable quantity of patients with increased BMD (27.9 %). Among the tuberculosis and lung cancer patients with the reduced BMD mostly were patients who abuse alcohol, among sarcoidosis patients it were patients with respiratory insufficiency.
Conlusion. The changes of BMD are possible at all studied diseases and often did not correlate from by the generally accepted factors of risk. Therefore for setting of correction therapy the densitometric is needed preliminary inspections of patients.

To download   
full version need login

9. Original research

 

Reasons of origin, frequency and character of relapses of tuberculosis in Ternopil area

L.A. Hryshchuk, V.D. Rudyk, O.I. Gradova, Yu.S. Zavodovich, G.I. Demyanova, N.B. Pelehat, S.O. Bilyk

The aim — study reasons, frequency and character of relapse tuberculosis in the Ternopol area for 2006—2009.
Materials and methods. A retrospective analysis is conducted from data of hospital of frequency of relapses charts, indexes of morbidity on tuberculosis for 104 patients which treated in Area tubercular dispensary in 2006—2009. The persons of able to work age, which do not have permanent work, predominated among them — 65 (62.5 %) and pensionary — (22.1 %).
Results and discussion. In the article information is resulted on the amount of cases, to morbidity by the relapses of tuberculosis for the last three years on the Ternopil area. It is set that among all of forms of active tuberculosis amount of cases of relapses diminished from 174 to 122, and morbidity from 15.8 to 11.2 on 100 thousands of population. Among patients with a tuberculosis — accordingly from 150 to 111 person and from 13.6 to 10.2 on 100 thousands of population. Principal reasons of relapses it was been: features of flow of illness and concomitant diseases (COPD, chronic diseases of liver and stomach, bronchial asthma, diabetes mellitus) — 35.6 %, careless attitude toward the health — 26 %, abuse of alcohol, narcotics, smoking — 26 %.
Conclusion. For diminishing of frequency of origin of relapses of tuberculosis it is necessary to conduct more intensive course of complex therapy taking into account concomitant diseases, complications, presence of harmful habits. It is necessary to activate the leadthrough of sanitary-educational work with the purpose of forming of responsible relation of patient to the health.

To download   
full version need login

10. Original research

 

Tuberculosis and pneumonia at a HIV-positive patients:the diseasing analysis

V.S. Gojdyk, N.S. Gojdyk, L.I. Kovtunovich, S.K. Servetskij, A.I. Gozhenko

The aim — establishment of laws between level of a tuberculosis among adult population of Ukraine and among a HIV-positive patients was the purpose of the given work.
Materials and methods. For task in view realization the analysis of the statistical data, concerning prevalence of a tuberculosis among country adult population has been carried out, comparison with the data on inspection and disease of a HIV tuberculosis-positive patients is spent. 5872 visitings of the phthisiatrician in polyclinic of the Odessa Regional Center on preventive maintenance and struggle against AIDS (OCPA AIDS) and 1654 case records of the patients passing treatment in stationary branch OCPA AIDS during the period with 2006 for 2009 are studied.
Results and discussion. As a result of researches, it is established that disease of a tuberculosis at a HIV — the positive patients who have been written out from a hospital with improvement, correlates with level of disease among adult population of Ukraine. At the same time the received results testify that among the died patients the quantity of cases of the revealed tuberculosis continues to grow, despite reduction in 2009 of level of disease on the country.
Conclusions. Drawn on dependence existence are between level of distribution of a tuberculosis among all population and among a HIV-positive patients, about necessity to continue perfection of early diagnostics of a tuberculosis at a HIV-positive patients as the started forms in most cases lead to a lethal outcome, and also about perspectives of the further studying of separate forms of the tuberculosis in particular accompanied bacterial allocating as most socially of the significant.

To download   
full version need login

11. Original research

 

Features of clinical course of community acquired pneumonia against a background of ischemic heart disease depending on the verification Chlamydophila pneumonia

M.M. Ostrovskyy, O.I. Varunkiv

The aim — is to evaluate the clinical course of community acquired pneumonia against a background of ischemic heart disease depending on the verification Chlamydophila pneumonia.
Materials and methods. We conducted in-depth clinical, laboratory and instrumental examination of 102 patients with community acquired pneumonia aged 50 to 65 years.
Results and discussion. Community acquired pneumonia, damaging the vast majority of people of working age and characterizes with high mortality and disability of patients because of complications, and forms one of the most burdensome medical and social problems. Clinical course of community acquired pneumonia significantly changed in recent years due to the rise in verification of atypical microorganisms, primarily of viral and chlamydial infection as a possible etiological factor in pathology. For community acquired pneumonia against a background of coronary heart disease in patients infected with Chlamydophila pneumoniae, unlike intact individuals more typical symptoms are: dry inefficient cough, subfebrile on the background and expressed intoxikation phenomena and leukocytosis syndrome, the prevalence of duplex mikrofokale lung lesion.
Conclusion. Identification of inefficient dry cough, crepitation, intoxikation syndrome signs, absence of fever, barbed pain on the side nature of lung inflammatory infiltration in community acquired pneumonia against a background of ischemic heart disease is the basis for a focused search of Chlamydophila pneumoniae.

To download   
full version need login

12. Original research

 

Clinical and immunological efficacy izofon in children with tuberculosis

O.І. Belogortseva, V.Р. Kostromina, Zh.І. Krivosheeva, M.А. Volyk, N.V. Simonenkova, I.V. Koposova, O.Ye. Sivachenko, Ya.I. Dotsenko

The article presents the influence of drugs izofon on the immune system in children with tuberculosis in the scheme of treatment which was included izofon and a control group of children with pulmonary tuberculosis who received standard chemotherapy regimens. It has been estimated that the drug izofon had immunomodulatory effects on the immune system and positively affected on the state of mucosal immunity in patients with tuberculosis, reduced the factors of specific and nonspecific inflammation in the bronchi.

To download   
full version need login

13. LECTURES

 

AIDS-infection: clinical manifestation of on the skin and on the visible mucous membranes

V.I. Stepanenko, V.G. Kolyadenko

The original clinical classification of AIDS is being presented here. Some clinical characteristics of infectious and not infectious dermatosis and their dynamic process under the AIDS cover is represented here.

To download   
full version need login

14. Lectures

 

Exogenous allergic alveolitis

А.S. Svincickiy

The purpose of this article was to learn a wide range of general practitioners and pulmonologist with the problem of exogenous allergic alveolitis. The article presents basic achievements in studying the problem of extrinsic allergic alveolitis (EAA) submitted pathomorphological picture of the disease, given the current views regarding the ethiology, pathogenesis, diagnosis and stages of treatment schemes EAA.

To download   
full version need login


Publisher


Services


Partners


Advertisers


Subscribe








© VIT-A-POL