DIAGNOSTICS OF THE ACTIVE AND LATENT TUBERCULAR INFECTION AMONG CHILDREN AND TEENAGERS USING DIASKINTEST PREPARATION

Purpose: To estimate the efficiency of test using Diaskintest preparation for tubercular infection’s identification and an opportunity of it’s usage in decision the problem of preventive tubercular therapy.Materials and methods: There have been included 220 children and teenagers in the research.Results: Of the total number of children, 92 patients with positive reaction to Mantu test Манту with 2 TE PPD-L and negativereaction to the test with Diaskintest preparation have been recognized infected with MBT. 79 person had positive results of theboth tests. 40 person of this number had an active tuberculosis, 2 - inactive changes, and among 25 person - tuberculosis datahas not been revealed. 10 person had negative results of the both tests. 117 patients have been recognized infected with MBT,however children with PM+DT (92 people.) did not require usage of the preventive therapies, and 25 patients with PM+DTrequired usage of the preventive therapies in connection with presence of a latent tubercular infection.Summary: There has been shown the efficiency of Diaskintest preparation in diagnostics of an active and latent tubercularinfection and an opportunity of it’s usage as an indicator of high risk of an active tuberculosis development while decision thequestion on the necessity of the preventive therapy usage

DIFFERENTIAL-DIAGNOSTIC CHARACTERISTICS OF INFILTRATIVE PULMONARY TUBERCULOSIS DEPENDING ON THE NATURE OF INFLAMMATORY TISSUE REACTION (PRODUCTIVE OR EXUDATIVE)

Purpose: assessment of the free radical oxidation system and antioxidant protection, immune and cytokine status in patients with pulmonary infiltrative tuberculosis, depending on the type of inflammatory tissue reaction. Materials and Methods: the study included 60 patients with infiltrative pulmonary tuberculosis with exudative and productive type of inflammation.Statistical analysis of the data was performed using the program Statistica 6.0. Results: the patients with productive type of inflammation are mainly characterized by a limited process with poor bacterioexcretion, moderate disturbances in the free-radical oxidationsystem, antioxidant protection, immune and cytokine status. In patients with exudative type widespread destructive process with massive excretion of Mycobacterium tuberculosisprevails, as well as severe disturbances in the free-radical oxidationsystem, antioxidant protection, immune and cytokine status. Summary: the clinical and laboratory characteristics of infiltrative tuberculosis with different types of inflammatory tissue reaction should be considered duringprescription of pathogenetic treatment and prediction of the course and of the outcome of tuberculosis process

Free-radical oxidation condition of the patients with infiltrative pulmonary tuberculosis depending on the pathogenetic treatment method

Objective: to assess the impact of the methyldioxotetrahydropyrimidine sulfonisonicotinoyl hydrazide medication on the free-radical oxidation processes and the possibility of its use as a multifunctional mean of pathogenetic tuberculosis therapy. Material and methods: a comparative analysis of treatment efficiency, clinic-laboratory data, and free-radical oxidation indices of 50 patients with active pulmonary tuberculosis, which obtained methyldioxotetrahydropyrimidine sulfonisonicotinoyl hydrazide and a standard pathogenetic therapy, was carried out. Results: a decrease in the frequency and severity of destruction of lung tissue, the cessation of bacterial release, rapid resolution of infiltration in the lung tissue, which was accompanied by the normalization of the parameters of the antioxidant protection system, was revealed under the influence of methyldioxotetrahydropyrimidine sulfonisonicotinoyl hydrazide. Conclusions: the use of methyldioxotetrahydropyrimidine sulfonisonicotinoyl hydrazide as a pathogenetic medication for patients, who received antituberculosis treatment, results in substantial positive clinic-laboratory dynamics, increase of treatment efficiency, and normalization of free-radical oxidation indices in comparison with those, who received standard pathogenetic therapy

EFFICIENCY PATHOGENETIC TREATMENT OF PATIENTS WITH PULMONARY TUBERCULOSIS WITH EXUDATIVE TYPE INFLAMMATORY TISSUE REACTION

Purpose: evaluation of the effectiveness of the Tubosan and Thiotriazoline combined pathogenic treatment of patients with infiltrative pulmonary tuberculosis with exudative type of inflammatory tissue reaction.Materials and methods: the study included 60 patients, statistical analysis of the data was performed on a PC using the software Statistica 6.0 under Windows XP.Results: the use of a combination of drugs Tubosan and Thiotriazoline as part of an integrated treatment of infiltrative tuberculosis contributes to a significant improvement in clinical and radiological symptoms, indicators of cytokine and immune status, free radical oxidation and antioxidant protection. There are statistically significant differences depending on the surveyed group. The antioxidant and immunomodulatory effect of Tubosan and Thiotriazoline is proved.Summary: the use of these drugs is accompanied by a pronounced positive clinical and laboratory dynamics and normalization of free radical oxidation and antioxidant protection, immune and cytokine status and is reasonable and appropriate

Характеристики некоторых препаратов с антиоксидантной активностью и их применение для лечения туберкулеза

The review presents methods for management of free radical reactions in pulmonary tuberculosis patients which are of great importance for relief of clinical symptoms, pathomorphological changes, and the outcome of the disease. It describes the effect of various antioxidant drugs on the course of tissue inflammatory reaction and the development of destructive changes in the lungs.В обзоре представлены методы коррекции свободнорадикальных процессов в организме больных туберкулезом легких, которые имеют большое значение для купирования клинических симптомов, патоморфологических изменений, исхода заболевания. Показано влияние различных препаратов, обладающих антиоксидантным действием, на течение тканевой воспалительной реакции, развитие деструктивных изменений в легких.Авторы заявляют об отсутствии у них конфликта интересов

Особенности формирования иммунного ответа при туберкулезе с выделением лекарственно-чувствительных и лекарственно-устойчивых штаммов

The review presents literature data on the formation of the immune response to tuberculosis, features of the cellular and humoral link depending on detection of drug susceptible and drug resistant strains of M. tuberculosis. It describes the role of cytokines and genetic factors in disorders of immune reactions affecting pathomorphosis and clinical manifestations of tuberculosis.В обзоре представлены данные литературы о формировании иммунного ответа при туберкулезе, об особенностях клеточного и гуморального звена в зависимости от выделения лекарственно-чувствительных и лекарственно-устойчивых штаммов M. tuberculosis. Показана роль цитокинов, генетических факторов при нарушениях иммунных реакций, влияющих на патоморфоз и клинические проявления туберкулеза

Особенности терапии больных туберкулезом легких гамма-интерфероном в зависимости от характера тканевой воспалительной реакции

The objective: to evaluate effectiveness of treatment of infiltrative pulmonary tuberculosis patients with exudative or productive types of the tissue inflammatory reaction when additional immunotherapy with recombinant IFN-γ is used.Subjects and Methods. 127 infiltrative tuberculosis patients were enrolled in the study, of them 66 had an exudative type of the inflammatory reaction (2 Groups OG-1 and GS-1 were formed), 61 had a proliferative type (2 Groups OG-2 and GS-2 were formed). Patients from OG-1 and OG-2 Groups additionally received different regimens with recombinant interferon-γ.Result: Comprehensive treatment of infiltrative tuberculosis including intramuscular administration (according to a certain regimen) of recombinant IFN-γ contributes to achievement of pronounced positive changes of clinical and radiological symptoms in patients with both exudative and productive types of the tissue inflammatory reaction. In the groups treated with recombinant IFN-γ, restoration of the cellular immune response, cellular cooperation, normalization of the cytokine profile and increased phagocytosis activity were confirmed by the results of laboratory tests.Цель исследования: изучить эффективность лечения больных инфильтративным туберкулезом легких при экссудативном или продуктивном типах тканевой воспалительной реакции путем дополнительной иммунотерапии рекомбинантным ИФН-γ.Материалы и методы. В исследование было включено 127 пациентов с инфильтративным туберкулезом, у 66 – присутствовал экссудативный тип воспалительной реакции (сформировано 2 группы ОГ-1 и ГС-1), у 61 – пролиферативный тип (сформировано 2 группы ОГ-2 и ГС-2). Пациенты групп ОГ-1 и ОГ-2 дополнительно получали рекомбинантный интерферон-γ по разным схемам.Результат. Проведение комплексной терапии инфильтративного туберкулеза с включением внутримышечного введения (по схеме) рекомбинантного ИФН-γ способствует выраженной положительной динамике клинико-рентгенологических симптомов у больных как с экссудативным, так и с продуктивным типом тканевой воспалительной реакции. В группах с использованием рекомбинантного ИФН-γ лабораторно зафиксировано восстановление клеточного иммунного ответа, клеточных коопераций, нормализация цитокинового профиля и повышение активности фагоцитоза

