Tuberculosis and Lung Diseases最新文献

The authors observed a case of pinched, calcified, caseously degenerated right uterine appendages in girls aged 14 and 11 years. The disease showed mild symptoms and it was occasionally detected by intravenous urography. Both patients underwent surgery--elimination of tuberculous salpingitis with calcified caseous necrosis. No treatment in the former case and specific treatment in the latter led to two different outcomes: late recurrence and recovery. Pinched, calcified, caseously degenerated uterine appendages are a rare pathology in children in particular. Ovarian dermoid cysts and calcified lymph nodes are differentially diagnosed. Diagnosis and treatment require surgical intervention (laparotomy, laparoscopy), sanitization of an infection focus, chemotherapy.

By using the experience gained by the pilot areas, the WHO collaborating center has shown the efficiency of implementation of the WHO program adapted to the conditions of Russia and the necessity of re-equipping and strengthening of a bacteriological service and improving the qualification of physicians and laboratory workers of an antituberculous service and the general medical service in tuberculosis control. The results of the work have forced the Ministry of Health and Social Development of the Russian Federation to adoption of a number of normative documents that are aimed at improving the detection, diagnosis, and treatment of tuberculosis. At the same time, the fair realization of these documents requires supervisory institutes to make a continuous monitoring, to improve further the material-and-technical basis of the tuberculosis dispensary of a bacteriological service, and to raise the level of the staffs skills.

Active tuberculosis infection is most likely to occur within the first year since the entry of M. tuberculosis (MBT) into the human organism. Contact duration is one of the determinants of the outcome of the meeting of MBT and a macroorganism. Patients with chronic infection foci and/or immune system dysfunction have been the particular concern of medical workers. The impaired defense system from alien information can lead to the development of tuberculosis. The repertoire of immunocompetent cells and interleukins in children with a tuberculin test conversion from epidemiological foci is similar to that in those with active tuberculosis. According to immunological characteristics, the patients with a tuberculin test conversion without an established contact differ from those with tuberculosis and children with a conversion and a contact with a bacteria-excreting person. They had an allergic constitution, which manifested itself as the higher frequency of allergic dermatosis. This fact resulted in mixed allergic reactions, which enlarged papulae during tuberculin diagnosis.

The significance of contacts in the development of the disease was studied in 117 first detected children and adolescents with in 2006-2009. Contacts with tuberculosis patients were established in 53% of patients. The indirect signs of contacts were found in 40% of patients, with a migration factor in 20% of cases and the poor social environment in 20%. The direct and indirect signs of contacts could not be detected in only 7%. Among the patients with established contacts, in 11% of them the contact was defined as important social relations. By the degree of hazard, this type of contact was comparable with a family contact. With the high informative value of tuberculin diagnosis in 82% of patients and with a more than one-year contact in 55%, the disease was identified in 22% of patients during planned tuberculin diagnosis and in 30% during planned study for contacts. Detection of 19% patients for complaints engages attention. The late diagnosis of the disease in children in contact is shown by the disseminated pattern or complicated course observed in 68% of patients, as well as by calcification on detection in 89% of patients with tuberculosis of intrathoracic lymph nodes. There is a need for pediatrician's higher phthisiatric alertness and the joint work of pediatricians and pthisiatricians to attract and monitor the examination and treatment of children by the results of tuberculin diagnosis, including those in contact. According to the tuberculin susceptibility, the earliest diagnosis of minor forms of tuberculosis in children in contact can be made using computed tomography.

The Mycobacterium tuberculosis (MBT) culture isolated from the sputum of 25 patients was experimentally studied. The probiotics were tested for their bacterium-neutralizing effect on a dense Luwenstein-Jensen medium, by using the absolute concentration method. The nature of their bactericidal and bacteriostatic effects was assessed from the presence and intensity of MBT growth on day 21 after inoculation. In most cases, the probiotics exerted an inhibitory effect on MBT growth. The latter was completely or partially suppressed by Trilact in 96% of cases (baseline concentration) and in 80% (1:40 dilution), Bifidum 791 BAG in 92% (baseline concentration) and 84% (1:40 dilution), Biovestin in 76% (baseline concentration) and in 88% (1: 40 dilution), and Biovestin-lacto in 88% (baseline concentration and 1: 40 dilution). Thus, the liquid probiotics have a target antagonistic effect on Mycobacterium tuberculosis growth in vitro, which opens up possibilities for their further study in an effort to use these agents in the complex tuberculosis therapy aimed at enhancing the efficiency of its treatment.

