Vol 67, No 11 (2012)

PHTHISIOLOGY: CURRENT ISSUES
THE ACHIEVEMENTS AND THE WAY OF INNOVATIVE DEVELOPMENT ОF PHTHISIOLOGY
Erokhin V.V.
Abstract
.
Annals of the Russian academy of medical sciences. 2012;67(11):4-8
views
CHEMOTHERAPY OF TUBERCULOSIS: PROBLEMS AND PERSPECTIVES
Vasil’eva I.A., Samoilova A.G., Ergeshov A.E., Bagdasaryan T.R., Chernousova L.N.
Abstract

Challenges of tuberculosis chemotherapy under conditions of high drug resistant (DR) tuberculosis burden are discussed. Ultimate results of treatment by standard regimens of 1658 patients with new tuberculosis cases and relapses were analyzed. Favorable ultimate results were observed among both patients with new tuberculosis cases and relapses having drugs sensitivity. Efficacy of tuberculosis treatment by standard regimens of chemotherapy is decreasing as a result of DR amplification. Risk factors of unfavorable ultimate result among pulmonary tuberculosis patients are primary resistance to isoniazid (OR =2,1) and multiple drug resistance of M. tuberculosis (OR =8,0). Earlier onset of treatment and correct individual therapy with second line drugs as a result of rapid methods of DR tuberculosis diagnostics are those approaches which provide the best therapeutic effect among multiple drug resistant tuberculosis patients both in culture conversion (97,7%) and cavity closure rate (82,7%).

 

Annals of the Russian academy of medical sciences. 2012;67(11):9-14
views
OPTIMISATION OF DIAGNOSTICS AND DIFFERENTIAL DIAGNOSTICS DISSEMINATED PULMONARY TUBERCULOSIS
Demikhova O.V., Karpina N.L., Lepekha L.N., Bagirov M.A., Amansakhedov R.B.
Abstract

One of the reasons of dramatic situation with tuberculosis in Russia is untimely diagnostics of tuberculosis. The aim of the study was to identify the causes of diagnostic mistakes when we deal with disseminated pulmonary tuberculosis at current stage and to modernize the diagnostic process. The analysis of the diagnostic activity of the consultative diagnostic center of Central Tuberculosis Research Institute of Russian Academy Medical Sciences for 2011 was performed with special attention on the results of the survey of 505 patients with pulmonary dissemination. The frequency of discrepancies of disseminated pulmonary tuberculosis diagnostics was 96,1%. Based on the studies carried out the main causes diagnostic mistakes in patients with disseminated pulmonary tuberculosis were determined. New directions of improving of tuberculosis diagnostics were developed: overall high-technology examination of patient, adherence to the diagnostic procedure, developed by consultative diagnostic center of Central Tuberculosis Research Institute(CTRI), timely performing fiber-optic bronchoscopy with complex biopsy and diagnostic surgery procedures, further training of primary health care doctors. Implementation of proposed activities will significantly (by 3–5 times) reduce the time for diagnostics of respiratory system disease.

 

Annals of the Russian academy of medical sciences. 2012;67(11):15-21
views
SELECTIVE EFFECTS OF PULMONARY SURFACTANT ON VARIOUS SUBPOPULATIONS OF ALVEOLAR MACROPHAGES IN THE MODEL OF EXPERIMENTAL TUBERCULOSIS
Erokhin V.V., Lepekha L.N., Erokhina M.V., Bocharova I.V., Kurynina A.V., Onishchenko G.E.
Abstract

Pulmonary surfactant is necessary component for maintenance of high level of phagocytic activity of alveolar macrophages. Tuberculosis inflammation reduces the production of surfactant by type II cells and phagocytic activity of alveolar macrophages. The effects of exogenous pulmonary surfactant on the ultrastructural changes of various subpopulations of alveolar macrophages were studied by TEM-method. For investigations the bronchial alveolar lavage fluid from guinea pigs infected of M. tuberculosis and treated by isoniazid or isoniazid + exogenous pulmonary surfactant were used. It was shown that isoniazid + exogenous pulmonary surfactant normalizes the heterogeneous population of alveolar macrophages providing stimulating effects on their maturation and phagocytic activity more effectively than isoniazid therapy.

 

Annals of the Russian academy of medical sciences. 2012;67(11):22-28
views
FEATURES ОF METABOLIC ACTIVITY ОF VASCULAR ENDOTHELIUM IN PATIENTS WITH PULMONARY TUBERCULOSIS
Kaminskaya G.O., Abdaullaev R.Y., Komissarova O.G.
Abstract

81 patients with active pulmonary tuberculosis were investigated. The morpho-functional status of vascular endothelium was evaluated by plasma levels of stable metabolites of nitric oxide, endothelin-1 and von Willebrand factor antigen. Typical increase of endothelin-1 in positive correlation with systemic inflammatory response syndrome (SIRS) expression was established. Nitric oxide level decreased in patients with chronic and severe course of disease. Decrease of nitric oxide level was not associated with SIRS but was consequence of specific intoxication. von Willebrand factor antigen decreased in patients with recent and limited spread of tissue damage but increased progressively with intensity of SIRS. This complex of changes (contrast shifts of nitric oxide and endothelin-1 and von Willebrand factor antigen increase) manifested in endothelium metabolic dysfunction syndrome and developed pre-conditions for microcirculation disturbances.