Возможности патогенетической терапии при лечении новой коронавирусной инфекции COVID-19

The objective: to increase efcacy of treatment of patients with new coronavirus infection COVID-19 by prescription of Remaxol.Subjects and Methods: 105 patients with confrmed new coronavirus infection COVID-19 with lung damage from 25 to 50% (CT-2) were examined and divided into 2 groups (Main Group and Comparison Group). All patients received standard treatment; patients from Main Group (55 people) additionally received Remaxol intravenously 200.0 ml No. 10 daily, then No. 5 every other day. Treatment efcacy was assessed between the 3rd and 4th week of the study.Results: the patients treated with Remaxol showed more pronounced positive changes of clinical and laboratory symptoms (lower frequency of fever, improved state of health, appetite, decreased dyspnea, cough and wheezing, higher level of SpO2, decreased neutrophilia and blood clotting, ferritin levels, a signifcant increase in activity of superoxide dismutase in erythrocytes and a decrease in myeloperoxidase activity in neutrophils) versus patients receiving standard treatment. The CT lung scan after 3 weeks in patients from Main Group showed the transformation of ground-glass areas into impactions according to the consolidation type in 58.2% (32 people), in 52.2% (29 people) there appeared an organizing pneumonia, a decrease in size of impactions was observed in 54.6% (30 people); in Comparison Group ‒ in 24.0% (12 people), 20% (10 people) and 24% (12 people), respectively, in all three comparisons (p < 0.05).Цель исследования: повышение эффективности лечения больных с новой коронавирусной инфекцией COVID-19 при назначении препарата Ремаксол.Материалы и методы: обследовано 105 пациентов с подтвержденной новой коронавирусной инфекцией COVID-19 с поражением легочной ткани от 25 до 50% (КТ-2), которые были разделены на 2 группы (основная и группа сравнения). Все пациенты получали стандартное лечение, пациенты основной группы (55 человек) дополнительно получали Ремаксол внутривенно по 200,0 мл № 10 ежедневно, затем № 5 через день. Контроль за эффективностью лечения осуществлялся между 3-й и 4-й нед. исследования.Результаты: у пациентов, получавших Ремаксол, отмечалась более частая выраженная положительная динамика клинических и лабораторных симптомов (снижение частоты лихорадки, улучшение самочувствия, появление аппетита, уменьшение одышки, кашля и хрипов, повышение SpО2, снижение нейтрофилеза, повышенной свертываемости крови, уровня ферритина, достоверное повышение активности супероксиддисмутазы в эритроцитах и уменьшение активности миелопероксидазы в нейтрофилах) по сравнению с пациентами, получавшими стандартное лечение. На КТ легких через 3 нед. у пациентов основной группы преобразование участков «матового стекла» в уплотнения по типу консолидации отмечалось у 58,2% (32 чел.), у 52,2% (29 чел.) наблюдалась картина организующейся пневмонии, уменьшение размеров уплотненных участков отмечалось у 54,6% (30 чел.); а в группе сравнения – у 24,0% (12 чел.), 20% (10 чел.) и 24% (12 чел.) соответственно, во всех трех сравнениях (p < 0,05)

Specific features of the immune response to tuberculosis when drug susceptible and drug resistant strains of M. tuberculosis are detected

The review presents literature data on the formation of the immune response to tuberculosis, features of the cellular and humoral link depending on detection of drug susceptible and drug resistant strains of M. tuberculosis. It describes the role of cytokines and genetic factors in disorders of immune reactions affecting pathomorphosis and clinical manifestations of tuberculosis