2 research outputs found
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