Saratov JOURNAL of Medical and Scientific Research

Phthisiology

Prognosis of development of unfavorable phenomena of chemotherapy in patients with for the first time revealed tuberculosis of lungs

Year: 2015, volume 11 Issue: №4 Pages: 576-582
Heading: Phthisiology Article type: Original article
Authors: Danilov A.N., Morozova T.l., Doktorova N.P.
Organization: Saratov State Medical University, Saratov Research Institute of Rural Hygiene
Summary:

Aim: development of criteria and a method of prognosing of emergence of adverse side effects to the first mode of chemotherapy at patients with for the first time revealed tuberculosis. Materials and Methods: The analysis of the collateral reactions (CR) on tubercular preparations has been carried out at 214 patients receiving treatment at the first mode of chemotherapy. During the treatment an indicator of quality of life by a technique the DIGNITY (health, activity, mood), a condition of intersystem interaction of respiratory and cardiovascular systems of an organism (Hildebrant's coefficient), a vegetative index of Kerdo were estimated at patients. Results. Ufavorable effects on PTP develop at every third patient (33,6%). The CR different types depends on the age and availability of the accompanying pathology. Allergic reactions develop at patients with existence of endocrine pathology (27,8%) authentically more often, toxic — at patients with defeats of nervous system (56,3%). Extent of change of an index of Kerdo of 59,4±2,4%, Hildebrant's coefficient 48,9± 1,6% in the first 4 weeks of treatment of the patient corresponds to emergence of CR in the first 3 months of chemotherapy. Conclusion. Dynamics of coefficient of Hildebrant, Kerdo's index and an indicator of treatment, SAN at the initial stages, are considerably associated with the risk of development of side effects of chemotherapy and were a basis of the developed computer system expert for prognosing the development of these complications. The predictive value of system is 76,3% of sensitivity at 84,7% of specificity.

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Probability of developing severe sepsis in patients of elderly and senile age with necrotic erysipelas

Year: 2015, volume 11 Issue: №2 Pages: 198-201
Heading: Phthisiology Article type: Original article
Authors: Shapkin Yu.G., Khilgiyaev R.H., Mikhailenko K.A.
Organization: Saratov State Medical University
Summary:

Objective: the probable determination of severe sepsis in patients of elderly and senile age with necrotic erysipelas based on a comprehensive assessment (clinical examination using systems — scales and determination of the level markers of SIRS). Material and methods. The analysis of peculiarities of necrotic erysipelas clinical course in 59 patients. The first group consisted of 17 patients with severe sepsis, the second — 18 patients with sepsis without multiple organ failure, in the comparison group —22 patients with local infection. We determined albumin, urea, creatinine, pro-calcitonin of plasma. The scale SAPS III was used to quantify SIRS, scale SOFA —to determine the extent of damage to organs and systems. Results. The most sensitive marker of developing sepsis in patients with necrotic erysipelas was procalcitonin. The second important indicator of SIRS severity in patients with necrotic erysipelas was the blood albumin. Scale SAPS III also allows to select a group of patients with high risk of developing severe sepsis. Use of the SOFA to predict the scale has been found out to be less important. Conclusion. A comprehensive assessment of the severity of the condition by scale SAPS III in combination with determining the levels of procalcitonin and plasma albumin is advisable to apply for prediction the probability of developing severe sepsis in patients of elderly and senile age with necrotic erysipelas. For the last indicator it is important to assess of absolute values and the decrease of its concentration.

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Influence of periodicity of fluorographic examination of population on the frequency of occurrence of bacillary excretion and destructive forms of tuberculosis in persons with the firstly diagnosed disease

Year: 2014, volume 10 Issue: №4 Pages: 659-662
Heading: Phthisiology Article type: Original article
Authors: Danilov A.N., Morozova T.I.
Organization: Saratov State Medical University
Summary:

Aim: to establish the structure of the relationship between the change in regulations of fluorographic regimen and frequency of occurrence of bacillary excretion (MBT+), destructive forms of the disease in patients with newly diagnosed tuberculosis. Materials and Methods. 1,428 cases with newly diagnosed tuberculosis — a form №089u-tub, as well as other types of reports of the Saratov region have been analyzed. Statistical analysis has been performed by computer software «Microsoft Excel» and «Statistica-6.0». Analysis of the data by the test of Kolmogorov — Spirin has showed normality of their distribution. Confidence index was assessed by Student's. Differences were assessed as valid if the probability was 95% (P

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Hixozide in therapy of tuberculosis of bronchi

Year: 2014, volume 10 Issue: №2 Pages: 293-300
Heading: Phthisiology Article type: Original article
Authors: Morozova T.l., Barinboym O.N., Doktorova N.P., Danilov A.N.
Organization: Saratov State Medical University
Summary:

The purpose of the article is to evaluate the efficacy and tolerability of the combined inhaled anti-TB preparation Hixozide for improving the effectiveness of medical treatment of patients suffering from tuberculosis of bronchus. Material and Methods. Hixozide (made in Russia), the active substance Hydroxymethylchinoxylindioxydum 100mg + Isoniazidum 250 mg, was delivered via inhalations using a compressor nebulizer within 21 days in the course of the complex chemotherapy. Inclusion criteria: newly diagnosed patients and patients with relapsed tuberculosis with the presence of tuberculousendobronchitis, drug sensitivity saved to isoniazid. Exclusion criteria: the state of preventing the appointment of adequate treatment, HIV-infection (group 1, n=30). The comparison group was consisted of patients receiving standard treatment in combination with inhaled administration of Isoniazid (group 2, n=21). Rezults. The clinical study has figured out: after a course of inhalations of Hixozide the clinical cure of bronchial tuberculosis occurs after the period of 2 months of treatment (according to the results of endoscopy of bronchi); more patients — 69.2% versus 38.1% in the comparison group, p=0,039 showed a positive trend during the nonspecific endobronchitis — 85,7% vs. 52,9%, p=0,017; the treatment and bacteriological conversion were achieved: 143±27 days in the first group vs. 164±32 days in the control group, p=0,019. Adverse reactions to Hixozide demanding its abolition occurred in 13,3%, they were stopped and did not affect the health of patients in the future. Conclusion. Inhaled Hixozide in the complex treatment of patients with tuberculosis accelerates clinical cure of tuberculosis of the bronchi, healing the lesions in the lung tissue and abacillation.

