scholarly journals Mechanisms of implementation of osteopenic conditions in patients with combined course of chronic pancreatitis and hypertensive disease

2018 ◽  
Vol 42 (4) ◽  
pp. 36-41
Author(s):  
T. I. Viun
Keyword(s):  
Chronic Pancreatitis ◽  
Acid Phosphatase ◽  
Treatment Group ◽  
Bone Tissue ◽  
Biochemical Markers ◽  
Comparison Group ◽  
Metabolic Disturbances ◽  
Hypertensive Disease ◽  
Total Acid ◽  
Vdr Gene

The comorbidity of chronic pancreatitis (CP) and hypertensive disease (HD), which are often combined with each other, can be considered as predictor states of the complication formation. This is due to the intersection of individual pathogenic links, which are enhanced by their combination. As such a complication, it is possible to consider osteoporotic conditions, leading to metabolic disturbances of bone tissue with quantitative and qualitative changes. The emergence of secondary osteoporosis (SO) is not only phenotypically but also genetically conditioned, which is the basis for studying the gene aberrations of “osteopenically directed genes” and determining the content of SO biochemical markers. Aim of study: to establish the features of the comorbid course of CP and hypertension, to optimize the diagnosis of osteoporotic conditions by studying the content of biochemical markers of OP (total acid phosphatase (TAP) and tartrate-resistant acid phosphatise (TRAP)) and polymorphism of the vitamin D receptor genes (VDR). Materials and methods of research. To solve this problem, 110 patients with CP were examined and further divided into 2 groups: treatment group — 70 persons with CP and hypertensive disease (HD), and the comparison group — 40 patients with isolated CP. These groups were representative by age and sex. The condition of bone tissue was studied in assessing the content of indicators of total acid phosphatase (TAP) and non-prostatic acid phosphatase (TRAP) in blood serum. At the same time, VDR was determined. Results. It was found that the vast majority of patients in the treatment group (84.3%) had an unfavourable B-allele; against the comparison group — 77.5% of events. Changes in the VDR gene polymorphism affected the incidence of the osteoarticular system (CCP, χ2 = 20.81, p <0.01) and had a statistically significant relationship in the distribution of alleles between groups (CCP, χ2 = 30.08, p <0.01). The parameters of TAP and TRAP in patients with combined course of HP and CP were 8.7 ± 2.3 U/L and 5.1 ± 2.3 U/L, respectively, and in the comparison group — 6.9 ± 3.0 U/L and 3.5 ± 2.1 U/L. Thus, the content of TAP and TRAP exceeded the control in the treatment group by 2.5 (TAP) and 1.9 (TRAP) times (p<0.01) and in the comparison group by 2.0 (TAP) and 1.3 TRAP) times (p<0.01), which allowed us to state the development of osteopenic conditions. The distribution of alleles of the VDR gene was characterized by the predominance of the B-allele and was “supported” by changes in the biochemical markers of osteoporosis, which led to the development of osteopenicconditions in such individuals. Thus, the combination of HP and CP is an unfavourable factor in the development of osteoporosis and the basis for early detection of osteoporetic changes. Conclusions. In the combined course of CP and arterial hypertension, there is an increase in the number of persons with the B-allele of the VDR gene (84.3% of cases), the carriers of which have a high risk of osteopenia. With the comorbidity of CP and HD, there are fluctuations in the content of TAP and TRAP, correlating with VDR. Increase in the content of TAP and TRAP in patients with CP and HD often occurs against the background of an unfavourable B-allele of the VDR gene. Combined course of CP and HD is the basis for early diagnosis of osteoporotic complications.

scholarly journals BIOMARKERS OF OSTEO-DEFFICIENCY IN THE COURSE OF SECONDARY OSTEOPOROSIS IN PATIENTS WITH COMORBID CHRONIC PANCREATITIS AND ARTERIAL HYPERTENSION

2020 ◽  
Vol 20 (4) ◽  
pp. 16-20
Author(s):  
T.I. Viun ◽  
L.M. Pasieshvili ◽  
S.V. Viun ◽  
A.S. Marchenko ◽  
O.V. Karaya
Keyword(s):  
Chronic Pancreatitis ◽  
Acid Phosphatase ◽  
Arterial Hypertension ◽  
Comparison Group ◽  
Practical Importance ◽  
Main Group ◽  
Secondary Osteoporosis ◽  
Control Group ◽  
Tartrate Resistant Acid Phosphatase ◽  
Detection Of Biomarkers

