TREATMENT EFFICIENCY OF DRUG SUSCEPTIBLE PULMONARY TUBERCULOSIS

The article describes the study of comparative efficiency of fenazid (isonicotinoilhydrazine-О,N’) ferrous dihydrate sulphate (II) and isoniazid in drug susceptible pulmonary tuberculosis patients.The high treatment efficiency namely significant improvement and improvement was observed in the patients of Group 1 – 84.1% which could be compared to the standard treatment regimen (85-7%) in Group 2. The total number of adverse reactions in the main group was confidently lower – 18.6% against 33.9%, p < 0.05. Hepatotoxic reactions with 2-3 fold increase of alaninetransferase level was registered significantly less (9.3%) in Group 1 compared to the Group treated with isoniazid

Immunological methods in diagnosis of sarcoidosis end tuberculosis of lung

Differential diagnosis disseminated diseases provides sarcoidosis and tuberculosis. Frequency of mistakes consists over 40% [Visel AA, 2013]. That’s why including of new diagnosis methods is weary important. Оbjective: to indicat diagnosis value of immunologic methods in differential diagnosis with sarcoidosis and tuberculosis. In the department of phthisiopulmonology were examined 66 patients with lung over 2013 to 2014. Complex of examination included: examination of the respiratory excretion material (sputum) for detection of MBT using laboratory methods, X-ray examination (computed tomography), histological examination after transbronchial biopsy of lung tissue. All of diagnosis were proved by histological and bacteriological methods. After complex of examination patients were divided in two groups: I group (n=32) – pulmonary TB; II group (n=17) – sarcoidosis II study. All of patients were examined with immunologic tests (tuberculin skin test (TST), Diaskintest® (DST) QuantiFERON ®-TB Gold (QFT) and T.-SPOT.TB test (T-SPOT). In the I group this tests was significant different positive results with QFT (78,1%), T-SPOT (71,9%), DST (81,3%) in comparison with negative results of this tests (p˂0,001). Diagnostic value was: TST (DSe – 84,4%, DSp – 40,0%, Dv – 70,2%, PVPR – 75,0%, PVNR – 54,5%); QFT (DSe – 74,2%, DSp – 88,2%, Dv – 79,2%, PVPR – 92,0%, PVNR – 65,2%); TB.SPOT (DSe – 80,6%, DSp – 87,5%, Dv – 83,0%, PVPR – 92,6%, PVNR – 70,0%); DST (DSe – 81,3%, DSp – 94,1%, Dv – 85,7%, PVPR – 96,3%, PVNR – 72,7%); Сonclusion: diagnostic value of immunologic tests QFT, TB.SPOT and DST was more significantly higher in comparison with TST. The use of immunological tests can help in differential diagnosis of tuberculosis and sarcoidosis

Experimental Evaluation of the Protective Efficacy of Tick-Borne Encephalitis (TBE) Vaccines Based on European and Far-Eastern TBEV Strains in Mice and in Vitro

Tick-borne encephalitis (TBE), caused by the TBE virus (TBEV), is a serious public health threat in northern Eurasia. Three subtypes of TBEV are distinguished. Inactivated vaccines are available for TBE prophylaxis, and their efficacy to prevent the disease has been demonstrated by years of implication. Nevertheless, rare TBE cases among the vaccinated have been registered. The present study aimed to evaluate the protective efficacy of 4 TBEV vaccines against naturally circulating TBEV variants. For the first time, the protection was evaluated against an extended number of phylogenetically distinct TBEV strains isolated in different years in different territories. The protective effect did not strongly depend on the infectious dose of the challenge virus or the scheme of vaccination. All vaccines induced neutralizing antibodies in protective titers against the TBEV strains used, although the vaccines varied in the spectra of induced antibodies and protective efficacy. The protective efficacy of the vaccines depended on the individual properties of the vaccine strain and the challenge virus, rather than on the subtypes. The neutralization efficiency appeared to be dependent not only on the presence of antibodies to particular epitopes and the amino acid composition of the virion surface but also on the intrinsic properties of the challenge virus E protein structure

