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Issue. Articles

2(5) // 2011



1. Editorial


Clinical-laboratory peculiarities of the course of multidrug-resistant pulmonary tuberculosis in Ukraine

I.V. Liskina, S.D. Kuzovkova, .A. Zhurylo, A.I. Barbova, G.M. Vishnevskaya, L.M. Zagaba

The article is devoted to one of the most actual questions of phthisiology — to investigation of peculiarities of clinical course, laboratory diagnostics of multi-drug resistant pulmonary tuberculosis (MDRTB).
Period of investigation was 1 year. According to clinical data the sexual and aging characteristics of these patients, some details of managing procedure, exact clinical diagnoses, character of MBT resistance, spectrums of drug resistance, which are prevailed among patients, were established. It was elucidated that peak incidence covers the age group 21—39 years, among patients with MRTB phenomenon of acquired (secondary) resistance is prevailing — in 165 (73.66%) persons and HRS-spectrum drug resistance is predominated.

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2. Editorial


Psycho-emotional aspects of tuberculosis

O.O. Tarasyuk, A.V. Verbinets, V.. Zavyalkin

Tuberculosis is a stressful factor for the patient that leads to the development of an introvert condition of a patient with depression and requires not only drug therapy but also a special psychological and social adjustment with regard to individual psychosocial characteristics of the patient. Correction of the emotional state, reduction of depressive manifestations helps to normalize the treatment regimen, optimize relationships with medical staff, create a new, positive motivation for treatment.

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3. Original research


Dynamics of lipid peroxidation and antioxidant status in rats during acute lung injury

L.A. Hryshchuk, M.I. Marushchak

The changes of lipid peroxidation and antioxidant status in blood and lung homogenate in the dynamics of experimental acute lung injury were investigated in the article. The intensification of free radical oxidation processes within 24 hours of monitoring and activation of antioxidant status in the first hours after injury, which has compensatory nature, were determined.

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4. Original research


An estimation of antimycobacterial therapies for patients with pulmonary tuberculosis efficiency using indexes of immunological researches

.L. Platonova, .A. Tkach, .I. Sakhelashvili, G.V. Shchurko, N.Ye. Lapovets, G.D. Shtybel

The aim value of immunological researches in the estimation of efficiency of the intensive standardized antimycobacterial therapy for patients with the first diagnosed destructive pulmonary tuberculosis.
Materials and methods. Complex immunological researches with the study of the state of -, - link and specific antituberculosis immunity conducted in 35 the first diagnosed patients with a destructive pulmonary tuberculosis before beginning and on the stage of completion of the intensive standardized antimycobacterial therapy.
Results and discussions. Character of immunological changes for the first diagnosed patients with a widespread destructive pulmonary tuberculosis under act of antimycobacterial therapy of intensive phase of treatment is studied. Approximately, in the halves of inspected diminishing to tension in the system of specific antiphthisic immunity (in 45.7 %), and deceleration of processes of antibody (in 46.4 %) is set. That specified on the decline of activity of specific process and, accordingly on efficiency of the intensive standardized chemotherapy. For other persons, where indexes of tuberculine allergy are, products of immunoproteins and formation of circulatory immune complexes increased, or held out at the level of initial sizes — treatment can be estimated as ineffective.
Conclusions. In obedience to strategy of DOTC, immunological researches are the important adding to generally accepted, bacteriological and roentgenologic inspections for control after efficiency of the intensive standardized chemotherapy of the first diagnosed pulmonary tuberculosis , because of represent development of specific process in a dynamics, characterizing efficiency of antimycobacterial therapy to the same.

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5. Original research


The immune system in abdominal tuberculosis

M.I. Sakhelashvili, N.Ye. Lapovets, L.Ye. Lapovets

In most patients with abdominal tuberculosis a moderate oppression of cellular immunity (reduction of T-lymphocytes and T-helper cells) with activation of humoral immunity (increased number of B-lymphocytes and activated B-lymphocytes) were noted. At the same time the level of proinflammatory interleukins (IL-1β, IL-6 and TNF-α), especially TNF-α, increased significantly.

