A study of the prevalence and clinico-immunological specific characteristics of coexistance of tuberculosis and HIV/AIDS

Кафедра "Фтизіатрії та пульмонології

Effect of decasan nebulized therapy on the clinical course in patients with community acquired pneumonia

Кафедра "Фтизіатрії та пульмонології

The roentgenological manifestation of pulmonary tuberculosis in HIV-positive patients

Due to the precipitous decline in epidemiological situation of HIV-infection in Ukraine and in the world, annual increasing of the number of HIV-associated tuberculosis cases is observed. Tuberculosis in HIV-positive patients is characterized by difficulty of the diagnostic. The article presents the results of the analysis of the roentgenological manifestation of pulmonary tuberculosis in HIV-positive patients

Review article. Migration as a social determinant of the increased active TB and MDRTB incidents

Background: Ukraine and R. Moldova report the biggest incidence of tuberculosis and the highest rate of migrants among European Region countries. For an average 1 bilion migrants, for whose this process - migration, is an effectively and immediately tool to reduce poverty, conflict and escape for improving the life condition for their families. Migrants are the backbone of health systems in all OECD countries and the safety valve in the global economy. On the other hand the migration is a big challenge, especially for the TB epidemiological security. At the most of migrants the risk for active TB developmen and the increase of multidrug resistant TB incidents. is correlated with social risk factors (low life conditions, overcrowding, disruption from the health care services), epidemiological risk factors (infectious contact) and biological features (young age, male sex, some physiological conditions, associated diseases). Risk factors association values more evident than the severity of an one risk factor. The review study was conducted using relevant scientific resourses. Conclusions. Despite of high trends of migration noted in the 20th centery the phemonen of migration as risk factor for TB development is low studied. Massive irregular emigrants automatically involves the reducing of the public health actions for providing the TB epidemiological security goals both hosting countries and country of origin, where is a high burden for TB, especially MDR-TB. Radiological and immunological screening in pre-departure is the most important procedure for decreasing of the rates of TB. Raising awareness among migrants about TB, emphasizing that diagnosis and treatment is free of charge and independent regarding migration status are important TB control actions. Considering high relevance of migration on the risk of TB development a TB national survey in the actual geopolitical context must be performed in both hosting countries and country of an origin

Malabsorption syndrome as a manifestation of systemic effects in advanced forms of pulmonary tuberculosis

As of October 2012 84 countries had re¬ported at least 1 case of extensively drug resistant tuberculosis (EDR TB). In November 2012, the WHO epidemiological surveillance stated: all new TB cases in the world are 3,7 % of multi-drug resistant tuberculosis (MDR TB); 60,0 % of MDR TB among the new cases of TB are documented in Brazil, China, India, and South Africa

Indicators of cytokine regulation in patients with multidrug-resistant pulmonary tuberculosis

One of the reasons for worsening the epidemiological situation is the change of biological properties of bacilli, the failure of the first and the second courses of chemotherapy, interrupted treatment, relapse tuberculosis (TB), unadequit treatment, contact with patients drug resistant tuberculosis insufficient effectiveness of existing TB drugs [3,7 ]. Production of IL-6 and IL-10 in TB patients is independent of drug resistance, but increases in response to increased synthesis of endotoxins by MBT; the magnitude of endogenous intoxication and cytotoxic hypoxia creates prerequisites for the development of drug resistant strains. The IL-18/IL-10 ratio in these patients characterizes the increase in severity of the patient's state, the spread of inflammation processes in the lungs and the development of drug resistance; there is a significant bulk of the Tx-lymphocyte type 2 (CD4+), which indicates the development of deep gap in cell-mediated immune response and prevalence of an ineffective anti-inflammation immune activation

Сахарный диабет и туберкулез: Риск сочетания двух эпидемий

Diabetes mellitus and tuberculosis: the risk of combination of two epidemicsNumeroase studii arată că diabetul zaharat necontrolat poate duce la multe complicații, inclusiv la boli vasculare, polineuropatie și la creșterea sensibilității la infecții. S-a demonstrat că diabetul zaharat (DZ) poate duce la creșterea susceptibilității tuberculozei (TB), conform mecanismelor care sunt direct legate de hiperglicemie și insulinație celulară, precum și conform efectelor indirecte asupra funcției macrofagelor și limfocitelor, ceea ce reduce rezistența organismului. Scopul studiului. Determinarea frecvenței și a eficacității tratamentului bolii comorbide tuberculoză și diabet zaharat (TBC/DZ). Metode de cercetare. A fost efectuată o analiză retrospectivă a 1687 de fișe de observație clinică a pacienților (20152018) (f. №003 / o), care sunt înscrise în registrul bazei clinice a Dispensarului Regional de TBC din Cernăuți. Rezultate. După efectuarea unui studiu retrospectiv, am constatat că polimorfismul TB / DZ apare în 6,6% din cazuri. Concluzii. Conform rezultatelor studiului nostru, prevalența comorbidității TB / DZ este de 6,7% din eșantionul general. La 16,9% din cazurile de tuberculoză diagnosticată cu poli- și comorbiditate este înregistrat DZ. Comorbiditatea TB / DZ este predominantă la bărbați (79,9%), la vârsta de 45-70 de ani și se caracterizează prin mai mult de jumătate din cazuri cu formă clinică diseminată (58%).Сахарный диабет и туберкулез: Риск сочетания двух эпидеми