Трудности дифференциальной диагностики туберкулеза и саркоидоза органов дыхания

TB doctors and pulmonologists are very well familiar with the issue of differential diagnostics between pulmonary tuberculosis and sarcoidosis. Despite the introduction of new diagnostic tools for disseminated diseases, the absence of pathognomonic, clinical, X-ray and morphological signs of the disease remains to be the big problem resulting in the significant number of diagnostic mistakes (60-75%). The Mantoux test with 2 TU is still used for differential diagnostics between tuberculosis and sarcoidosis. Till present among immunological tests the skin tuberculin test has remained to be the only one for tuberculosis diagnostics. However recently some new highly informative immunological tests have appeared allowing diagnosing tuberculosis on a higher level and thus giving up Mantoux test with 2 TU. The article presents the clinical case confirming the value of immunological tests in differential diagnostics between sarcoidosis and tuberculosis.Врачам-фтизиатрам и врачам-пульмонологам давно знакома проблема дифференциальной диагностики туберкулеза и саркоидоза легких. Несмотря на внедрение новых методов диагностики диссеминированных процессов, большой проблемой является отсутствие патогномоничных, клинико-рентгенологических и морфологических признаков заболевания, что приводит к высокому числу диагностических ошибок (60-75%). В комплексе дифференциальной диагностики туберкулеза и саркоидоза до настоящего времени применяется проба Манту с 2 ТЕ. Среди иммунологических тестов до недавнего времени кожный тест с туберкулином был единственным в диагностике туберкулеза. Однако в последние годы появились новые высокоинформативные иммунологические тесты, которые позволяют на ином уровне проводить диагностику туберкулеза и отказаться от применения пробы Манту с 2 ТЕ. В статье представлен клинический пример, который подтверждает значение иммунологических тестов в дифференциальной диагностике саркоидоза и туберкулеза

Эффективность терапии туберкулеза легких с сохраненной лекарственной чувствительностью микобактерий

The article describes the study of comparative efficiency of fenazid (isonicotinoilhydrazine-О,N’) ferrous dihydrate sulphate (II) and isoniazid in drug susceptible pulmonary tuberculosis patients.The high treatment efficiency namely significant improvement and improvement was observed in the patients of Group 1 – 84.1% which could be compared to the standard treatment regimen (85-7%) in Group 2. The total number of adverse reactions in the main group was confidently lower – 18.6% against 33.9%, p < 0.05. Hepatotoxic reactions with 2-3 fold increase of alaninetransferase level was registered significantly less (9.3%) in Group 1 compared to the Group treated with isoniazid.Статья посвящена изучению сравнительной эффективности феназида (изоникотиноилгидразин-О,N’) железа (II) сульфат дигидрат и изониазида у больных туберкулезом легких с сохраненной лекарственной чувствительностью возбудителя. Получена высокая эффективность лечения «значительное улучшение» и «улучшение» у пациентов 1-й группы - 81,4%, что сопоставимо со стандартной схемой терапии (85,7%) во 2-й группе. Общее число нежелательных побочных реакций в основной группе отмечалось достоверно реже - 18,6% против 33,9%, p < 0,05. Гепатотоксические реакции с повышением в 2-3 раза уровня аланинтрансаминазы зарегистрированы значительно реже (9,3%) в I группе по сравнению с группой получавших изониазид - 23,2%

Возможности иммунологических методов в дифференциальной диагностике саркоидоза и туберкулеза органов дыхания

Differential diagnosis disseminated diseases provides sarcoidosis and tuberculosis. Frequency of mistakes consists over 40% [Visel AA, 2013]. That’s why including of new diagnosis methods is weary important. Оbjective: to indicat diagnosis value of immunologic methods in differential diagnosis with sarcoidosis and tuberculosis. In the department of phthisiopulmonology were examined 66 patients with lung over 2013 to 2014. Complex of examination included: examination of the respiratory excretion material (sputum) for detection of MBT using laboratory methods, X-ray examination (computed tomography), histological examination after transbronchial biopsy of lung tissue. All of diagnosis were proved by histological and bacteriological methods. After complex of examination patients were divided in two groups: I group (n=32) – pulmonary TB; II group (n=17) – sarcoidosis II study. All of patients were examined with immunologic tests (tuberculin skin test (TST), Diaskintest® (DST) QuantiFERON ®-TB Gold (QFT) and T.-SPOT.TB test (T-SPOT). In the I group this tests was significant different positive results with QFT (78,1%), T-SPOT (71,9%), DST (81,3%) in comparison with negative results of this tests (p˂0,001). Diagnostic value was: TST (DSe – 84,4%, DSp – 40,0%, Dv – 70,2%, PVPR – 75,0%, PVNR – 54,5%); QFT (DSe – 74,2%, DSp – 88,2%, Dv – 79,2%, PVPR – 92,0%, PVNR – 65,2%); TB.SPOT (DSe – 80,6%, DSp – 87,5%, Dv – 83,0%, PVPR – 92,6%, PVNR – 70,0%); DST (DSe – 81,3%, DSp – 94,1%, Dv – 85,7%, PVPR – 96,3%, PVNR – 72,7%); Сonclusion: diagnostic value of immunologic tests QFT, TB.SPOT and DST was more significantly higher in comparison with TST. The use of immunological tests can help in differential diagnosis of tuberculosis and sarcoidosis. Дифференциальная диагностика саркоидоза и туберкулеза органов дыхания до настоящего времени представляет значительные трудности. Частота ошибок при постановке диагноза составляет более чем 40% (Визель А.А., 2013). Значение иммунологических методов в дифференциальной диагностике с саркоидоза и туберкулеза не определено, что послужило основанием для настоящего исследования. В ФГБУ «СПб НИИФ» Минздрава России было обследовано 66 пациентов с изменениями в легких и внутригрудных лимфатических узлах за период с 2013 по 2014 г. Все диагнозы были доказаны с применением гистологического и бактериологического методов. Пациенты были разделены на две группы: I группа (n = 32) – туберкулезом легких; группа II (n = 17) – саркоидозом органов дыхания II ст. и обследованы с постановкой иммунологических тестов (проба Манту с 2ТЕ, проба с Диаскинтестом® (ДСТ), QuantiFERON ®-TB Gold (QFT) и Т.-SPOT.TB тест (T-SPOT). Достоверные различия были получены при сравнении положительных и отрицательных результатов тестов (p˂0,001) в I и II группе. Диагностическое значение тестов: проба Манту с 2ТЕ (ДЧ – 84,4% , ДС – 40,0%, ДЭ –70,2%, ПЗПР – 75,0%, ПЗОР – 54,5%); QFT (ДЧ – 74,2%, ДС – 88,2%, ДЭ – 79,2%, ПЗПР – 92,0%, ПЗОР – 65,2%); T.SPOT (ДЧ – 80,6%, ДС – 87,5%, ДЭ – 83,0%, ПЗПР – 92,6%, ПЗОР – 70,0%); ДСТ (ДЧ – 81,3%, ДС – 94,1%, ДЭ – 85,7%, ПЗПР – 96,3 %, ПЗОР – 72,7%). Выводы: диагностическое значение иммунологических тестов QFT, TB.SPOT и ДСТ значительно выше был в сравнении с пробой Манту с 2ТЕ. Применение данных методов может существенно помочь в дифференциальной диагностике туберкулеза и саркоидоза.