The prevalence of comorbidities has been growing for the last decades. Therefore, the detection of biomarkers for diagnostic and prognostic purposes is of great practical importance. The aim of this study was to assess the biomarkers of osteo-defficiency in the course of secondary osteoporosis in patients with comorbid chronic pancreatitis and arterial hypertension. We examined 110 patients with chronic pancreatitis: 70 of them had comorbid hypertension, and 40 patients were found as having no comorbidities. The age of patients ranged from 33.2 ± 2.1 (main group) and 32.9 ± 3.1 years (comparison group); women predominated (72.9% and 70%, respectively). The control group includes 78 healthy individuals of the same age and sex. Diagnostic investigation included studying clinical and anamnestic characteristics of patients (duration of the disease, manifestations of the course, frequency of recrudescence, fractures) and biochemical parameters of bone metabolism: osteocalcin, total bone phosphatase and tartrate-resistant acid phosphatase and the establishment of correlations between these parameters and incidence of complications. It was found that in the isolated course of chronic pancreatitis there is a high (R = 0.60) statistically significant (p <0.01) correlation between the levels of osteocalcin and pancreatic elastase-1. A negative statistically significant (p <0.01) mean correlation (R = -0.49) was found between the content of tartrate-resistant acid phosphatase and age of the patients having comorbidity of chronic pancreatitis and hypertension, as well as there is a moderate correlation between the content of tartrate-resistant acid phosphatase and the duration of hypertension, which is statistically significant (R = 0.36, p <0.01). The levels of total bone phosphatase and tartrate-resistant acid phosphatase in the main group exceeded the reference values in 2.5 and 1.9 times respectively (CMU; U = 866.0; p <0.01), while in the comparison group were 2 times (total bone phosphatase) and 1.3 times higher (tartrate-resistant acid phosphatase) times, respectively (CMU; U = 821.0; p <0.01) that enables to diagnose the development of osteopenic conditions. That is, the combined course of chronic pancreatitis and hypertension should be considered as unfavourable tandem in the development of secondary osteoporosis and requires early osteoporotic screening.

scholarly journals STUDY OF BIOCHEMICAL MARKERS’ CONTENT OF BONE TISSUE METABOLISM IN THE ORAL LIQUID OF PATIENTS WITH GENERALIZED PERIODONTITIS

2020 ◽  
pp. 10-15
Author(s):  
I.V. Vozna ◽  
A.V. Samoilenko ◽  
S.V. Pavlov
Keyword(s):  
Vitamin D ◽  
Periodontal Disease ◽  
Vitamin D Deficiency ◽  
Bone Tissue ◽  
Biochemical Markers ◽  
Oral Fluid ◽  
Comparison Group ◽  
Study Group ◽  
Periodontal Tissue ◽  
Tissue Metabolism

The study aims to determine the concentration of vitamin D in the oral fluid, markers of bone destruction as well as to assess the diagnostic value of these indicators to optimize special programs for diagnostics and prevention of major dental diseases in the industrial region’s residents. The object and research methods. There were examined 178 patients. The study group consisted of 126 patients with generalized periodontitis of initial (8), I (32), II (68), and III (18) severity levels, chronic course who are working in hazardous conditions of the "Dniprospetsstal" plant in Zaporizhzhya. The comparison group included 32 patients with periodontitis of initial (5), I (10), II (11), and III (6) severity degrees, which do not have occupational health risks. The control group consisted of 20 relatively healthy individuals without signs of periodontal tissue disease. The level of vitamin D, VDBP, MMP-8, and osteocalcin was determined by enzyme-linked immunosorbent assay. Research results. It is established, that the patients with the initial severity of periodontal disease have minor vitamin D deficiency and as the severity progresses, the vitamin D deficiency increases. Therefore, in the third severity of the inflammatory process, there is a severe deficiency of vitamin D. It should be noted that in the study group patients who were working in hazardous production conditions, the decrease of vitamin D content in the oral fluid was more pronounced relative to the patients in the comparison group with periodontal disease and no occupational hazards. Vitamin D deficiency depends on the severity of periodontitis, which is confirmed by the established strong feedback of the comparison group (γ = -0.790, p <0.05), and that of the study group (γ = -0.778, p <0.05). Periodontitis was accompanied by a significant loss of vitamin D and was associated with a sharp decrease of VDBP protein. That is, not only the concentration of vitamin D changes but so does the protein responsible for the transfer and utilization of this vitamin. We have found a correlation between the VDBP presence in the sample and the severity of periodontitis. Strong feedback of the comparison group (γ = -0.962, p <0.05) and that of the study group (γ = -0.966, p <0.05) was detected. The patients had impaired bone tissue metabolism, which was accompanied by the bone destruction marker MMP-8 increase. The obtained data show a significant increase of MMP-8 content in the oral fluid in periodontitis patients, compared to the individuals with clinically intact periodontium, and reliably reflects the severity of the disease. We have established a direct strong connection between the level of MMP-8 in the oral fluid and the degree of the disease using the method of mathematical analysis. The correlation coefficient was (γ = 0.892, p <0.05) in the comparison group and (γ = 0.965, p <0.05) in the study group. The results of studying bone tissue formation activity considering the level of osteocalcin have shown that osteocalcin decreases with increasing severity of the disease. The correlation between osteocalcin levels and disease severity in the patient groups had strong feedback both in the comparison group (γ = -0.919, p <0.05) and in the study group (γ = -0.987, p <0.05). Conclusions. Biochemical markers allow detecting disorders of bone tissue metabolism and their level of concentration depends on the severity of periodontal tissue disease. The vitamin D deficiency, the concentration of VDBP, MMP-8, osteocalcin are more pronounced in the patients with periodontal disease experiencing occupational hazards compared to the patients who are not exposed to such conditions. The obtained results substantiate the feasibility of enzyme-linked immunosorbent assay introducing vitamin D, VDBP, MMP-8, osteocalcin in laboratory screening of periodontal tissue diseases as highly informative biochemical markers used for diagnostics and prognosis.

