Immunodiagnostic Tests in the Assessment of Specific Sensitization to <i>M. tuberculosis</i> in Children under the Current Epidemical Situation

The objective: to study the degree of specific sensitization according to the results of intradermal immunodiagnostic tests in children with different manifestations of tuberculosis infection under the current epidemic situation.Subjects and Methods. The degree of tuberculin sensitization was studied in 299 children from different age groups (0-14 years old) who were registered for dispensary follow-up in 2018-2019.Based on the results of a tuberculosis recombinant allergen test (TRA), the degree of specific sensitization was studied in children with tuberculin tests conversion (n = 102) and infected with Mycobacterium tuberculosis (MTB) for 2 years or more (n = 165) exposed to tuberculous infection in their families and from healthy environment, and 145 patients under 14 years old with local respiratory tuberculosis.Results. Moderate sensitization to tuberculin predominated in children with converted tuberculin test exposed to tuberculous infection in their families and those from healthy environments. According to the results of TRA test, a high degree of sensitization was observed 4.7 times more frequently in children with tuberculin test conversion exposed to tuberculosis in their families. In children from healthy environments, negative responses to TRA test were registered 2.4 times more frequently. In 73% of children infected with MTB, results of annual Mantoux tests didn’t differ much. Hyperergic reactions to TRA test in infected children exposed to tuberculous infection were 10 times more frequent than in those from healthy environments. A direct correlation was found between the high degree of sensitization to active M. tuberculosis and exposure to a tuberculosis case with a positive result of sputum test (χ2 < 0.001, p < 0.05). In the case of converted tuberculin test and infection with M. tuberculosis for 2 years or more, pronounced and hyperergic reactions to TRA test were registered with equal frequency and did not depend on the timing and duration of infection. A high risk factor and predictor of the disease development is high sensitization of the host to active M. tuberculosis which is found in patients with tuberculosis using TRA test six times more frequently versus Mantoux test (OR 5.951, 95% CI 3.548 and 9.981). The demonstrated results are important for the identification of children facing a high risk to develop active tuberculosis and preventive treatment prescription.

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ACTUAL ISSUES OF TUBERCULOSIS IN ADOLESCENTS EXPOSED TO TUBERCULOSIS INFECTION

Tuberculosis and lung diseases ◽

10.21292/2075-1230-2018-96-6-17-20 ◽

2018 ◽

Vol 96 (6) ◽

pp. 17-20 ◽

Cited By ~ 1

Author(s):

E. S. Ovsyankina ◽

L. V. Panova ◽

F. A. Poluektova ◽

A. Yu. Khiteva ◽

E. A. Viechelli

Keyword(s):

Health Education ◽

Life Quality ◽

Poor Performance ◽

Diagnostic Procedures ◽

Mantoux Test ◽

Skin Tests ◽

Recombinant Allergen ◽

Tuberculous Infection ◽

Hygienic Measures ◽

Close Relatives

The article characterizes respiratory tuberculosis in adolescents exposed to tuberculous infection. Exposure to tuberculosis in the family or when contacting close relatives makes the biggest contribution into development of the disease unless the patient is isolated from those exposed. Advanced and severe forms of tuberculosis with bacillary excretion are detected, compromising the life quality of adolescents. The main causes of late diagnostics are poor performance of TB services, primary medical units, low level of health education aimed at the increase of motivation to have planned medical examinations in the general population and to take relevant sanitary and hygienic measures in the sites of infection. Adolescents from the sites with bacillary excretion, and, first of all, if multiple or extensive drug resistant tuberculosis is detected, are to be considered a high priority group facing the risk to develop the disease with more frequent monitoring and deeper examination. In primary medical units, should any sings typical of tuberculosis be presented, it is sensible to add skin tests (Mantoux test and test with tuberculous recombinant allergen) to the minimum diagnostic procedures. Organizational, methodical and health education activities in the sites of infection are to be improved.

