Posibilităţile moderne şi particularităţile de organizare a depistării şi diagnosticării tuberculozei organelor respiratorii în Republica Moldova şi peste hotare (revista literaturii)

Summary. Up-to-date possibilities and peculiarities in organizing and diagnosis of the Respiratory tract tubersulosis in the Republic of Moldova and in the foreign countries. The summary presents certain new materials on tuberculosis detecting diagnosis and verifying the diagnosis of the national and international authors. It was demonstrated that in these certain epidemiological circumstances this problem is very complicated. There are described the basic diagnosis methods and the organizing forms of the pulmonary tuberculosis detection. A special attention was to the changes that take place in the system of detecting the patients with tuberculosis and up-to-date peculiarities of the diagnosis process. It was shown that the modern diagnosis of the respiratory tract tuberculosis still remairs a difficult clinical problem.Резюме. Современные возможности и особенности организации выявления и диагностики туберкулеза органов дыхания в Р. Молдова и в зарубежных странах. В статье представлены обобщенные новые материалы по выявлению, диагностике туберкулеза и верификации диагноза отечественных и зарубежных авторов. Показано, что в сложившейся эпидемиологической обстановке эта проблема является наиболее острой. Описаны основные диагностические методы и организационные формы выявления туберкулеза легких. Обращено внимание на происходящие изменения в системе выявления больных туберкулезом и на современные особенности диагностического процесса. Отмечено, что современная диагностика туберкулеза органов дыхания остается непростой клинической проблемой

Туберкулез и другие заболевания легких у лиц пожилого и старческого возраста: данные научных публикаций и собственных наблюдений

Rezumat În condițiile epidemiologice încordate privind tuberculoza pulmonară și schimbările demografi ce, ftiziopneumologia gerontologică și geriatrică reprezintă un compartiment important al medicinei contemporane. Scopul studiului realizat a fost prezentarea viziunii contemporane asupra problemei tuberculozei și a unor afecțiuni respiratorii, inclusiv ale altor sisteme și organe, în rândul persoanelor ≥65 de ani. Au fost analizate datele din literatură și datele proprii, obținute prin observarea pacienților cu tuberculoză, cu alte afecțiuni pulmonare și ale altor sisteme și organe. Sunt prezentate particularitățile de vârstă ale fiziologiei și patologiei organelor aparatului respirator și ale altor sisteme și organe, importanța clinică a comorbidității și multimorbidității, polipragmaziei și complianței bolnavilor vârstnici sau bătrâni cu tuberculoză. Revizuirea analitică pluriaspectuală a literaturii privind cercetările științifice în domeniul gerontologiei respiratorii și geriatriei, precum și observațiile proprii, au determinat că problema tuberculozei și a altor patologii concomitente, inclusiv respiratorii nespecifice, căpătând noi caracteristici, nu numai că își menține actualitatea în societatea contemporană, ci și capătă o importanţă deosebită pentru sistemul ocrotirii sănătății. Abordarea asistenței medicale a pacienților din grupa persoanelor vârstnice sau bătrâne trebuie să fi e complexă, ținând cont de cunoștințele contemporane în domeniul ftiziopneumologiei.Summary During the poor epidemiological situation concerning pulmonary tuberculosis and changes to demographic and gerontological and geriatric phthisiopulmonology represents a special and important field of the modern respiratory medicine. The purpose of the study was to present a contemporary view on the problem of tuberculosis and other respiratory diseases, including other systems and organs among people aged 65 and older. There were analyzed the data from the literature and the data obtained among people aged 65 and older with tuberculosis and other concomitant diseases, including other lung diseases. There are presented the age peculiarities of the physiology and pathology of the organs of the respiratory system and of other systems and organs, the clinical importance of comorbidity and multimorbidity, polypragmatism and the compliance of the elderly and olderly patients with tuberculosis. Pluriaspective analytical review of the literature on scientific research in the field of respiratory gerontology and geriatrics and our observations revealed that the problem of tuberculosis and other concomitant pathologies, including nonspecific respiratory pathologies, acquiring new characteristics, not only remains relevant in contemporary society, but also presents as being very important for the health care system. The approach to medical care for old patients must be complex, taking into account contemporary knowledge in the field of phthisiopneumology.Резюме В условиях эпидемиологической напряженности по туберкулезу легких и изменений демографической ситуации геронтологическая и гериатрическая фтизиопульмонология представляет собой особый и важный раздел современной медицины. Цель статьи – представить современный взгляд на проблему туберкулеза и других респираторных заболеваний, у людей в возрасте 65 лет и старше. Были проанализированы данные литературы и данные собственных наблюдений за больными туберкулезом легких, неспецифическими заболеваниями легких и другими сопутствующими заболеваниями в возрасте ≥65 лет. Представлены возрастные особенности физиологии и патологии органов дыхательной системы и других систем и органов, клиническое значение сопутствующей патологии и мультиморбидности, полипрагмазии и приверженности лечению пожилых пациентов больных туберкулезом. Аналитический обзор литературы по респираторной геронтологии и гериатрии и наши наблюдения показали, что проблема туберкулеза и других сопутствующих патологий, включая неспецифические респираторные заболевания, приобретая новые характеристики, не только остается актуальной в современном обществе, но и является очень важной для системы здравоохранения. Подход к оказанию медицинской помощи пациентам пожилого возраста должен быть комплексным, с учетом современных знаний в области фтизиатрии и геронтологии

Structura și caracteristicile epidemiologice ale infiltratelor pulmonare în Republica Moldova

Nicolae Testemitanu State University of Medicine and Pharmacy, Chiril Draganiuc Phthysiopneumology InstituteThe high frequency, heterogeneity of structure, similarity of the clinical x-ray picture of pulmonary infiltrates (LI) is one of the priority proble ms of respiratory medicine. According to the literature, tuberculosis has a special place among pulmonary diseases characterized by infiltrate. The burden of tuberculosis is associated not only with the charge on public health, but also with great losses in economics of many nations, as tuberculosis is apt to strike people with capacity to work [1-4]. Aim Monitoring and assessment of the burden of LI among the population of the Republic of Moldova. Меthods Analysis of statistical indicators and clinical data in patients with LI in 2017. Results Among the etiological and pathomorphological diversity of LI, pneumonic occupy leading positions. In 2017, the incidence rate of pneumonia was 898,0 per 100.000 of the population. In the structure of nonspecific bronchopulmonary diseases, pneumonia accounted for 38,2%. A large contribution to the overall burden of respiratory diseases was made by a contingent of patients with infiltrative pulmonary tuberculosis (IPT), both among new cases (78,6%) and among relapses (89,4%). The incidence rate per 100.000 population was 56,8. Infiltrates with destruction of the lungs and bacterial excretion, as well as lobar caseous pneumonia were of particular significance. In addition, the increasing threat of the development of antimicrobial resistance and associated HIV infections, viral hepatitis in the presence of infiltrative processes in the lungs increased the likelihood of adverse treatment outcomes. The mortality rate from pneumonia was 22,8, and from IPT – 2,2 per 100.000 population. Сonclusion Epidemiological tensions and difficulties in diagnosing LI determine the need to optimize the prevention of diseases, systematic screening, the successful introduction of new diagnostic tools, treatment and rehabilitation of patients. Regarding to, United Nations Common Position on Ending HIV, TB and Viral Hepatitis through Intersectoral Collaboration, in the framework of the United Nations Sustainable Development Goals Issue-based Coalition on Health and Well-being for All at All Ages in Europe and Central Asia, supported by in the Republic of Moldova