Problemy tuberkuleza i bolezneĭ legkikh
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Probl Tuberk Bolezn Legk · Jan 2009
Comparative Study[Evaluation of hepatic function in new cases of pulmonary tuberculosis due to the use of standard chemotherapy regimens I and IIB].
The frequency and magnitude of hepatotoxic reactions were compared in 147 new cases of pulmonary tuberculosis within the first three months of chemotherapy (CT) by standard regimen 1 [H, R, Z, S (E)] (Group 1) and regimen 2B [the same drugs + kanamycin (amikacin) and fluoroquinolones] (Group 2). Their efficiency was evaluated from 6 serum indices--the level of bilirubin, the activities of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (AP), and gamma-glutamyl transpeptidase (GGTP), and thymol test results. Tests were monthly carried out. ⋯ Following 2 months of CT, in Group 1 positive changes continued in the studied markers and, with regimen 2B treatment, abnormal changes began increasing again. After 3 months abnormal changes were single in the markers of hepatic damage with regimen 1 treatment and there was a repeated significant rise in the values of AP and GGTP with regimen 2B. It is concluded that in addition to ALT and AST, GGTP is of great informative value in controlling the hepatotoxic effects of CT.
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Probl Tuberk Bolezn Legk · Jan 2009
Comparative Study[Pathomorphism of tuberculous pleurisy in elderly and senile individuals].
The pathomorphism of tuberculous exudative pleurisy in elderly and senile individuals has been investigated in the past 30 years. Comparison of clinical, X-ray, laboratory, morphological, and immunological data in patients of the first (1978-1987) and second (1998-2007) periods has revealed the signs characteristic of the negative pathomorphism of the disease: progressive latency of tuberculous pleurisy and a lower Mantoux reaction, a lower detection rate for epithelioid giant-cell granulomas in the patients' biopsy specimens, a higher rate of pleural tuberculous inflammation, an increased frequency of comorbidity, a higher drug resistance rate in Mycobacterium tuberculosis, and decreased therapeutic efficiency. In this connection, elderly and senile persons with pleural effusion should be examined in a tuberculosis dispensary, with the bacteriological and morphological verification of the diagnosis being made. Their treatment should comprise the currently available antituberculous and pathogenetic agents.
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Probl Tuberk Bolezn Legk · Jan 2009
Historical Article[Surgery for respiratory tuberculosis at the Research Institute of Phthisiopulmonology, I. M. Sechenov Moscow Medical Academy: history and current trends].
The authors present concise data on the history of surgical treatment for pulmonary tuberculosis at the Research Institute of Phthisiopulmonology, I. M. Sechenov Moscow Medical Academy (1918-2008). ⋯ Mini-invasive surgery using video-assisted technologies have received wide recognition in the diagnosis and surgical treatment of pulmonary tuberculosis. The results of treatment depend on the extent and presence of complications of a tuberculous process, comorbidity, suppressed immunity, and the scope of a surgical intervention. Overall, the efficiency of surgical treatment of patients with pulmonary tuberculosis is 90% or more.
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Probl Tuberk Bolezn Legk · Jan 2008
Comparative Study[Mercury pollution of the habitable area of the Amur Region and the endemia of tuberculosis].
Analysis of the 1991-2006 statistical data of the Amur Region has indicated that the prevalence of tuberculosis does not depend on the level of ambient air pollution, the total amount of mercury-containing pesticides introduced into the plough-lands, and the environmental emission of metallic mercury at gold mining. The established set and the level and ratio of major mineral and trace elements in the blood of healthy individuals are suggestive of their adaptation to the specific geochemical environment. The excess and deficiency of major mineral and trace elements in the blood of patients with pulmonary tuberculosis result from the occurring pathomorphological, pathophysiological, metabolic, and other disorders that hamper the excretion of toxicants.