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The Physician’s Task and the Problem of Documentation

Methods of Information in Medicine ◽

10.1055/s-0038-1636642 ◽

1964 ◽

Vol 03 (01) ◽

pp. 11-19 ◽

Cited By ~ 4

Author(s):

A. Proppe

Keyword(s):

Statistical Evaluation ◽

Age Groups ◽

Diagnostic Methods ◽

Early Age ◽

Case Histories ◽

Lupus Vulgaris ◽

Pathological Conditions ◽

Clinical Methods ◽

Corpus Hippocraticum ◽

High Degree

SummaryCase histories suitable for statistical evaluation can be found even as far back as in the Corpus Hippocraticum. Such simple data as the patient’s age, body weight, size, the date of menarche, etc. are practically always included in the case records, and it is demonstrated that, when such data are recorded in a system of documentation suitable for mechanical sorting, it may enable us to draw conclusions of very great importance. Mechanical registration methods have revealed that, in the determination and recording of data as hitherto carried out. there has been a surprisingly large number of errors and a high degree of unreliability. This view has a considerable influence on modern clinical methods; it renders a more democratic relation between physician and patient necessary and makes clear the need for measures to enhance the reliability of diagnosis and treatment of pathological conditions. The author illustrates this view with reference to the mechanical falsification of the thesis of the proneness of early age groups to lupus vulgaris, furthermore with reference to the mechanical rationalization of modern routine diagnostic methods, to the constant surveillance of adverse effects on public health and to the protection against allergic reactions with the aid of recording systems of personal allergy and intolerance data with mechanical sorting and computer techniques.

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TO STUDY THE DYNAMICS OF IMMUNITY IN BLACK-AND-WHITE COWS DEPENDING ON AGE

Molochnoe i miasnoe skotovodstvo ◽

10.33943/mms.2020.33.88.011 ◽

2020 ◽

pp. 49-52

Author(s):

М.В. ДОВЫДЕНКОВА

Keyword(s):

Bactericidal Activity ◽

Phagocytic Activity ◽

Physiological State ◽

Age Groups ◽

Statistical Processing ◽

Natural Resistance ◽

Black And White ◽

Feeding Methods ◽

High Degree ◽

The Relationship

Проведена статистическая обработка сформированной базы данных показателей неспецифической резистентности MS «Excel» с целью изучения динамики иммунитета по параметрам бактерицидной, лизоцимной и фагоцитарной активности у крупного рогатого скота черно-пестрой породы разных возрастов. Было установлено, что средние значения показателей лизоцимной и бактерицидной активности у телят в 6 мес были ниже (47,89% и 49,09%, соответственно), чем у животных в 3—4 года (53,75% и 52,81%). Выведено уравнение регрессии, описывающее взаимосвязь между средними показателями фагоцитарной активности и возрастом при высокой степени достоверности (R2=0,90). Изменения лизоцимной и бактерицидной активности в зависимости от возраста были недостоверными (R2=0,58 и R2=0,49, соответственно). Установлена высокая корреляция между бактерицидной и лизоцимной активностью. Отмечена динамика изменения неспецифического иммунитета у коров различных возрастных групп. Создание баз данных и постоянный мониторинг основных показателей естественной резистентности в зависимости от различных факторов (породы, возраста, стадий лактации, кормления, способов содержания), которые влияют на данные показатели, необходимо для оценки физиологического состояния организма животных и их устойчивости к болезням. Statistical processing of the generated MS "Excel" on indicators of non-specific resistance database was carried out with the aim of studying the dynamics of the development of immunity in terms of bactericidal, lysozyme and phagocytic activity in black-and-white cattle of different ages. It was found that the average values of indicators of lysozyme and bactericidal activity in calves at 6 months were lower (47.89% and 49.09%, respectively) than in animals at the age of 3—4 years (53.75% and 52.81%). The equation of regression was derived, it describes the relationship between the average indicators of phagocytic activity and the age with a high degree of reliability (R2=0.90). The changes in lysozyme and bactericidal activity depending on age were dubious (R2=0.58 and R2=0.49, respectively). The high correlation between bactericidal and lysozyme activity was established. It was noticed that the cows of different age groups experienced the dynamics of changes in nonspecific immunity. The creation of databases and constant monitoring of the main indicators of natural resistance, depending on various factors (breed, age, stages of lactation, feeding, methods of keeping) that affect these indicators, is necessary for assessing the physiological state of the animals’ body of and their resistance to diseases.

