Viability of causative pathogen in patients with drug-sensitive and drug-resistant forms of respiratory tuberculosis

To predict outcomes of tuberculosis we investigated the viability of Mycobacterium tuberculosis (MTB) in relation to drug resistance of strains and clinical manifestations of tuberculosis. During the study on solid Löwenstein - Jensen medium, we determined the speed, growth rate and drug resistance of MBT in 5945 cultures, isolated from the sputum of patients with pulmonary tuberculosis - residents of the Irkutsk region (2193 -from newly diagnosed patients, 3752 - from previously treated patients). The criterion of high viability of MBT was the growth rate of >100 colonies over 20 days; and low viability corresponded with the growth rate of 30 days. 2171 cultures (36.5 %) had high viability of MBT strains, 3021 (50.8 %) - low, and 753 (12.7 %) cultures had average degree of viability. A high degree of pathogen viability was more often determined in newly diagnosed patients with tuberculosis of intrathoracic lymph nodes (all patients with HIV-infection without antiretroviral therapy), fibrotic-cavernous and infiltrative tuberculosis. Among previously treated patients with tuberculosis the high viability of MBT was often determined in patients with fibrous-cavernous and infiltrative tuberculosis, and caseous pneumonia. Cultures from previously treated patients with tuberculosis of intrathoracic lymph nodes had low degree of viability. The number of drug-sensitive strains was 1992, drug-resistant ones - 3953, including 1430 strains with multidrug resistance. We have found that 37.5 % drug-resistant strains associated with a high degree of viability (multidrug resistance - 38.5 %), it's was more often than the drug-sensitive (35.4 %; p < 0.01)

El estudio pedagógico como tecnología de formación docente

The modern development of teacher training system demonstrates the rethinking of teacher professional competences and focuses on general pedagogical, educational, methodological and psychological skills of a comprehensive school teacher. Improving the effectiveness of school education makes high demands on the personal qualities and professional competences of a teacher. In the new socio-economic conditions the approaches to the organization and content of methodological work in terms of in-service teacher training are changing. The successful pedagogical process is largely determined by the activity of emotionally secure, socially and professionally competent teacher, ready to continuing professional development. It implies a broad general cultural background, mastering of reflective skills. The study of these problems is associated with the increasing role of professional components in the development of teacher as a highly qualified specialist. This is due to the multidimensional scope of teacher’s activities, research attitude to the work, readiness to implement innovations. Such specialists make it possible to provide methodological support and i-service training of teachers at a qualitatively new level.El desarrollo moderno del sistema de formación docente demuestra el replanteamiento de las competencias profesionales docentes y se centra en las habilidades pedagógicas, educativas, metodológicas y psicológicas generales de un maestro escolar integral. Mejorar la efectividad de la educación escolar exige mucho sobre las cualidades personales y las competencias profesionales de un maestro. En las nuevas condiciones socioeconómicas, los enfoques para la organización y el contenido del trabajo metodológico en términos de capacitación docente en servicio están cambiando. El exitoso proceso pedagógico está determinado en gran medida por la actividad de un maestro emocionalmente seguro, social y profesionalmente competente, listo para continuar el desarrollo profesional. Implica un amplio trasfondo cultural general, el dominio de las habilidades reflexivas. El estudio de estos problemas está asociado con el creciente papel de los componentes profesionales en el desarrollo del maestro como especialista altamente calificado. Esto se debe al alcance multidimensional de las actividades de los docentes, la actitud investigadora hacia el trabajo, la disposición para implementar innovaciones. Dichos especialistas hacen posible brindar apoyo metodológico y capacitación i-service de docentes a un nivel cualitativamente nuevo

Features of Epidemic Process of Tuberculosis in the Territory with High Prevalence of HIV Infection

