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Issue. Articles

2(2) // 2010



1. Editorial


Medic-social problems of the HIV-infection/AIDS in Ukraine

V.. Petrenko

Today Ukraine stays in category of country with concentration stage of the epidemic HIV-infection, focuses between group of the most higher infected risk: user of the injections drug; women of the commercial sex; men which have sex with man. According to the epidemiological dates between this groups the spreading HIV-infection is different but higher. For stop spreading of the HIV-infection between this groups need to increased the level of the prophylactic action in this risk groups throw all the Ukraine and increased intensiveness and quality of this action.

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2. Original research


Comparative analysis of up-to-date bacteriological and some genetic methods of tuberculosis diagnostics

.I. Barbova

The aims. The comparative analysis of the methods bacteriological testing of tuberculosis and DNA-hyb-ridization.
Materials and methods. Searching 1965 smears of sputum from patients with first diagnosed tuberculosis. Searching was providing by the light microscopy by Ziehl—Neelsen, luminiscent microscopy by Hgeman, semination was made on nutrition media of the Levenstein—Yensen after impruving the reactive NALC-OH. Genetic searching was providing by direct DNA-hybridization method.
Results and discussion. The results of comparative analysis of up-to-date bacteriological and genetic diagnostic methods of tuberculosis were represented. It was revealed that technique of medium inoculation is most informative among up-to-date applied bacteriological methods of tuberculosis detection. It is diagnostic value was more then 80 percents of detection if all tuberculosis forms.
Conclusion. Metods of the luminescent bacterioscopy more sensitive nearly on 10.0 %, compaire with light bacteriscopy. Diagnostic volue of bacteriological culturing methods consist 80 % in all the form of tuberculosis. It was shown that genetic method of direct DNA-hybridization enable to detect of tuberculosis in nearly 90 percents cases. This technique is the rapid method and may be applied both for screening and therapy control.

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3. Original research


The problem of progressing pulmonary tuberculosis and its some pathological peculiarities

I.V. Liskina, O.V. Kchmil

The aim. Research the problem of progressing pulmonary tuberculosis and its some pathological peculiarities
Material and methods. Group of patients consist of 23 persons with after surgical  treated fibrous-cavity tuberculosis of lungs and tuberculoma of lungs. Used complexy clinics-laboratory researching, microbiologic searching of sputum, histologic searching of operation material.
Result and discussion. The article is devoted to actual modern problem — to progressing pulmonary tuberculosis. The main reasons which are promoted to development of progressive forms of pulmonary tuberculosis are showed. A some clinical-laboratory and morphological peculiarities of high activity of tuberculosis inflammatory process are demonstrated on the example of group of 23 inpatients with fibrous-cavernous tuberculosis and tuberculomas and which one have undergo surgical treatment.
Conclusion. Histological feature of modern progressive of the tuberculosis are present. Reactivation of the tuberculosis processes during tuberculomas can counts feature modern pathomorphosis of tuberculosis. Perifocal exudate-necrosis reaction of the lung tissue is a morphological component of progressing tuberculosis during fibrous-cavernous tuberculosis and tuberculomas of lungs.

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4. Original research


The role of glucagon in preclinical glycemia disturbances development in patients with pulmonary tuberculosis

.G. Andreeva

There was presented the results of study glucagon and blood glucose concentration during test with insulin hypoglycemia in patients with normal glucose tolerance an patients with preclinical glycemia disturbances.
By means of external insulin introduction was discovered decrease of hypoglycemic insulin effect in patients with impaired glucose tolerance. The pathogenetic importance disturbance in system of glucagon/insulin in development of preclinical glycemia disturbances in patients with pulmonary tuberculosis.

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5. Original research


First-year mortality monitoring of tuberculosis patients in Lugansk region

N.I. Phomicheva, N.A. Gritsova, .S. Mazgnik

Dynamics, structure and reasons of death at tuberculosis patients within first year of observation had been investigated for potential impact elaborating on this index as well as on general mortality level.
510 case histories of tuberculosis patients elder than 18 years old died of different reasons not later than after a year of tuberculosis establishment have been analyzed. Firstly in Lugansk region first-year mortality intensive index has been calculated for the period between 2005 and 2009. The strong trend for declining was detected whereas the average index in Ukraine is quite stable with some tendency for growing.
Nevertheless structure mortality analyzes revealed serious challenges of early mortality preventing which characterize case detecting quality rather than the disease pathomorphosis.