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Suicidal Ideation Profiles in Patients with Fibromyalgia Using Transdiagnostic Psychological and Fibromyalgia-Associated Variables

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010209 ◽

2020 ◽

Vol 18 (1) ◽

pp. 209

Author(s):

Jorge L. Ordóñez-Carrasco ◽

María Sánchez-Castelló ◽

Elena P. Calandre ◽

Isabel Cuadrado-Guirado ◽

Antonio J. Rojas-Tejada

Keyword(s):

Suicidal Ideation ◽

High Risk ◽

Suicide Risk ◽

Fibromyalgia Impact Questionnaire ◽

Cross Sectional Study ◽

Psychological Pain ◽

Cross Sectional ◽

Psychological Variables ◽

Interpersonal Needs Questionnaire ◽

High Degree

Several studies have emphasized the heterogeneity of fibromyalgia patients. Furthermore, fibromyalgia patients are considered a high-risk suicide group. The ideation-to-action framework proposes a set of transdiagnostic psychological factors involved in the development of suicidal ideation. The present study aims to explore the existence of different subgroups according to their vulnerability to suicidal ideation through these transdiagnostic psychological variables and a set of variables typically associated with fibromyalgia. In this cross-sectional study, 151 fibromyalgia patients were assessed through the Revised Fibromyalgia Impact Questionnaire, Beck Depression Inventory-II, Plutchik Suicide Risk Scale, Interpersonal Needs Questionnaire, Defeat Scale, Entrapment Scale, Psychache Scale, and Beck Hopelessness Scale. A K-means cluster analysis identified two clusters, one (45.70%) according to a low vulnerability, and a second (54.30%) with a high vulnerability to suicidal ideation. These clusters showed statistically significant differences in suicidal ideation and suicide risk. However, no differences were observed in most socio-demographic variables. In conclusion, fibromyalgia patients who present a clinical condition characterized by a moderate-high degree of physical dysfunction, overall disease impact and intensity of fibromyalgia-associated symptoms, along with a high degree of perceived burdensomeness, thwarted belongingness, defeat, entrapment, psychological pain and hopelessness, form a homogeneous group at high risk for suicidal ideation.

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Organizations' Relative Degree of Exposure to Selection Discrimination Litigation

Public Personnel Management ◽

10.1177/009102600203100302 ◽

2002 ◽

Vol 31 (3) ◽

pp. 277-292 ◽

Cited By ~ 10

Author(s):

David E. Terpstra ◽

R. Bryan Kethley

Keyword(s):

High Risk ◽

Federal Court ◽

Court Cases ◽

Industry Type ◽

Government Sector ◽

Risk Of Exposure ◽

Primary Selection ◽

The Government ◽

High Degree ◽

Industry Sectors

This study examined nearly 400 federal court cases in which substantive, or primary, selection devices were legally challenged as being discriminatory. The findings indicated that the relative frequency of occurrence of discrimination charges varied for different types of organizations. Some industry sectors and some job types were associated with a much greater risk of exposure to litigation than others. For example, the government sector appeared to have a relatively high degree of exposure to selection discrimination litigation. The findings also indicated that the outcomes of the federal court cases (whether the ruling was for the defendant/employer or for the plaintiff) varied by industry type, job type, and type of discrimination charge. Specific recommendations are offered to organizations that operate in high risk industry sectors, and that have high risk job types, with an eye toward reducing the possibility of litigation.

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TREATMENT OF TUBERCULOUS PLEURAL EFFUSIONS WITH PARTICULAR REFERENCE TO ADRENAL CORTICOSTEROIDS

PEDIATRICS ◽

10.1542/peds.22.6.1074 ◽

1958 ◽

Vol 22 (6) ◽

pp. 1074-1087

Author(s):

Margaret H. D. Smith ◽

Nicholas Matsaniotis

Keyword(s):

