1,721,064 research outputs found
The assessment of different tuberculosis-related features in Moldova regions
Full text linkBackground: Tuberculosis represents a social-related disease and for identifying the priority interventions for reducing its impact must be identified themain disparity features of patients.
Material and methods: Global Competitiveness Report and Report of the National Centre for Health Management were used. The clinical study wasretrospective, randomized, selective, and included 263 new pulmonary TB cases registered in three different Moldovan regions: Chisinau (center), Balti(north) and Cahul (south).
Results: Attributable risk identified that in Chisinau compared to Balti predominated patients in economical vulnerable state, without health insurance,GeneXpert MTB/ Rifampicin sensible and those who successfuly finished the treatment. In Balti compared to Chisinau predominated chronic alcoholabusers, co-morbid patients, severe pulmonary tuberculosis, direct addressing to the hospital, patients infected with GeneXpert MTB/Rifampicin resistantstrains of Mycobacteria. The major differences between Chisinau and Cahul groups, with predominance in Chisinau were homeless, co-morbid patientsand those who successfully finished the treatment course. In Cahul predominated patients with rural residence, direct addressed to the regional hospitaland severe forms of tuberculosis. Comparing the Balti and Cahul groups was established the predominance in Cahul of patients with rural residence, ineconomically vulnerable state and patient’s detection by general practitioner. In Balti predominated co-morbid patients, alcohol abusers, patients withsevere forms of tuberculosis.
Conclusions: Reduction of health care inequality will be achieved through social assistance of vulnerable groups and improvement of the general public life. demonstrates that in case of nosocomial infection of patients with acutecerebrovascular accident prevalent is nosocomial infection of the respiratory tract
Treatment failure in tuberculosis
Full text linkCatedra Pneumoftiziologie USMF „ N.Testemiţanu”,
Dispensarul Municipal de FtiziopneumologieThe effectiveness of DOTS antituberculous treatment achieves only 70% in our country, instead of 85% recommended by OMS. The epidemiological indexes are influenced by the social categories of patients. We studied the characteristic of TB patients with therapeutic failure and the risk factors of the development of therapeutic failure among the new detected TB patients.
Eficienţa strategiei DOTS în ţara noastră este estimată cu un succes terapeutic de pînă la 70%, în comparaţie cu 85% recomandată de OMS. Indicatorii epidemiologici ai TB sunt influenţaţi de categoriile sociale ale pacienţilor. Am studiat particularităţile bolnavilor de TB cu eşec terapeutic şi factorii de risc în dezvoltarea eşecului la cazurile noi de TB pulmonară
Особенности борьбы с туберкулезом и человеческие ресурсы
Full text linkUniversitatea de Stat de Medicină şi Farmacie
Nicolae TestemiţanuTuberculosis control is a priority for the health system of the
Republic of Moldova. In 2016, the National Tuberculosis Control
Program was adopted, according to the objectives of the worldwide implemented End TB strategy. The evaluation of the Program’s performance indicators established a positive dynamics;
however the rate of patients with severe forms and low incidence
of drug-resistant patients established barriers for the early detection, low activity in high risk groups and insuffi cient use of new
diagnostic methods. The high rate of therapeutic success was
conditioned by the exclusion of the drug-resistant tuberculosis
cohort, and the reduced mortality was endangered by the number
of patients diagnosed after death. The proportion of the TB-HIV
varied according to the regions, the maximum being in the north
of the country. The large number of hospital beds associated with
long-term hospitalization conditioned a fi nancial burden and
high risk of nosocomial infection transmission. The precarious
mechanism of tuberculosis patient centered care was established
an impediment for ensuring an optimal therapeutic efficacy.Борьба с туберкулезом является одним из приоритетов
здравоохранения страны. В 2016 году была утверждена Национальная Программа по борьбе с туберкулезом, которая
внедрила цели. Стратегии End TB. Оценка основных показателей эффективности Программы выявила положительную
динамику, однако высокий процент больных с тяжелым
течением туберкулеза и значительная доля пациентов с
лекарственной устойчивостью демонстрируют наличие
препятствий в обследование групп риска и недостаточное
использование новых методов диагностики. Высокий показатель успешности лечения был обусловлен исключением
больных с лекарственной устойчивостью, а снижение
смертности включало большое число пациентов с диагнозом,
установленным после смерти. Доля ТБ-ВИЧ варьировала в
зависимости от регионов, самый высокий уровень выявлен
на севере страны. Большое число больничных коек, связанных с длительной госпитализацией, обусловливает высокие
финансовые затраты и риск внутрибольничной инфекции.