Intensive phase efficacy of injected drugs – isoniazid and rifampicin in the treatment of patients with lung tuberculosis and hepatobiliary pancreatic comorbidities

Background: One of the most important tuberculosis control action represents the effective anti-tuberculosis treatment. The standard regimens are associated with high level of side effects, especially at patients with hepatobiliary and pancreatic co-morbidities. Material and methods: There were studied clinical and laboratory indices of a total number of 60 new pulmonary tuberculosis cases, with proved hepatobiliary and pancreatic comorbidities, distributed in the 1st study group, consisted of 30 patients treated with the standard anti-tuberculosis treatment, all drugs being administrated orally and the 2nd control group, consisted of 30 patients, treated with the standard anti-tuberculosis treatment with injected forms of first line anti-tuberculosis drugs isoniazid and rifampicin. Results: The clinical improvement of the patient’s general state under the influence of intravenous use of isoniazid and rifampicin was confirmed by a lower expressiveness of intoxication and bronchopulmonary syndroms, as well as by a better radiological dynamics and higher rate of microscopic convertion at the end of intensive phase of the tuberculosis treatment. Biochemical disturbances due to tuberculosis treatment were less evident at the patients treated with intravenous isoniazid and rifampicin, confirmed by a better rehabilitation of mathematic indices of endogenous intoxication. Conclusions: Assessing the differences between the clinical and laboratory tolerance of tuberculosis drugs according to the way of administration, it was proved the importance of individualization of the standard treatment at patients with hepatobiliary and pancreatic disorders by intravenous use of isoniazid and rifampicin in intensive phase of the treatment, for improving the therapeutical effectiveness

Implementation of Foreign Experience in Employee Motivation into the Activity of Ukrainian Enterprises

The actual value of the issue in question lies in the new challenges present in the labor market and the transformation of public relations in connection with COVID-19, making it necessary to reconsider the mechanism of employee motivation, i.e. using the latest instruments for the utilization and management of labor resources. We believe that reasonable implementation of effective employee motivation instruments, developed by successful enterprises, will lead to highly productive work of employees at enterprises and increase the efficiency of human resources utilization. The article aims at analyzing the motivational models of the leading countries and to form the principles of implementing their experience in the business practice of Ukrainian enterprises. The research results in identifying popular instruments used abroad, which are most effective in the current situation in Ukraine, namely: motivating employees to innovative activity by evaluating the results obtained; employees involvement in the management, strategic planning and distribution of corporate profits; flexibility and social dimension of salaries and wages; scoring and rating employees’ performance; encouraging competition and teamwork. The principles of introducing an effective employee motivation model based on foreign experience are formed. It is concluded that if Ukrainian enterprises use employees’ motivation instruments that have proved their effectiveness abroad, then, if used systematically and holistically, they will bring economic growth to the enterprises and social development to the country, in general

Использование сиропа изониазида для профилактики туберкулеза у детей

Utilizarea izoniazidei sirop pentru prevenirea tuberculozei la copiiThe purpose of the study was to conduct a comparative analysis of the use of isoniazid in the form of syrup and tablet for the prevention of tuberculosis in children. Materials and methods. 114 children at risk who were on sanatorium treatment at Chernivtsi children’s sanatorium (Ukraine) were examined for tuberculosis. For chemoprophylaxis in children the drug “Isoniazid” was used: 61 children received the drug in the form of syrup (group 1), 53 - in tablet form (group 2). On the basis of Institute of Pneumology “Marius Nasta” (Romania) 83 children enrolled to the 1 group received preventive therapy with isoniazid in the form of syrup. Results. Significantly lower levels of total protein were reported in 1 group - by 9.6% than in patients in 2 group (р<0.05). Also significantly higher levels of bilirubin - by 17.2 %, ALT (alanine transaminase) - by 19 %, AST (aspartate transaminase) - by 22.4 % and thymol test - by 15.5 % were reported in 2 group compared with 1 group (p <0.05), evidencing that there are preconditions for the development of toxic hepatitis when using isoniazid in tablet form. It is well established that the changes in blood chemistry were much more pronounced in children who received isoniazid tablets and were increasing up to the completion of the course of chemoprophylaxis. Conclusions. The results of complex clinical, laboratory and instrumental study allow us to recommend “Isoniazid” in the form of syrup 100 mg / 5 ml as highly effective drug for the prevention of tuberculosis in children.Использование сиропа изониазида для профилактики туберкулеза у дете