Tuberculin Test ◽

Bed Rest ◽

Tuberculous Infection ◽

Pleural Effusions ◽

Pleural Biopsy ◽

Extensive Experience ◽

Antituberculous Drug ◽

Time Of Admission ◽

General Care ◽

Test Cultures

On the basis of our own experience with tuberculous pleural effusions in children as well as on the more extensive experience of other clinicians working with adult patients, we believe that adrenal corticosteroids, given simultaneously with adequate antituberculous drug therapy, not only exert no deleterious effect on the underlying tuberculous infection, but frequently hasten clinical and roentgenographic improvement. Six consecutive patients with tuberculous pleural effusions are here presented. Diagnosis was established with the aid of tuberculin test, cultures of gastric washings and pleural fluid, and pleural biopsy. Treatment included administration of INH, PAS and prednisone. The clinical and roentgenographic response was unusually prompt in the five patients with early effusions. On the basis of this experience we recommend the following treatment: INH (20 mg/kg/24 hr) for a period of at least a year, PAS (0.5 gm/kg/24 hr) for the same length of time; and prednisone (1.0 mg/kg/24 hr) for a period of about 4 to 6 weeks, with diminishing doses during the ensuing 2 weeks. The general care should be that given to any child with early active tuberculosis, including bed rest during the febrile period but rarely beyond it. If such treatment can be instituted early, the incidence of pleural adhesions, with ventilatory impairment and development of scoliosis, is probably lessened. The sixth patient, who was suffering from fibrocaseous pleurisy at the time of admission to our hospital, recovered slowly; in this case adrenal corticosteroid therapy appeared to exert no effect on the course of the disease.

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Pulmonary tuberculosis among men over forty

Epidemiology and Infection ◽

10.1017/s0022172400020246 ◽

1959 ◽

Vol 57 (4) ◽

pp. 367-385 ◽

Cited By ~ 1

Author(s):

Cecily M. Tinker

Keyword(s):

Royal College ◽

Age Groups ◽

The Elderly ◽

Older Age ◽

Personal Hygiene ◽

Tuberculous Infection ◽

Elderly Men ◽

Female Population ◽

Heavy Smoking ◽

Increased Risk

1. A review of the few studies so far made on the high mortality from tuberculosis among elderly men, and a consideration of the available statistics, indicate that urbanization is one of the principal factors responsible.2. In the present inquiry, which was confined to London, 445 newly diagnosed cases of tuberculosis in men over 40, together with the same number of paired controls, were studied by means of a questionnaire and of personal interview.3. It was found that the tuberculous patients differed significantly from the controls in the following characteristics; Scots, Irish, Welsh, or foreign nationality; single, widower or divorced; resident in common lodging houses or hostels; inadequate or special diet; history of gastrectomy; a winter cough; shortness of breath; insufficient sleep; and heavy drinking and smoking. On the other hand, overtime or night work, diabetes, rheumatoid arthritis, asthma, and mental illness were distributed fairly evenly in the two groups.4. Unfortunately no group of elderly women exists in this country living under the same sort of conditions as the elderly men studied here, so that it was impossible to determine how far the various factors considered were responsible for the high rate of late adult male tuberculosis. A study, however, of a population of established civil servants living under ordinary conditions revealed little difference between the observed rates of tuberculosis and those expected on the basis of national notification figures for men and women in the older age groups.5. It appears that a low standard of personal hygiene, associated especially with heavy smoking and drinking and residence in loading houses, predispose to the development of tuberculosis in the elderly male. Part of the evil effect of living in common lodging houses in particular may be due to the increased risk of exposure to tuberculous infection that it entails.6. It is tentatively concluded that the casual workers of an urbanized community are one of the principal reservoirs of tuberculous infection in large towns, and since there is no numerically comparable female population, this group, and its immediate male contacts, account in large measure for the difference between the male and female tuberculosis rates in the older age groups.This work was initiated during the tenure of a Prophit Scholarship of the Royal College of Physicians, and completed with the aid of a grant from the Medical Research Council.I am indebted to members of the Prophit Committee of the Royal College of Physicians for their support and encouragement, and most particularly to Dr G. S. Wilson, Director of the Public Health Laboratory Service, under whose guidance the work was carried out. Figures relating to the incidence of tuberculosis in the Civil Service are published by kind permission of Dr W. E. Chiesman, Treasury Medical Adviser, and Dr M. C. W. Long, Dr J. W. Parks, and Dr H. Stannus Stannus, whose departmental records were used to compute the figures.I am greatly indebted to the consultants and staff of the seventeen chest clinics who co-operated in the investigation, for their interest and help in tracing patients, and to the medical superintendents of numerous sanatoria and chest hospitals, and to the surgeons who permitted me to interview patients under their care as controls.I should like also to acknowledge the assistance received from the medical officers of health of the metropolitan boroughs who kept me informed of notifications from lodging houses in their areas, and supplied information about the accommodation.