Несовершенный подход к пациенту с туберкулезом является
препятствием в обеспечении оптимальной терапевтической
эффективности
Oxidative stress and inflammation biomarkers in pulmonary tuberculosis
Full text linkBackground: Tuberculosis outcome and clinical features of the infection are influenced by the degree of the multiplication of mycobacterias, host’s defense mechanisms and the organism’s capacity to fight through the antioxidant mechanisms against the aggression of the oxidative stress. The aim of the study was to assess the oxidative stress and inflammatory biomarkers in pulmonary tuberculosis.
Material and methods: A prospective study, which included 46 patients with pulmonary tuberculosis and 36 healthy persons determined according to the clinical and biochemical criteria, was performed. The oxidative stress was assessed through the level of the advanced oxidation protein products, advanced glycation end-products, fibrinogen, amino acid catabolic products, activity of N-acetyl-β-D-glucosaminidase. The determination of the total antioxidant activity of plasma was performed through ABTS and CUPRAC methods. IL-8 and TNF-α were assessed using analysis kits of BOSTER (USA) producer.
Results: Was established high level of the oxidative stress following the assessment of the concentration of the advanced oxidation protein products, advanced glycation end-products, fibrinogen, N-acetyl-β-D-glucosaminidase, urea and creatinine. High concentration of amino acid catabolic products was attributed to the nephrotoxic properties of the medication. Was identified high level of the plasma total antioxidant activity and antioxidant compounds. Cytokines concentration IL-8 and TNF-α was several times higher than in the control group and they were assessed as specific biomarkers.
Conclusions: High level of the protein peroxidation, advanced glycation end-products, fibrinogen, protein catabolism compounds, pro-inflammatory cytokines – IL-8 and TNF-α confirmed the boosting of the oxidative stress. The elevated total antioxidant activity and antioxidant proteins demonstrated the organism’s capacity to redress the oxidative aggression
Aлгоритм оценки риска неудачного лечения туберкулеза легких
Full text linkCatedra Pneumoftiziologie, IP USMF Nicolae TestemiţanuSummary.
R Moldova reports the highest incidence of tuberculosis (114,3/100.000)
in European Regions, the lowest
treatment success rate (52,3%) and
the highest treatment failure rate
(2009-6,2%, 2010-19,6%, 2011-
3,6%). Using, a study group of 201
new pulmonary TB cases with treatment failure and a control group of
105 new pulmonary TB cases cured,
were evaluated risk factors for antituberculosis treatment failure and
was performed an algorithm of risk
estimation of treatment failure.Резюме.
Р. Молдова подтверждает самый
высокий уровень заболеваемости
туберкулезом (114,3/100.000), самый низкий уровень эффективности результата лечения (52,3%) и
самый высокий уровень неудачного
лечения туберкулеза легких (2009 –
6,2%, 2010 – 19,6%, 2011 – 3,6%) в
Европейском Регионе. Были изучены причины неудачного лечения
туберкулеза легких как факторов
риска у основной группы, составленной из 201 нововыявленных
больных с неудачным лечением и
соответственно у контрольной
группы, составленной из 105 нововыявленных больных с удачным
лечением. Был составлен алгоритм
оценки риска неудачного лечения
для использования пневмофтизиатрами
Caracterul manifestărilor imune ale bolnavilor de tuberculoză pulmonară cu eşec terapeutic
Full text linkThe article prezents results of investigation of immuological system and natural resistance at 16 new cases with pulmonary tuberculosis with treatment failure. It was determined the cauzal relation between degree of immuological disturbances, absence of immunomodulator treatment and DOTS failure. The combination DOTS and immuopathogenetical treatment improves and increase the treatment effectiveness
Factorii de risc socio-economici ai eşecului tratamentului tuberculozei pulmonare şi rolul lucrătorului asistenţei medicale primare în depistarea lor
Full text linkCriza socio-economică instalată în anii 1990, determină cea mai joasă rată a succesului tratamentului (52,3%) şi cea mai înaltă rată a eşecului (19,6%). Studiul epidemiologic al 198 de bolnavi cu eşec şi 105 cu succes terapeutic a determinat că factorii puternic asociaţi cu eşecul sunt: detenţia, utilizarea drogurilor, alcoolismul, fumatul, condiţiile de trai nesatisfăcătoare, reşedinţa urbană, nivel jos de şcolarizare, şomajul. Bolnavii cu risc social sunt depistaţi de medicul de familie, pe cale pasivă, cu simptomatologie subacută, din focar tuberculos, cu boli asociate
Risk factors segregation of tuberculosis patients: retrospective, cohort study
Full text linkCatedra de pneumoftiziologie, Universitatea de Stat de Medicină și Farmacie
”Nicolae Testemiţanu”, Chișinău, Republica MoldovaRezumat
Introducere. Tuberculoza reprezintă o boală infecţioasă
asociată determinanţilor sociali ai sănătăţii, ale căror neluare
în consideraţie conduce la deficienţe în controlul maladiei.