Scales of epidemic process of HIV-associated of tuberculosis are especially noticeable in regions with high prevalence of HIV infection and tuberculosis. A striking example of this situation is the Irkutsk region – the territory with the highest prevalence of HIV infection in the Russian Federation and one of the most unsuccessful one on tuberculosis – in 2010 became Russian “leader” and in prevalence of the HIV-associated tuberculosis, keeping a position “in the first five” so far. It is clear, that all this cannot but imply negative manifestations of two considered epidemic processes at their simultaneous development in one territory. The above-said facts predetermined carrying out the retrospective epidemiological analysis of spread of tuberculosis among the cumulative population in the Irkutsk region, a territory of high risk of HIV infection.The purpose of the work was to assess features of spread of tuberculosis in the territory of the large center of HIV infection (Irkutsk region).Results. The expressed negative impact of HIV infection on epidemic process of tuberculosis in the studied region, shown in divergence of trends and higher levels of epidemiological indicators in comparison to the all-Russian data is established.Conclusion. As a result of a research the trend of regional incidence of tuberculosis, multidirectional with the all-Russian indicators, is established from the moment of epidemic spread of HIV infection that demonstrates integration of epidemic processes of the studied infections. Even on condition of regress of epidemic process of tuberculosis at the end of the analyzed period which is followed by decrease in incidence of all population, HIV infection has a significant impact on his tension that, certainly, demands the strengthened measures of epidemiological control of these socially important infections

The Socio-Epidemiological Environment and the Health of Infants without Having Been Impacted by Maternal HIV Infection

The results of a cohort study of 177 newborns, from birth until they were 18 months old, are presented. The 87 of those children had lacked impact of maternal HIV infection, and 90 children were not exposed to HIV prenatally. Antisocial factors were observed among the newborns exposed to a prenatal HIV infection which had a negative impact upon them throughout infancy. The social deviance of their family members with a HIV infection was 10.5 times higher than the standard risk of a neonatal abstinence syndrome, 4 times higher than a standard risk of growth retardation during fetal development, and 3.8 times higher than a standard risk of postnatal development disorders. Undiagnosed infants who were exposed to a HIV-infection constitute a medico-social risk group requiring scrupulous and extended medical assistance

Risk Factors of a Progradient TB Course in Children with Perinatal HIV-infection: the Results of a Cohort Study

Cohort study of 130 children with monoinfection TB and co-infection of HIV was carried out. For the first time, both a progradient and a regradient TB course were identified. The progradient diseases pattern in a group of patients with HIV co-infection appears to be 5.3 times higher than in a group of patients with monoinfection. High frequency linkage of epidemiological, social, and medicobiological risk factors were recognized. Predictive significance of the progradient TB course in children with HIV-infection was observed in the following: a contact with TB infected individuals, imperfections in the pediatric observations and the evasion of fluorographic testing by adults interacting with the children and the social deviations of adult members of the family

Lipid profile stability and prognostic value in adolescents: 22-year prospective study

Aim. To prospectively assess dynamics, stability, and prognostic value of blood lipid profile (LP) in adolescents, for identifying early coronary heart disease prevention approaches. Material and methods. This prospective study included 347 boys and 332 girls. During 22-year follow-up, six clinical examinations were performed (at the age of 13-14, 15-16, 19-20, 21-22, 26 and 34-35 years). Examination program included measuring levels of total cholesterol (TCH), high-density lipoprotein CH (HDL-CH), and triglycerides (TG), body weight (BW) and height (BH), subscapular, abdominal, and triceps skin fold thickness (SST, AST, and TST), pubescence assessment. Results. Gender differences in LP, especially in pubescence, could not be completely explained. Increased LP atherogenity and dyslipidemia (DLP) rates in young males were associated with increased BW and fat tissue percentage. Mildly increased and normal TCH, HDL-CH, low-density lipoprotein CH (LDL-CH) in pubescent boys and girls were equally stable and not associated with increased risk of atherogenic DLP in adult age. In pubescent adolescents, TCH predicted its level in 34-35 year-olds only in combination with physical development parameters. Overweight in pubescent boys was an independent predictor of future hypercholesterolemia in adult age. Conclusion.The observed age LP dynamics points to the need for early preventive measures in risk groups and general population, starting in pre-pubertal or early pubertal periods