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6. Original research


Specific features of the course of tuberculosis infection of HIV-infected patients and AIDS-patients (on autopsy materials)

S.. Istomin, V.N. Buryatynsky, G.V. Koval

The aim — to investigate the specific features of the course of tuberculosis infection of VIP-infected patients and AIDS-patients,
Materials and methods. The authors examined 119 autopsy (of 758 conducted in 5 years — 2006—2010 based upon our prosecution).
Results and discussions. In all lethal cases of combination of HIV/AIDS+tuberculosis, there was no isolated defeat of lungs. In 49.68 % apart from lungs also in-chest l/k, liver, kidneys, spleen were drawled in pathological condition. In 24.4 % besides of indicated organs there were found sharp specific changes in l/k of abdomen and intestines. In the rest percentage groups almost regularly were distributed cases of defeat of brain, its covers and also electoral combined drawing of other inside organs and systems.
It was also established that apart from specific features and pathogenesis the pathomorphosis of mycobacterial infection in case of immune deficit is also observed: untypical morphology of tuberculosis leptomeningitis, defeats of spleen tissue and intestines. In 25 % of cases diagnosis of pulmonary tuberculosis defined as first diagnosed and in 75 % — patients were transferred in chronical Group. 93.64 % in past has relation with inside-vein injection of narcotic substances.
Conclusion. There is growth of Co-infection of tuberculosis and HIV/AIDS and death rate from this united infection. Patients prevail with «drug addicts» anamnesis. Found out atypical morphology of tuberculosis leptomeningitis , impression of kidney tissue and intestine.

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7. Original research


The evaluation of some parameters of oxidant-antioxidant system in patients with idiopathic interstitial pneumonia

V.. Zhadan

Objective: to determine the status of oxidant-antioxidant system in blood of patients with idiopathic interstitial pneumonias (IIP).
Materials and methods. Examined 22 patients with IIP, and there were 11 people with IFA and 11 persons with NSIP according to nosology of the disease. Biochemical studies were performed in plasma and erythrocytes of venous blood. The number of malondialdehyde (MDA) was assessed by status of lipid peroxidation. Status of the antioxidant system was evaluated by the activity of glutathione-S-transferase (GT), glutathione reductase (GR), catalase, and ceruloplasmin concentrations.
Results and discussion. We studied and evaluated indicators of oxidant-antioxidant system in blood of patients with IIP, depending on the form of the disease. Established that patients with IFA are significant decrease the enzyme activity GR by 26.1 % compared to controls, patients with total group and patients with NSIP tend to decrease the activity of this enzyme. The concentration of ceruloplasmin in blood plasma in the total group of patients was significantly decreased by 23.0 %, while the catalase activity was significantly increased by 60.6 %. Patients with IFA concentration of ceruloplasmin were reduced by 21.9 % and in patients with NSIP — by 22.0 %. Catalase activity in patients with FA significantly increased by 38.0 % and in patients with NSIP — by 25.6 % of control values.
Conclusions. Patients with IIP had been identified a number of biochemical disruption that plays role in the pathogenesis of this disease. These disorders are appeared by changes in functional status of antioxidant system of blood. There are decreases enzyme activity of GR and concentration of ceruloplasmin, and increase catalase activity in the patients with IIP, while the number of MDA, the end product of lipid peroxidation, remains almost unchanged.

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8. Original research


Clinical characteristics and chemotherapy response in pulmonary tuberculosis patients with thyroid pathology

S.L. Matveyeva

In 50 patients with new case of pulmonary tuberculosis echostructure and function of thyroid were examined. In 54 per cent of examined persons thyroid pathology was diagnosed. Clinical signs of tuberculosis estimated in ball system were more severe in patients with thyroid pathology. The rates of intoxicative symptoms disappearance, bacilli excretion stopping and cavitation healing at the end of chemotherapy intensive phase significantly higher in patients with unchanged echostructure and function of thyroid. The results pay attention at the necessity thyroid pathology screening in tuberculous patients.