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6. Original research


Estimation of influence of the tiotropium bromide on the surface-active fractions of lung surfactant system, levels of cytokines on the nosotropic aspects of becoming and progressing of the chronic obstructive pulmonary disease II stages

M.O. Kulynych-Miskiv, .. strovskyy

Aims. Estimate of tiotropium bromide on the surface-active fractions of lung surfactant system, level of TNFα, interleukin-4, interleukin-6, gamma-IFN in bronchoalveolar contents in patients with chronic obstructive pulmonary disease II stages.
Material and methods. Estimated 11 patients with CDL stage. Matirial for investigation was broncoalveolar lavage by Clements (1967) in the modification of Ramires (1980). Level NF-α, INF-gamma, IL-4, IL-6 find out by immunefermentative analises on «StatFax 303 Plus» with reagents «» (« », Russia). For researching SSL used equipment like torsions scales Willgelm—Lugmer.
Result and discussion. In the present study data on the pathogens features of immune response, content of TNF-α, gamma-interferon, interleukin-4 (IL-4), interleukin-6 (IL-6) and pulmonary surfactant system in the treatment of chronic obstructive pulmonary disease. Application of the drug tiotropium bromide (Spiriva ® «Beringer Ingelhaim») in treatment of chronic obstructive pulmonary disease contributes to faster regression of clinical and laboratory symptoms, increases the functionality of the cell number of phagocytes, leading to reduction of TNF-α and IL-6, compared with patients who received traditional therapy.
Prescriptions tiotropium bromide in provides a more qualitative level of full restoration of IL-4 and INFγ bronchoalveolar contents of patients with COPD stage II.
Conclusion. Found that in patients who received drug treatment of tiotropium bromide, existing content more normal restoration of surface-active fraction pulmonary surfactant system, which clearly correlates with the prolongation of the drug.

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7. Original research


Antimycobacterial activity of the new fluoroquinolone gemifloxacin

O.V. Panasiuk, G.V. Radysh

The aim was to study antimycobacterial activity of gemifloxacin using its analog Factive (Russia, «Verofarm»).
Materials and methods. During the study minimum inhibitory concentration (MIC) of the medicine was evaluated by the growth of M. tuberculosis (MBT) H37Rv, susceptible and resistant strains of MBT and nontuberculous mycobacteria in vitro. Also bacteriostatic activity in blood was evaluated.
Results and discussion. Minimal concentration of Factive, that inhibited growth of M. tuberculosis was 12,5 mkg/ml. Growth of nontuberculous mycobacteria and studied resistant strains of MBT was inhibited with concentration of Factive 20 mkg/ml. Bacteriostatic activity of blood after administration of 320 mg of gemifloxacin was seen during at least 6 hours.
Conclusion. Factive (gemifloxacin) is strong fluoroquinolone with wide spectrum of activity and also shows antibacterial effect on MBT, both susceptible and mono-, poly- and multidrug resistant and nontuberculous mycobacteria, having antimycobacterial activity in blood during 6 hours. This allows us to consider gemifloxacin as possible medicine for treatment of drug resistant tuberculosis, and also mycobacteriosis.

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8. Original research


Clinic-functional features of motion of cardio-respiratory pathology for patients with the chronic obstructive pulmonary disease

P.R. Gerych, R.I. Yatsyshyn, M.M. Ostrovskiy

Aim. study Clinic-functional features of motion of cardio-respiratory pathology for patients with the chronic obstructive pulmonary disease.
Material and methods. In-process the resulted outcomes of research of clinical and functional indexes of the cardio-vascular and respiratory systems are in 128 patients with sharpening of COPD II—III an item with the isolated motion (first group) and in combination with concomitant and comorbus of IHD (second group) to beginning and in a time of completion of stationary treatment. In 56 (40.62 %) patients on COPD II—III an item is diagnosed concomitant and comorbus of IHD I—II functional class after NYHA. The diagnosis of comorbus of IHD was proposed in the process of dynamic clinical, laboratory and instrumental inspection in the conditions of permanent establishment at treatment of the last sharpening after criteria which were developed by us in a clinic. Diagnostics of concomitant IHD was based on testifying to carried before heart attack of myocardium and also on the typical clinical displays of stenocardia, which were confirmed the instrumental methods of research.
Results and discution. The analysis of clinical signs of intensifying of COPD rotined that at the beginning of stationary treatment frequency and their expressiveness for patients in the groups of inspection substantially did not differ between itself. At the same time a decline of practically all parameters of spirogram was more expressive in the sub-group of patients with united concomitant and comorbus IHD, that is the sign of growth of hypoxaemia and hemodynamic violations.
Conclusion. The got results witnessed the high presence of cardio-vascular pathology for patients on COPD of middle and heavy degree of flow, which predetermines the not simple choice of medicinal treatment both in the period of stationary treatment and in ambulatory-polyclinic terms.