Overweight prognostic value in adolescent boys: 10-year prospective study

Aim. To assess dynamics, stability, and prognostic value of overweight (OW) in adolescent boys. Material and methods. This prospective study included 376 adolescent boys. During 10-year follow-up, five clinical examinations were performed (at the age of 12, 13, 15, 17, and 22 years). Examination program included measuring body weight and height, body mass index (BMI), subscapular, abdominal, and triceps skin fold thickness, pubescence assessment. Results. In pubescence period, anthropometry dynamics demonstrated formation of adult obesity type, with central subcutaneous adiposity. OW and obesity prevalence increased as early as in late pubertal period (after 15 years). More than in 50% of the adolescent boys, OW was registered in early adulthood period. Among 22-year-olds, 54,5% suffered from OW or obesity in early adolescence. BMI increase in adolescence was associated with its later stabilization (tracking) and increased risk of OW and obesity in early adulthood. OW and obesity in early adulthood were observed in adolescent boys with OW or high-normal BMI. Conclusion. The observed age dynamics of anthropometric parameters points to the need for early preventive measures in risk groups and general population, starting in pre-pubertal or early pubertal periods

Pedagogical Studio as a Teacher Training Technology

The modern development of teacher training system demonstrates the rethinking of teacher professional competences and focuses on general pedagogical, educational, methodological and psychological skills of a comprehensive school teacher. Improving the effectiveness of school education makes high demands on the personal qualities and professional competences of a teacher. In the new socio-economic conditions the approaches to the organization and content of methodological work in terms of in-service teacher training are changing. The successful pedagogical process is largely determined by the activity of emotionally secure, socially and professionally competent teacher, ready to continuing professional development. It implies a broad general cultural background, mastering of reflective skills. The study of these problems is associated with the increasing role of professional components in the development of teacher as a highly qualified specialist. This is due to the multidimensional scope of teacher's activities, research attitude to the work, readiness to implement innovations. Such specialists make it possible to provide methodological support and i-service training of teachers at a qualitatively new level

El estudio pedagógico como tecnología de formación docente

The modern development of teacher training system demonstrates the rethinking of teacher professional competences and focuses on general pedagogical, educational, methodological and psychological skills of a comprehensive school teacher. Improving the effectiveness of school education makes high demands on the personal qualities and professional competences of a teacher. In the new socio-economic conditions the approaches to the organization and content of methodological work in terms of in-service teacher training are changing. The successful pedagogical process is largely determined by the activity of emotionally secure, socially and professionally competent teacher, ready to continuing professional development. It implies a broad general cultural background, mastering of reflective skills. The study of these problems is associated with the increasing role of professional components in the development of teacher as a highly qualified specialist. This is due to the multidimensional scope of teacher’s activities, research attitude to the work, readiness to implement innovations. Such specialists make it possible to provide methodological support and i-service training of teachers at a qualitatively new level.El desarrollo moderno del sistema de formación docente demuestra el replanteamiento de las competencias profesionales docentes y se centra en las habilidades pedagógicas, educativas, metodológicas y psicológicas generales de un maestro escolar integral. Mejorar la efectividad de la educación escolar exige mucho sobre las cualidades personales y las competencias profesionales de un maestro. En las nuevas condiciones socioeconómicas, los enfoques para la organización y el contenido del trabajo metodológico en términos de capacitación docente en servicio están cambiando. El exitoso proceso pedagógico está determinado en gran medida por la actividad de un maestro emocionalmente seguro, social y profesionalmente competente, listo para continuar el desarrollo profesional. Implica un amplio trasfondo cultural general, el dominio de las habilidades reflexivas. El estudio de estos problemas está asociado con el creciente papel de los componentes profesionales en el desarrollo del maestro como especialista altamente calificado. Esto se debe al alcance multidimensional de las actividades de los docentes, la actitud investigadora hacia el trabajo, la disposición para implementar innovaciones. Dichos especialistas hacen posible brindar apoyo metodológico y capacitación i-service de docentes a un nivel cualitativamente nuevo