Annals of the Russian academy of medical sciences. 2012;67(11):29-33
views
CYTOLOGIC FEATURES ОF BRONCHOALVEOLAR LAVAGE IN EVALUATION OF COURSE OF EXOGENOUS ALLERGIC ALVEOLITIS
Lepekha L.N., Aleksandrova E.A., Evgushchenko G.V., Makar'yants N.N., Lovacheva O.V.
Abstract

Application of complex of modern cytologic methods of research bronchoalveolar lavage allowed to allocate most characteristics of development of lymphocytic and macrophagic reaction of bronchial tree in different course of exogenous allergic alveolitis. The most indicative in assessment of origin of exogenous allergic alveolitis development is the characteristics of macrophagic population. In acute course of exogenous allergic alveolitis the considerable number of young activated and non-activated macrophages, increased number of mature phagocytes is observed. Even more significant increase of phagocytic macrophages is observed at dissemination which is primarily is connected with participation of these cells in lymphocytic apoptosis which takes place in high percentage of lymphocytes (up to 49%). Increased number of mature phagocytes is observed at chronic course of exogenous allergic alveolitis that is an important diagnostic pattern of this option of development of exogenous allergic alveolitis in association with the lowest T-helpers/T-supressors index.

 

Annals of the Russian academy of medical sciences. 2012;67(11):34-38
views
NEW THERAPY SCHEMES FOR ACUTE, SUBACUTE AND CHRONIC VARIANTS OF EXTRINSIC ALLERGIC ALVEOLITIS
Makar'yants N.N., Shmelev E.I.
Abstract

In order to improve treatment of patients with exogenous allergic alveolitis morphologically different variants of the disease, i.e. acute, subacute and chronic were identified and confirmed. For each variant of exogenous allergic alveolitis new therapy schemes were proposed. The study included 74 patients who were divided into 5 groups. In the first group with acute exogenous allergic alveolitis inhalation glycocorticosteroids in high doses in combination with plasmapheresis were prescribed, in the second group standard therapy with systemic glycocorticosteroids was prescribed. The third and the fourth group consisted of patients with subacute exogenous allergic alveolitis. The protracted ambroxol inhalation using nebulizers and the reduced dose of systemic glycocorticosteroids were used in the third group; and the standard dose of systemic glycocorticosteroids was used in the fourth. The fifth group consisted of patients with chronic exogenous allergic alveolitis, who received the standard dose of glycocorticosteroids and cytostatic drugs. After one month of therapy, it was ascertained that the use of high doses of inhalation glycocorticosteroids in combination with plasmapheresis in patients with acute exogenous allergic alveolitis led to significant improvements in clinical and CT presentation, physical activity tolerance, as well as the use of systemic glycocorticosteroids. The use of ambroxol inhalation in patients with subacute exogenous allergic alveolitis led to a significant improvement in clinical symptomatology, functional parameters and CT presentation, thus enabling to reduce the dose of glycocorticosteroids used and to avoid unwanted side effects.

 

Annals of the Russian academy of medical sciences. 2012;67(11):39-44
views
PREVENTION OF TUBERCULOSIS: CURRENT APPROACHES TO DEVELOPMENT OF VACCINES
Stukova M.A., Zabolotnykh N.V., Vinogradova T.I., Gergert V.Y., Apt A.S., Erokhin V.V., Kaprelyants A.S., Yablonskii P.K., Kiselev O.I.
Abstract

This review is focused on recent advances in development of new vaccines for the prevention of tuberculosis. The main reasons for lack of BCG vaccine efficacy in different populations and geographic regions are presented. Design of new vaccines based on live modified strains of Mycobacterium bovis BCG, attenuated strains of Mycobacterium tuberculosis, recombinant proteins and viral vectors is considered in the specific examples. The usage of the heterologous «prime-boost» vaccination strategy against tuberculosis is discussed.

 

Annals of the Russian academy of medical sciences. 2012;67(11):45-52
views
SHORT MESSAGES
IMPACT OF SUBCLINICAL PRIMARY HYPERPARATHYROIDISM ON CARDIOVASCULAR MANIFESTATIONS OF ESSENTIAL ARTERIAL HYPERTENSION
Iskenderov B.G., Sisina O.N.
Abstract

At 95 patients with essential arterial hypertension features of structural and functional remodeling of left ventricular and humeral artery depending on a level parathyroid hormone in blood are studied. It is shown that while increasing of plasma parathyroid hormone level frequency and expressiveness of left ventricular and humeral artery remodeling increases whereas diastolic function and endothelium-dependent vasodilatation considerably decrease. Subclinical primary hyperparathyroidism in patients with essential arterial hypertension is detected in 22,1% of cases.

 

Annals of the Russian academy of medical sciences. 2012;67(11):53-58
views
THE ROLE OF INTERLEUKIN-1 AND ASSOCIATED CYTOKINES IN GASTRIC CARCINOGENESIS
Matveeva L.V., Mosina L.M.
Abstract

This review presents detailed analysis of scientific data on influence of the associated with interleukin-1 cytokines on the development of malignant tumors of stomach with the definition of spectrum of diagnostic and therapeutic possibilities. Cytokines associated with interleukin-1 directly and indirectly involved into gastric carcinogenesis. Implementation of pro- and contreoncogenic effects depends on many factors. The serological and genetic criteria changes of interleukin-1 have high diagnostic value and prognostic significance opening new differential approaches to the treatment of precancer conditions and gastric cancer.

 

Annals of the Russian academy of medical sciences. 2012;67(11):59-65
views

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies