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Issue. Articles

1(4) // 2011



1. Lectures


Tuberculosis of oral mucosa: clinical manifestations, diagnosis, differential diagnosis

.. Raznatovska

TB incidence among dentists take 3—4 place in Ukraine as well as the main route of transmission of tuberculosis airborne, while dentists are in direct contact with patients.
The article presents the main clinical forms of tuberculosis of the oral mucosa. Dentist needs to know the clinical manifestations, the principles of diagnosis and differential diagnosis of this pathology, and promptly send the patient to a TB specialist.

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2. Editorial


A demographic situation in Ukraine through the context of epidemic of the HIV/AIDS

N.O. Ryngach

The article exposes a demographic situation in Ukraine, taking into account distribution of epidemic of HIV/AIDS. Ponderability of this powerful destabilizing factor is appraised by the estimations of middle age of death from AIDS and influence of death rate as a result of this reason on changing of index of life-span. The features of levels and dynamics of premature death rate of population are reflected from infectious and parasitogenic diseases in Ukraine and countries of European Union, in a that number sexual differentiation.
The calculations of size of the potential lengthening of life-span are carried out on condition of complete avoidance of losses of human life through AIDS.

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3. Original research


Actual issues of chemotherapy at patients with multidrug resistant destructive pulmonary tuberculosis

I.B. Byalik

The aim — optimization and increasing of chemotherapy effectiveness at patients with multidrug resistant destructive pulmonary tuberculosis.
Materials and methods. Different 5—12 month's polychemotherapy regimens of 5—7 antituberculosis drugs, including (depending on process character) III—IV generation fluoroquinolones, cycloserine or therizidone, capreomycin, PAS, claritromycin, sometimes pyrazinamide and ethambutol in increased doses (30—35 mg/kg) during intermittent administration, and in some cases pneumoperitoneum, were provided at 480 patients with earlier ineffectively treated and chronic multidrug resistant destructive pulmonary tuberculosis. Complex of clinical, roentgenologic, microbiological and other laboratory examinations were carried.
Results and discussion. Inclusion of III—IV generation fluoroquinolones in polychemotherapy regimens increased frequency of abacillation and regression of caverns to 20 %, cycloserine or therizidone — to 17—21 %, capreomycin to — 14,5 %, pneumoperitoneum — to 18—22,5 %. Administration of PAS, claritromycin and intermittent intake of pyrazinamide and ethambutol in increased doses were given less significant positive results. Polychemotherapy regimens of 6—7 drugs per one day were on 10—11 % more effective then regimens with 5 drugs.
Resume. Highly considerable reserves (capabilities) of improvement of treatment results of patients with multidrug resistant destructive pulmonary tuberculosis were determined and by optimal and complex application can essentially increase the effectiveness of treatment this difficult contingent.

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4. Original research


Remote results of the clinical looking after patient with tuberculosis of respiratory system of Transkarpation region, which took part in liquidation of failure Chernobyl NPP

E.P. Shymko, V.V. Skryp

In work analyzed the results of remote monitoring in 74 patients with different forms of active tuberculosis of the respiratory system which participated in liquidation of the Chernobyl disaster.

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5. Original research


Peculiarities of relationship between acute respiratory viral infections, flu and tuberculosis morbidities

M.. Savula, V.K. Pauchok, Yu.S. Zavodovych, .V. Bench, .. Pavelyeva

The Aim of the study is to elucidate the relationship between acute respiratory viral infections, flu incidences' and levels of tuberculosis morbidity and relapses.
Materials and methods. It was analyzed a monthly rates of tuberculosis morbidity and relapse, acute respiratory viral infections and flu incidences' in Ternopil region in 2006—2010 years. The methods of qualitative analysis of epidemiology data dynamics, correlation analysis and macromodeling were applied.
Results and discussion. It was established that the rate of acute respiratory viral infections and tuberculosis morbidities changes (especially in the periods of its maximal and minimal levels) during 2006—2010 period were synchronized with some of 3—4 weeks delay of tuberculosis levels. It was interpreted as certain effect of acute respiratory viral infections on tuberculosis morbidity and relapse. Acute respiratory viral infections outbreak was characterized by biphasic mode. A/H1N1 flu infective episode have disturbed this mode without any negative effect on tuberculosis epidemiology.
Conclusion. The increased incidence of acute respiratory viral infections have negative effect on tuberculosis rate of morbidity and relapse. A/H1N1 flu infective episode didn't enforce this negative effect.