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Dynamics of the main epidemic indicators of tuberculosis in the Saratov region

Year: 2014, volume 10 Issue: №2 Pages: 289-293
Heading: Phthisiology Article type: Original article
Authors: Danilov A.N., Morozova T.l., Doktorova N.P.
Organization: Saratov State Medical University
Summary:

Objective; analysis of the dynamics of the main indicators of the ТВ epidemic in the Saratov region during the 5-year period. Material and Methods. The analysis of major indicators of epidemic (morbidity and mortality) in the Saratov region during the five years of observation. In the work a comparative evaluation of the parameters studied with analogical indicators in the Russian Federation was carried out. Results. During the period from 2009 to 2013 situation of tuberculosis epidemic in the Saratov region has positively stabilized. Over the past five years, the mortality rate in the region has decreased, while in the Russian Federation as a whole only on 25%, the incidence of the population in the region fell by 20%. It has been established that the later detection of a tuberculosis process leads to an increase in mortality and maintains reservoir of ТВ infection. Conclusion. In the Saratov region ТВ infection is thoroughly controlled. There is a well-established system for the detection, diagnosis, treatment and prevention of this specific process.

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Difficulties of treatment of patients with tuberculosis and medical recommendations performed by them

Year: 2013, volume 9 Issue: №4 Pages: 741-743
Heading: Phthisiology Article type: Original article
Authors: Yudin S.A., Borzenko A.S., Delaryu V.V., Kaluzhenina А.А.
Organization: Volgograd State Medical University
Summary:

Purpose: To study the reasons influencing the treatment of patients. Material and methods: Anonymous questioning of patients with tuberculosis in number of 584 people being on treatment in antituberculosis hospitals, 92 phthisiopul-monologists and 144 therapists of Volgograd was performed. Results: The conducted research testifies that patients with tuberculosis consider that they observe medical recommendations completely in 76,5% of cases, and the opinion of medical workers was completely opposite, only 4,3% of phthisiopulmonologists and 2,8% of therapists. Most doctors were sure that medical recommendations were carried out by only a half of tuberculosis patients, that was told by 54,4% of phthisiopulmonologists and 31,3% of therapists. Conclusion: Commitment formation to treatment at patients with tuberculosis should be carried out taking into account those difficulties and problems which are specified by patients, and also critical evaluation of performance by patients of the medical recommendations influencing the result of treatment. At the solution of medical problems phthisiopulmonologists did not pay enough attention to influence of psychological factors, taking into account available gender, age and educational level of the patient that compels to look for new ways of interaction of phthisiopulmonologists and psychotherapists in development of the individual plan of treatment and rehabilitation of every patient with tuberculosis.

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Modern patterns of tuberculosis epidemiologic situation among children in the North-West of Russia

Year: 2011, volume 7 Issue: №2 Pages: 518-522
Heading: Phthisiology Article type: Original article
Authors: Isaeva N.Yu., Mayorova О.A., Galkin V.B., Archakova L.I.
Organization: St. Petersburg Scientific Research Institute of Phthisiopulmonology
Summary:

The research work has been carried out on the basis of official statistics data and results of curator departures. The purpose is to study the basic tendencies of tuberculosis epidemic situation among children for the period from 2004 till 2008 in the region of the North-west of Russia for working out priority antitubercular scheme. The disease morbidity has been investigated. Tendencies of situation development in each region with application of an estimation of morbidity rate have been defined. The nonparametric factor of correlation of Spirmen (c) has been taken into account. It is established that in case of normal epidemic situation, the basic indicators of tuberculosis in children from the Northwest of Russia are higher than all over the country. Epidemic situation in Kaliningrad is marked by accumulation of MBT+ in contingents. St.-Petersburg and Kaliningrad epidemic statistics accounts 52% from total number of ill children that influences a district indicator. In Kaliningrad and Arkhangelsk regions children from contact as a result of accumulation of adult MBT+ in contingents fall ill more often. The main method to reveal the pathology among children in St.-Petersburg is prevention, however children morbidity from contact with MBT+ in 2008 in 1,8 times lower than in the North-west Russia. The received data have found out that in Kaliningrad and Arkhangelsk regions the main direction in the antitubercular scheme is an increase in efficiency of treatment of tuberculosis in contingents of adults MBT+; in Murmansk, Pskov and Leningrad region it includes the modern preventive measures. For St.-Petersburg all directions of antitubercular work will be equally significant

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Molecular, Subcellular and Cellular Pathogenesis Mechanisms of Tuberculous Pneumonia

Year: 2009, volume 5 Issue: №2 Pages: 267-269
Heading: Phthisiology Article type: Review
Authors: V.V. Yerokhin
Organization: Saratov Central Scientific Research Institute of Tuberculosis
Summary:

Pathogenesis mechanisms of tuberculosis have been considered. It is shown, that important place in pulmonary tuberculosis therapy should belong to the means of pathogenetic therapy directed to the improvement of pulmonary circulation and living conditions of cells of lung parenchyma, restoration of local tissue immunity, including macrophage system and other defensive mechanisms, synthesis and secretion stimulation of surfactant, and use of surfactant medications.

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