scholarly journals GENETIC DETERMINANTS OF OSTEOPOROTIC RISK IN CALCIUM-DEPENDENT DISEASES - CHRONIC PANCREATITIS AND HYPERTENSIVE DISEASE.

2019 ◽  
Vol 6 (1) ◽  
pp. 43-49
Author(s):  
T.I. Viun
Keyword(s):  
Chronic Pancreatitis ◽  
Gene Polymorphism ◽  
Genetic Determinants ◽  
Hypertensive Disease ◽  
Vdr Gene ◽  
Calcium Dependent ◽  
Increased Risk ◽  
Definition Of ◽  
Osteoporosis Risk ◽  
Osteoporotic Risk

GENETIC DETERMINANTS OF OSTEOPOROTIC RISK IN CALCIUM-DEPENDENT DISEASES - CHRONIC PANCREATITIS AND HYPERTENSIVE DISEASEViun T.I., Pasieshvili L.M.Objectives: to determine the genetic determinants of osteoporotic risk in the comorbidity of calcium-dependent diseases - chronic pancreatitis and hypertensive desease. Subjects and methods: two groups of patients were formed for the study - the main one - 70 patients with chronic pancreatitis and hypertensive disease; and the comparison group - 40 persons with isolated course of chronic pancreatitis. The polymorphism of VDR, LCT and FDPS genes as well as the comparison of pathological alleles of these genes was investigated with the definition of the possible influence of these indices on the course of the disease and formation of complications. Results show that patients with a combined course of CP and HD have an increased risk of osteoporosis, which is expressed by an increase in the number of fractures compared with healthy people. As the genetic determinants of the development of osteopenic syndrome in these patients, there is the presence of the allele of the VR gene, the VDR gene and the SS allele of the FDPS gene. The presence of the LC allele of the LCT gene has no independent predictive value, but in combination with the identified variants of the genes, VDR and FDPS promote an increase in osteoporosis risk. Key words: chronic pancreatitis, hypertonic disease, osteoporosis, VDR gene polymorphism, LCT gene polymorphism, FDPS gene polymorphism. ГЕНЕТИЧНІ ДЕТЕРМІНАНТИ ОСТЕОПОРОТИЧНОГО РИЗИКУ ПРИ КАЛЬЦІЙЗАЛЕЖНИХ ЗАХВОРЮВАННЯХ – ХРОНІЧНОГО ПАНКРЕАТИТУ ТА ГІПЕРТОНІЧНОЇ ХВОРОБИ.В’юн Т. І., Пасієшвілі Л. М.Мета дослідження: визначити генетичні детермінанти остеопоротичного ризику при коморбідності кальційзалежних захворюваннях – хронічному панкреатиті та гіпертонічній хворобі. Матеріали та методи: для проведення дослідження було сформовано дві групи хворих - основна - 70 пацієнтів з хронічним панкреатитом та гіпертонічною хворобою; та група порівняння - 40 осіб з ізольованим перебігом хронічного панкреатиту. Досліджували поліморфізм генів VDR, LCT та FDPS, співставлення патологічних аллелей даних генів, з визначенням можливого впливу даних показників на перебіг захворювання та формування ускладнень. Результати показують, що пацієнти з поєднаним перебігом ХП та ГХ мають підвищений остеопоротичний ризик, який проявляється збільшенням кількості переломів порівняно зі здоровими особами. В якості генетичних детермінант розвитку остеопенічного синдрому у даних хворих є наявність алеля ВВ гена VDR і алеля СС гена FDPS. Наявність алеля CС гена LCT не має самостійного предиктивного значення, проте в комплексі з означеними варіантами генів VDR і FDPS сприяє збільшенню остеопоротичного ризику.Ключові слова: хронічний панкреатит, гіпертонічна хвороба, остеопороз, поліморфізм гена VDR, поліморфізм гена LCT, поліморфізм гена FDPS. ГЕНЕТИЧЕСКИЕ ДЕТЕРМИНАНТЫ ОСТЕОПОРОТИЧЕСКОГО РИСКА ПРИ КАЛЬЦИЙЗАВИСИМЫХ ЗАБОЛЕВАНИЯХ - ХРОНИЧЕСКИЙ ПАНКРЕАТИТ И ГИПЕРТОНИЧЕСКАЯ БОЛЕЗНЬ.Вьюн Т. И., Пасиешвили Л. М.Цель исследования: определить генетические детерминанты остеопоротического риска при коморбидности кальцийзависимых заболеваниях - хроническом панкреатите и гипертонической болезни. Материалы и методы: для проведения исследования были сформированы две группы больных: основная - 70 пациентов с хроническим панкреатитом и гипертонической болезнью; и группа сравнения - 40 человек с изолированным течением хронического панкреатита. Исследовали полиморфизм генов VDR, LCT и FDPS, сопоставление патологических аллелей данных генов, с определением возможного влияния данных показателей на течение заболевания и формирования осложнений. Результаты показывают, что пациенты с совокупным течением ХП и ГБ имеют повышенный остеопоротический риск, который проявляется увеличением количества переломов по сравнению со здоровыми лицами. В качестве генетических детерминант развития остеопенического синдрома у данных больных является наличие аллеля ВВ гена VDR и аллеля СС гена FDPS. Наличие аллеля CС гена LCT не имеет самостоятельного предиктивного значения, однако в комплексе с обозначенными вариантами генов VDR и FDPS способствует увеличению остеопоротические риска.Ключевые слова: хронический панкреатит, гипертоническая болезнь, остеопороз, полиморфизм гена VDR, полиморфизм гена LCT, полиморфизм гена FDPS. 