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High-risk HPV genotypes and cervical lesions association in postmenopausal women

European Journal of Public Health ◽

10.1093/eurpub/ckab120.044 ◽

2021 ◽

Vol 31 (Supplement_2) ◽

Author(s):

Ana Rita Fernandes Miranda da Costa ◽

Cláudia Sousa ◽

Erica Isidoro ◽

Regina Silva ◽

Cristiana Mourato

Keyword(s):

Cervical Cancer ◽

High Risk ◽

Postmenopausal Women ◽

Age Groups ◽

Low Grade ◽

High Grade ◽

Cervical Lesions ◽

Intraepithelial Lesion ◽

The Bethesda System ◽

High Risk Hpv

Abstract Background Persistent infection by high-risk Human Papillomavirus (hrHPV) are the major cause of cervical cancer. Studies report disparities in the incidence of infection and the various genotypes of this virus in different age groups, suggesting a higher frequency of hrHPV in young women and low-risk subtypes being predominant in older women. This study aimed to investigate the incidence and distribution of hrHPV genotypes in postmenopausal women as well as the correlation with the cytological findings. Methods 16 859 women, aged 50–64 years, performed cervical cancer screening test in Friuri Venezia Giulia region, Italy. The infection was evaluated by the Polymerase Chain Reaction methodology and the positive samples were evaluated by Liquid Based Cytology according to the Bethesda System from 2014. A statistical analysis was performed to study the molecular and cytological data of this population. Results hrHPV infection were found in 5.8% of the women and 78.3% of these were caused by hrHPV other than HPV16 and HPV18 (). Also, 65.7% of the positive samples were negative for intraepithelial lesion or malignancy while low grade squamous intraepithelial lesion was the most frequent (22.4%). There was an increase in the number of high-grade intraepithelial lesions in the presence of HPV16 compared to that recorded when this genotype was absent (20.8% vs. 8.5%). No cervical cancers were detected. Conclusions Infection with hrHPV is uncommon in postmenopausal women and it is mostly caused by subtypes less associated with the development of cervical cancer. Yet, HPV16 infection triggers the development of high-grade lesions.

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Features of in-hospital clinical course of pulmonary embolism in patients of different age groups

CARDIOVASCULAR THERAPY AND PREVENTION ◽

10.15829/1728-8800-2020-2423 ◽

2020 ◽

Vol 19 (5) ◽

pp. 2423

Author(s):

E. A. Shmidt ◽

S. A. Berns ◽

A. G. Neeshpapa ◽

P. A. Talyzin ◽

I. I. Zhidkova ◽

...

Keyword(s):

Pulmonary Embolism ◽

High Risk ◽

Clinical Course ◽

Diastolic Pressure ◽

Age Groups ◽

Statistical Processing ◽

Severity Index ◽

Cardiovascular Comorbidity ◽

Vein Thrombosis ◽

Comorbidity Status

Aim. To study the clinical course and management of patients with pulmonary embolism (PE) of various age groups hospitalized in a cardiology hospital.Material and methods. This prospective single-center study in the period from 2016 to 2018 included 154 patients with PE verified by computed tomography. Statistical processing was conducted using the MedCalcVersion 16.2.1 software package (Softwa, Belgium).Results. In all groups, female patients dominated, but the highest number of women (70,7%) belonged to the group of senile patients, while in the group <60 years, only half of patients with PE were women. Comorbid cardiovascular disease and deep vein thrombosis was diagnosed in eldest patients significantly more often than in those <60 years of age. The highest prevalence of cancer and recurrent PE were identified in the group of elderly patients. Thrombolytic therapy was performed most often in patients 60-75 years old, since these patients had a high risk of 30-day mortality according to Pulmonary Embolism Severity Index, but did not have severe comorbidities, as patients older than 75 years. An increase of right atrium size was found in the group of elderly and senile patients in comparison with patients <60 years. The highest pulmonary artery systolic and diastolic pressure was observed in the patients older than 75 years.Conclusion. In the Kemerovo Oblast, PE most often develops in patients aged 60-75 years and is characterized by a more severe clinical course compared with patients younger than 60 years. Patients over the 60 years of age have severe cardiovascular comorbidity status, atrial fibrillation/flutter and recurrent PE. Surgical treatment for senile patients is limited due to the high risk of postoperative complications, which specifies high mortality. Patients <60 years of age are a third of all patients hospitalized with PE. They have a low risk of mortality, but have an unfavorable course of the hospital period.

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