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Effectiveness of employment of Lypophlavon for correction of cytokine disbalance at patients with severe course of chronic obstructive disease of lungs and long term of tobacco smoking

A.K. Asmolov, .. Rybak, Ye.A. Baburina, N.A. Gerasimova, L.M. Bobrik

A high systemic and regional cytokine potential at smoker leads to progressing of chronic obstructive disease of lungs. The article presents studying materials of influence of Lypophlavon on cytokine disbalance at patients with chronic obstructive disease of lungs and long term of tobacco smoking. There were 80 patients under observation. They were divided into 2 groups. The 1st group patients received a complex treatment which influence on the main pathogenic mechanism depending on form and severity of disease. Lipophlavon was included in the complex treatment of 2nd group patients. Proinflammation cytokines (IL-1β and TNF-α) and lymphokine IL-4 were studied before and after the treatment in the patients of both groups. Lypophlavon usage effectiveness for proinflammatory cytokines’ level (Il-1β and TNF-α) correction
was proved.

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Deviation of the CNS in a HIV-infected persons

N.V. Rymarenko

HIV-dimension and other disturbance of the CNS is one of the basic feature of progressing HIV-infection in a patients. Early prescription of the high activity antiretrovirus therapy can helps to fights against HIV-dimension. It's nessary to control adverse affect of this therapy. One of the successful using preparation is represented of the protease inhibitor — LPV/rtv.

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Conception of the complications during tuberculindiagnostic: new formats can decide the problem

V.I. Petrenko

Early diagnostics of tuberculosis is the main methods of fights against tuberculosis. Tuberculin skin test of Mantoux stays the main methods of early and in time diagnostics of tuberculosis. Problems of technique providing of Tuberculin skin test of Mantoux can directs on results. Modification of Tuberculin skin test of Mantoux by factory «BIOLEK» that including 5 standard dosage syringes with tuberculin for providing tuberculinodiagnostics can helps to pass a lot of problems.

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12. Reviews


The role of Cytokines and their using in patients with tuberculosis

V.I. Petrenko, Y.A. Varchenko

A study of features of citoskiness immunoregulation for patients with a tuberculosis is for today perspective direction in a phthisiology. Application of preparations of interleukines appeared effective in clinical practice. Protektive role at tuberculosis is taken such interleukin like IL-1, IL-2, IL-6, IL-12, α-TNF, γ-FN, and vice versa — the negative is taken for IL-4. Increase of products γ-FN under act of antigens of mycobacterium tuberculosis use with a diagnostic purpose. One of mechanisms of oppression of specific cellular immunity for patients with tuberculosis does count blocking by mycobacterium tuberculosis the macrophages receptors to γ-FN. The ways of correction of immunological changes at tuberculosis are seen in complex citokinotherapy, that includes introduction of IL-2 α-TGF, L-1 and γ-IFN but in neutralization of TGF-β-receptors 3th type during the sharp and chronic phase of motion of process.

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13. Lectures


Sarcoidosis of the breathing organs

O.D. Nikolayeva

Sarcoidosis — system disease of unknown etiology, belonging on the morphological displays to the group of granulomatosis Characterized the defeat of many organs and tissues with an of mainly high quality flow. Lymphatic knots  and lungs are most often struck. A tissue reaction is presented a sarkoidosis granulosum in which absents perifocal inflammation and central necrosis.
Beginning of disease in majority unnoticed and develops gradually. A patient is disturbed by a weakness, decline of ability to work, perspiration, dry cough, subfebril temperature is periodically marked. Roentgenologic megascopic intrathoracic lymphatic knots and nidus-infiltrative changes come in pulmonary tissue. Treatment is conducted system corticosteroids, middle dose of prednizolon 20—25 mg in days. On the third stage diseases apply D-penicilamin. Delagil appoint at unbearableness of corticosteroids, plakvenil in combination with the vitamin E. Prognosis of the diseases is favorable.

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The Modern Condition of the Problem of Osteoarticular Tuberculosis in Ukraine and the Ways of its Solution

G.G. Golka, A.G. Istomin, T.G. Golka, S.P. Topchy

Having dwelt on the general problems of rendering therapeutic-diagnostic aid to patients with extra-pulmonary forms of tuberculosis, the authors give a detailed description of the experience gained in offering this kind of specialized medical aid at the Osteotuberculous Department of Kharkov Regional Tuberculous Hospital. A system of giving aid to patients with extrapulmonary tuberculosis is described. Recommendations for improving this kind of specialized medical aid to population are given.

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15. Education


Analysis of efficiency of introduction of credit-module system in teaching of subject pulmonology

P.R. Gerych, R.I. Yatsyshyn, M.M. Ostrovskiy

The analysis of efficiency of introduction of substantive provisions of the credit-module system of organization of educational process in teaching of subject «pulmonology» was conducted. The row of positive and negative moments in a study on clinical departments after a new system as a result of the conducted questioning of teachers of departments of therapy and students of the V—VI course of medical faculty was marked.

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