Diagnosis and clinical and X-ray characteristics of pulmonary tuberculosis in adolescents

adolescents. Fluorography is the basic method used as usual to detect tuberculosis in adolescents. The use of diaskintest in the diagnosis of tuberculosis infection in adolescents has reinforced its high informative value. The test was positive in 96.7% of the patients with tuberculosis and could reveal dormant tuberculosis infection in 29.2% of the cases. In the patterns of its clinical forms, there is a preponderance of secondary tuberculosis (infiltrative forms, including those with bacterial excretion); most (64.3%) cases show multidrug resistance (MDR) in Mycobacterium tuberculosis (MBT). Accelerated methods for determining MBT resistance in a number of patients can reveal MDR in MBT in early periods, which allows antituberculosis therapy to be timely corrected. Multidrug-resistant pulmonary tuberculosis is characterized by severe clinical symptoms and multisegmental destruction in the lung

EFFICIENCY OF INTEGRAL THERAPY AND POTENTIAL SIDE EFFECTS WHEN TREATING RESPIRATORY TUBERCULOSIS WITH MULTIPLE DRUG RESISTANCE

Treatment of multiple drug resistant tuberculosis presents a serious challenge. Use of perchlozon (thioureidoiminomethylpyridini um) in the combination with the other five anti-tuberculosis drugs during 6 months of treatment allowed achieving cessation of bacillary excretion and X-ray improvement in all patients from the main group. Monitoring and evaluation of adverse events have not detected any confident difference in the number of adverse events apart from endocrine and allergic ones while taking perchlozon in the combination with other drugs. All adverse events were minor and moderate as regards severity degree and were managed by symptomatic treatment and did not cause cancellation of the drug. The obtained results will promote achieving the high tuberculosis treatment effciency by the end of the main chemotherapy course and this will require further investigation

DIFFICULTIES IN DIFFERENTIAL DIAGNOSTICS OF RESPIRATORY TUBERCULOSIS AND SARCOIDOSIS

TB doctors and pulmonologists are very well familiar with the issue of differential diagnostics between pulmonary tuberculosis and sarcoidosis. Despite the introduction of new diagnostic tools for disseminated diseases, the absence of pathognomonic, clinical, X-ray and morphological signs of the disease remains to be the big problem resulting in the significant number of diagnostic mistakes (60-75%). The Mantoux test with 2 TU is still used for differential diagnostics between tuberculosis and sarcoidosis. Till present among immunological tests the skin tuberculin test has remained to be the only one for tuberculosis diagnostics. However recently some new highly informative immunological tests have appeared allowing diagnosing tuberculosis on a higher level and thus giving up Mantoux test with 2 TU. The article presents the clinical case confirming the value of immunological tests in differential diagnostics between sarcoidosis and tuberculosis