The goal of this investigation was to study the frequency of genotypes and alleles of CCR2 gene polymorphism V64I in patients with asthma and their relatives. The families of 70 probands diagnosed as having asthma and their 165 first-, second-, and third-degree relatives (a study group) were examined. The mean age of the probands was 45.65 ± 16.34 years; that of the relatives was 49.15 ± 15.23 years. The control group included 464 healthy individuals (mean age 32.7 ± 7.36). No statistically significant differences were found in the distribution of genotypes and alleles of the CCR2 gene between the probands, asthmatic patients, and controls. There were statistically significant differences in the distribution of allele frequencies between the groups of relatives with allergy and healthy relatives. The proportion of 641 allele carriers was significantly higher in the group of relatives with allergy than that of healthy relatives (p = 0.01). The odds ratio of identifying a 64I allele carrier in the group of relatives with allergy was 2.6 times higher than that in healthy relatives (95% CI, 1.3-5.4). It can be inferred that 64I allele carriage is a predisposing factor for allergy. The findings of CCR2 gene polymorphism are important to form a risk group, by taking into account the genotype of individuals by the CCR2 gene.

The paper presents experience with differential radionuclide imaging used to study the extent and activity of a pathological process in the mediastinal lymph nodes and lung tissue in 83 patients with pulmonary tuberculosis. The diagnostic value of a 99-mTc-technetril technique has been established to be similar to that of 67Ga citrate one. The sensitivity of the 99-mTc-technetril technique in a lung tissue inflammation focus was 97.0% and that of the 67Ga citrate technique was 91.5%. That of inflammatory changes in the mediastinal lymph nodes was 95.5 and 98.6%, respectively. Choosing a technique for patients with pulmonary tuberculosis has ascertained that 99-mTc-technetril has a low radiant energy of gamma quanta (140 Kev); a small half-life of 6.2 hours; radiation exposure is reduced 15-fold. The use of 99-mTc-technetril confirms the statement that tuberculosis spreads more commonly by the hematogenous route when the specific process is located in the upper lung and by the lymphatic bronchogeneous route when it is located in the lower lung.

In Russia, an intradermal Diaskintest® drug has been designed, which is a recombinant tuberculosis allergen based on M. tuberculosis-- specific proteins: ESAT-6 and CFP-10 produced by a genetically modified Escherichia coli culture. Diaskintest® test and Mantoux test with 2TE PPD-L were concurrently carried out in 300 children and adolescents with tuberculosis and followed up in risk groups at a tuberculosis dispensary to determine the sensitivity of the new skin test in active tuberculosis infection. Diaskintest® showed a high sensitivity not only in active tuberculosis, but also in occult, the so-called latent, tuberculosis infection. This is suggested by the following evidence. The high percentage (83.8%) of positive responses to Diaskintest® is noted in children and adolescents with tuberculosis, receiving an intensive course of chemotherapy. Negative tests were observed only in minor forms at the resolution stage. In the children who had completed treatment, positive tests were seen in 78.3%, moreover in those with prior tuberculosis of intrathoracic lymph nodes; negative tests were observed not earlier than 18 months after start of treatment. The highest sensitivity of Diaskintest® was shown in children with early primary tuberculosis infection and through family contact with bacteria-excreting subjects (91.7%). These children may be judged with the highest assurance to have latent tuberculosis infection, the population of which is in an active state at the moment of the study. The children with early primary tuberculosis infection, but in no family contact with bacteria-excreting individuals, showed a lower percentage of positive responses to Diaskintest® both before (37.5%) and after (10%) treatment, which suggests that there must be a lower bacterial burden in the child. A high percentage of positive responses to Diaskintest® (76.2%) were found in subjects with hyperergic reactions to tuberculin. These were in only 16.7% in the group of patients receiving preventive therapy. In children and adolescents with a persistent positive Mantoux test (for more than 3 years), the response to Diaskintest® was negative in most cases since in early infection when mycobacteria propagated, the reaction to the drug was positive, but as 3 years pass the probability of the infection transition to the persistence stage is high--at that time the response to Diaskintest® becomes negative. Diaskintest® induces no delayed hypersensitivity associated with BCG vaccination, suggesting its high specificity. There were no positive reactions in patients with nonspecific lung diseases.