Material și metode. A fost realizat un studiul retrospectiv,
de tip cohortă, care a inclus 668 de cazuri, înregistrate în municipiul Chișinău în perioada anului 2015. Criteriile de includere au constituit: vârsta peste 15 ani, diagnostic de ,,tuberculoză şi consimţământ informat semnat.
Rezultate. Segregarea pacienţilor conform particularităţilor sociale și economice a stabilit următoarele grupuri cu risc
sporit de îmbolnăvire: social (absenţa poliţei de asigurare, şomajul, condiţiile de de trai precare), biologici (vârsta cu risc
ftiziogenic, statutul comorbid, deprinderi habituale cu risc
morbid) și alte grupuri minore (contacţi, migranţi, persoane
cu istoric de detenţie). Factorii de risc au contribuit la depistarea tardivă a fiecărui al doilea bolnav. Rata mică a succesului
terapeutic este asociată cu o rată înaltă a deceselor.
Concluzii. Stratificarea pacienţilor în funcţie de grupul de
risc permite asigurarea unei abordări individualizate, centrate
pe pacient.Abstract
Introduction. Tuberculosis is an infectious disease associated to the health determinants and their lack of approach
contributes to the failure of disease control.
Material and methods. A retrospective, cohort type study
was performed using 668 patients registered in Chisinau during 2015. Including criteria were: age more than 15 years old,
patient diagnosed with tuberculosis and the signed informed
consent.
Results. Patients segregation according to the social and
economic features established several risk groups: social (lack
of health insurance, unemployment and poor living conditions), biologic (high risk phtysiogenic age, comorbid state,
harmful habits with morbid risk) and other minor groups
(contacts with infected people, migrants, individuals with history of detention). Risk factors contributed to the late detection of every second patient. Low treatment success rate was
associated with a high rates of death.
Conclusions. The patients stratification according to the
risk proportion permits the establishment of the patient-centered care and application of an individualized approach
Immune reactivity during antituberculosis treatment in pulmonary tuberculosis with treatment failure
Full text linkCatedra Pneumoftiziologie, USMF „Nicolae Testemiţanu”Immunological study was performed to 78 new pulmonary tuberculosis cases, before and
at the end of intensive phase of antituberculosis treatment. Results of the study group consisted
of 54 cases with treatment failure, were compared with a control group of 24 cases, cured with
the standard regimen. A healthy group of 50 individuals, was used as sample group for
comparison. It was established, that the celular and humoral immunoreactivity indices were more
disturbed in the study group, and could be consideretad as predictors for treatment failure.
Studiul reactivităţii imune a fost efectuat la 78 de bolnavi de tuberculoză pulmonară caz
nou înaintea iniţierii tratamentului antituberculos şi la sfîrşitul fazei intensive de tratament,
realizate în condiţii de stationar. Rezultatele testelor imunologice ale eşantionului de studiu
format din 54 de bolnavi de tuberculoză pulmonară, care au evoulat cu eşec terapeutic au fost
comparate cu rezultatele a eşantionului de control, format din 24 bolnavi de tuberculoză
pulmonară vindecaţi cu tratamentul standard antituberculos. S-a demonstrat, că majoritatea
indicilor reactivităţii imune celulare şi umorale au fost modificaţi mai intens şi mai rigid în
eşantionul de studiu, putînd fi consideraţi perdicitivi pentru eşecul terapeutic
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