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6. Original research


Prophylaxis of risk of professional infecting of the HIV-infection of medical workers in the workplace

M.O. Volodiy, I.O. Parpaley

Introduction of prophylactic and informing measures among medical workers will allow to decrease probability of infecting of medical workers HIV during implementation of the professional duties. Also being informed of medical workers about the methods of prophylaxis will allow to avoid  the preconceived attitude toward HIL to the patients and colleagues in hospitals.

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7. Original research


Psychosomatic and somatopsychic syndromes in the clinical presentation of diseases of the respiratory organs

L.D. Todoriko, V.I. Petrenko, I.V. Yeremenchuk, A.O. German

Understanding the multiplicity of factors, when explaining the nature of the somatic and psychic in case of chronic diseases of the respiratory organs at present, is necessary both for cooperation in the field of rational therapy and for an attempt to establish family and professional relations anew, as well as to spend spare time in a new fashion in response to restrictions imposed by a chronic disease.

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8. Original research


HIV-infection and tuberculosis: magnification of the problem in Kharkov region

.S. Shevchenko, S.L. Matveyeva, T.V. Sencheva, T.F. Kovaliova

Co-infection tuberculosis/HIV in Kharkov region in 2010 epidemiological analysis shows that the number of males prevails almost in two times comparing with females in the structure of co-infection tuberculosis/HIV.  Prevailed site of tuberculosis in HIV-infected persons is pulmonary tuberculosis (77.53 %). Tuberculosis is a main secondary disease with HIV-infection and the main cause of death in AIDS stage. This demands mutual coordinated efforts of Phthisiology and anti AIDS services for in time prophylaxis and diagnosis of tuberculosis in HIV-infected persons.

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9. Original research


Sarcoidosis of respiratory apparatus

N.O. Skorokhodova, T.V. Mariniuk , V.A. Petrov, V.N. Khlystun, E.A. Kovalenko, G.V. Zubov, V.A. Yevsa

The Aim of research was study of diagnostic, clinic, pathway and treatment of sarcoidosis in today condition.
Material and methods. 75 patients with sarcoidosis were studied during periods 2005—2010 years. Conducted estimation of common clinical symptoms, X-ray, computer tomography, function of external breathing, fibrobronchoscopy, biopsy of the intrathoracic lymph knots or lungs.
Results and discussion. Mostly the changes in lungs are identified during occupational medical examination — 49 (65.3 %), the basic clinical symptom is shortness of breath — 50 (66.7 %). Mostly sarcoidosis of bronchus shows itself through sarcoidos ectasia — 13 (17.3 %), constriction — 2 (2.7 %), tumour-like infiltration — 1 (1.3 %). Quite often it was identified double-sided diffusive catarrhal endobronchitis — 5 (6.7 %), hemorrhagic — 3 (4 %), preatrophical — 5 (6.7 %).
Conclusion. Atypical x-ray picture of sarcoidosis of respiratory apparatus causes (30.7 %) difficulties to correct diagnostics and requires histological verification. Thoracoscopical examination with biopsy of a lung and glands combined high level of information for diagnostics with comparatively low invasiveness.

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10. Original research


Side effects of TB medicines in practice

B.M. Puhlyk

The problem of side effects of medicines (drugs) in phthisiology, especially drug allergies (DA), is one of the most important because a significant effect on the quality of treatment of tuberculosis. In recent years, its frequency among this population reaches 15.95 %. In the clinics should be established early identification of DA through targeted clinical and anamnestic examination, management of skin and laboratory testing.

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11. Clinical case


Hepatolienal Syndrome as the sign of disseminated tuberculosis

M.M. Savula, N.M. Lopushanska, H.M. Baburnych, N.V. Deresh, V.O. Besky

Presented two clinical cases (adult males) with hepatolienal syndrome as the first manifestation of disseminated tuberculosis. In one case the hepatolienal syndrome was associated with Budd—Chiari syndrome. Difficulties of diagnostic process, significance of different tests and computer tomography of chest and abdomen cavities were discussed.

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12. Reviews


Tuberculous meningitis: is resultive diagnosis standard possible?

O.S. Shevchenko, S.L. Matveyeva

Information about methods of tuberculous meningitis diagnosis is analyzed in the review. It was paid attention at the importance of timely tuberculous meningitis diagnosis and difficulties of this disease differential diagnosis. Comparative estimation of different diagnostic methods for tuberculous meningitis was performed. The possibility of ball assessment degree for tuberculous meningitis probability on the base of diagnostic criterions was discussed.

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