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9. Reviews


Latent tuberculosis infection

V.I. Petrenko, L.D. Todoriko, Yu.A. Varchenko, G.F. Negrya, G.V. Radysh

Both in the economic developed countries and in developing countries, substantial part of cases of tuberculosis is the result of presence of persons with a latent tuberculous infection (LTBI). There is enormous potential of permanent transmission and development of disease with the one-third of the infected population of Earth. By the important component of control after tuberculosis in many industrialised countries with LTBI is providing by antiphthisic medications of separate persons from LTBI with the purpose of prevention of development of active illness. Plenty of researches rotined efficiency one-component therapy of izoniazid among all persons which took part in research, within the limits of 25—95 %. Among HIV-positive persons the treatment of LTBI shortened frequency of disease on AIDS and death among persons with a positive reaction on a tuberculin.

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10. Lectures


Fungal lesions of lungs at immunodeficiency conditions. Part 1

O.D. Nikolayeva, .V. Liskina

The aim of the article is to introduce a wide range of general practitioners, pulmonologists, and TB specialists with clinical manifestations of deep fungal infections, mainly affecting the lungs against the background of immune deficiency of various etiologies. Tactic of diagnosis and treatment of various fungal infections is presented with clinical cases and illustrations.

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11. Clinical case


A clinical case: differential diagnostics of disseminated tuberculosis of the lungs and adenoma of the thyroid gland

L.D. Todoriko, A.V. Boiko, V.O. Stepanenko, A.O. German

The paper presents a clinical case of metastasizing of the thyroid gland adenoma in the lungs as an example of differential diagnostics of disseminated processes; its structural organization and specific hormonal activity is demonstrated.

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12. Epidemic situation


HIV-infection/AIDS actual problem in Ukraine

R.G. Protcuk, E.R. Protcuk

In the article analyzed the epidemic situations of HIV-infection/AIDS in the world and Ukraine. The dynamic of the registration of the new cases of the HIV-infected persons in Ukraine for the last 10 years grew up to 146.9 % or in 2.5 times (from 17.5 to 100 000 population in 1999 year to 43.2 on 100 000 populations in 2009 year). Morbidity on AIDS has grew up to 246.4 % or in 3.5 times (from 2.8 to 100 000 population in 2002 year to 9.7 on a 100 000 population in 2009). The index of death rate of the patients with AIDS grew on 229.4 % or in 3.3 times (from 1.7 on 100 000 population in 2002 year to 5.6 on 100 000 populations in 2009 year).

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13. point of view


Pulmonary fat embolism in practice of phthisiatrist and pulmonologist

I.D. Duzhiy, V.D. Shishchuk, El-Astal Rayed Ziyad, S.V. Kharchenko

Based on literature data the authors substantiate the diagnosis of pulmonary fat embolism, emphasizing the lack of awareness of physicians in the diagnostic features of this complication. They cite the version of the pathogenesis of pulmonary fat embolism (PFE), justifying it with examples from their own experience. The authors discuss 5 cases of PFE and offer an algorithm for its diagnosis.

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14. Education


Informatively subject providing of educational process on the department of phthisiology of the Bogomolets National medical university

V.I. Petrenko, G.O. Tymoshenko

In the article is reflected an activity of the department from the improvement of capture students by knowledge from a phthisiology, namely: the study-methodical providing is represented for theoretical preparation of students and teachers in the conditions of credit-module systems. In the articles are marked a resulted information about textbooks, manual, methodical pointing, reference book from the study of phthisiology for students; practical skills and abilities of students, which he must know, and also the method of lead through of practical employments is described after a phthisiology and criteria of estimation of every his stage, regulation of final module control and method of evaluation of students.

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15. Education


Early exposure of co-infections of TB and HIV on prehospital stage

V.I. Zozulyak, I.I. Pylypenko

In this article, based on examination of 39 patients with co-infections of TB and HIV, the scheme of diagnostic signs of such pathology on prehospital stage is described. Performed analysis of the medical universities of the III and IV level students’ basic knowledge ensures a significant increase in the percentage of knowledge efficiency and practical skills of prophylaxis, timely diagnosis, and treatment of patients with TB/HIV co-ifections.

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