Tuberculosis and Lung Diseases最新文献

The centralized bacteriological laboratory of the Moscow Scientific-and-Practical Center for Tuberculosis Control Department of Public Health of the city of Moscow, examined the susceptibility of non-tuberculous mycobacteria (NTM) isolated and studied on the solid (Levenstein-Jensen) and liquid (Middlebrook 7H9 in the BACTEC-960 automatic system) media. A total of 159 cultures obtained from the solid medium and 132 from the liquid one were studied; of them there were 4 and 5 M. chelonae cultures, respectively, M. flavescense (n=6 and 4), M. fortuitum (n=34 and 28), MAC (n=52 and 44), M. xenopi (17 and 14), M. kansasii (n=41 and 35). Among the slowly-growing NTM, MAC was found to be resistant to streptomycin, isoniazid, rifampicin, and ethambutol in most cases. M. kansasii was sensitive to all basic antituberculous agents (ATAs) in most cases. M. xenopi was resistant to rifampicin in two thirds and to streptomycin, isoniazid, and ethambutol in a half of cases. Among the rapidly growing NTM, M. fortuitum was resistant to the study basic ATAs in most cases. No significant differences were found in the susceptibility/resistance of NTM to the basic ATAs depending on whether they had been isolated and their susceptibility evaluated on the solid and liquid media. Moreover, the duration of the entire study using the liquid medium was 2-3 times shorter.

The results of treatment for tuberculous spondylitis were studied in 160 children and adolescents receiving different chemotherapy regimens and in 145 after application of the currently available surgical methods. When an individual regimen was used in 1990-2000, recovery was achieved in 90.8 +/- 2.9% of cases; recurrent vertebral processes were observed in 7.1 +/- 2.5%. With the routine regimen, controlled treatment was terminated in 81.0 +/- 5.2% of cases and the number of recurrent vertebral processes was increased by 11.8 +/- 4.6%. With the DOTS-Plus regimen, treatment was completed in 91.0 +/- 4.1% of cases. Mycobacterium tuberculosis cultures were isolated from postoperative biopsy specimens in 6.8 +/- 3.5% of the 154 operated patients. The author presents the results of reconstructive operations using a free-pedicle autograft and a myovascular graft. In the late period, the operated vertebral portion was fixed to form a bone block in 83.3 +/- 5.6 to 88.0 +/- 7.9% of cases. There was an increase in spinal deformity in patients with a disseminated vertebral process.

The results of surgical treatment were analyzed in 205 patients with destructive pulmonary tuberculosis complicated by spontaneous pneumothorax and pleural empyema. The long-term course, extent, and activity of a tuberculous and purulent process in the lung and pleura determined the patients' severe condition and low respiration and cardiac function parameters. After complex preoperative preparation during 3-4 months, surgical treatment was performed in 84.9% of the patients after stabilization of a pneumopleural process and an intervention was made in 15.1% in the active phase of the disease. A good immediate efficiency was stated in 80% of the patients with this pathology, of them this was observed in 70.4% after pulmonectomy and pleuropulmonectomy, in 88.1% after pleurectomy and partial lung resection, and in 89.6 following thoracomyoplasty. The overall hospital mortality was 11.7%.

Fibrosing alveolitides (FA) are common diseases, as yet insufficiently known to practitioners. In most cases, objective and subjective difficulties arise in diagnosing FA in the outpatient setting. The course of FA has been analyzed in 48 patients from their first visit to a polyclinic to admission to a specialized pulmonology unit. There is a high rate of outpatient diagnostic errors that may be accounted for by the similarity of many lung diseases, at their onset in particular, by small-scale studies and district therapists' little experience in working with patients with FA. The results of comprehensive examinations of patients with FA in a specialized clinic are given.

The polymorphism of the TNF A gene was studied in 89 asthmatic patients and their 162 relatives in order to estimate the contribution of this candidate gene to the predisposition to the development of asthma and allergic diseases. A control group comprised 258 individuals without bronchopulmonary pathology The polymerase chain reaction was used to study the 308 G/A polymorphism of the TNF A gene. The findings suggest that the asthmatic patients and their relatives have no association of the polymorphism of the TNF A gene in position 308 with their predisposition to the disease. Analysis of the distribution of the frequencies of alleles and genotypes among their probands, relatives, and the control group revealed no statistically significant differences between the groups.

To study whether the genotype of a mycobacterial strain might affect the ability of macrophages (MP) to produce the key cytokines, we determined the synthesis of interferon-gamma (IFN-gamma), tumor necrosis factor-gamma (TNF-gamma), and interleukin-6 (IL-6) in the infection of murine MP with M. tuberculosis H37Rv and M. bovis BCG, the strains that belong to the same genetic group (M. tuberculosis complex) but are opposite in virulent properties. MP infection with a virulent and attenuated M. tuberculosis complex strain was shown to differently affect the synthesis of IFN-gamma, TNFaalpha-, and IL-6. MP infection with M. tuberculosis H37Rv activated the generation of IFN-gamma and that with M. bovis BCG substantially increased the levels of TFN-alpha and IL-6. The findings suggest that this model may be used to investigate the specific features of mycobacterial strains of various genotypic clusters with eukaryotic cells.