scholarly journals Diagnostic and prognostic value of polymorphism of candidate genes of secondary osteoporosis in patients with chronic pancreatitis and hypertension

2019 ◽  
Vol 43 (2) ◽  
pp. 52-59
Author(s):  
T. I. Viun ◽  
L. M. Pasiyeshvili
Keyword(s):  
Vitamin D ◽  
Chronic Pancreatitis ◽  
Gene Polymorphism ◽  
Bone Tissue ◽  
Candidate Genes ◽  
Frequency Distribution ◽  
Comparison Group ◽  
Secondary Osteoporosis ◽  
Vitamin D Receptors ◽  
Lactase Gene

Study of features of the combined course of a number of diseases of internal organs is caused by their mutually enhancing negative influence and need to correct diagnostic and therapeutic measures. Among such nosologies, attention is drawn to chronic pancreatitis (CP) and hypertension. Their comorbidity increases a risk of atypical clinical manifestations, torpid to conventional therapy and early development of complications. One of these complications is secondary osteoporosis. Developing structural and functional changes in the bone tissue are not only a compensatory response to an increased need for calcium ions, but also an independent factor in further disease progression when these pathologies are combined. An important role in the diagnosis and prediction of impaired metabolism of bone tissue is played by the study of the polymorphism of candidate genes, which can affect not only the development of osteoporosis, but also determine the timing of this complication to certain extent. Vitamin D (VDR) and lactase (LCT) genes are considered among them. Aim of research is to study the role of gene polymorphism of vitamin D receptors (VDR) and lactase gene (LCT) in the risk of developing osteopenic conditions in patients with comorbidity of CP and hypertension. Materials and methods. 110 patients with CP were examined, which made it possible to create two groups: main group — 70 people with comorbid CP and hypertension, and comparison group — 40 patients with isolated CP. Control group included 78 healthy individuals. All patients were representative by age and sex. The state of the bone tissue was determined by conducting double-energy X-ray absorptiometry (DEXA). Polymerase chain reaction was used to study the polymorphism of the vitamin D receptor (VDR) and lactase (LCT) genes. Results. Majority of patients in the main group (84.3%) had an unfavorable B-allele, in contrast to the comparison group, where this index was equal to 77.5% of cases. Changes in the VDR gene polymorphism, which influenced the frequency of lesions of the osteo-articular system, were stated. Lactose insufficiency (LI) was found out in more than half of the patients with CP (57.5%). Upon comorbidity of CP and hypertension, number of such patients increased (68.6%), which could be considered as a result of impaired vascular pancreatic regulation. At the same time, LI occurred against the background of normal (C/C) polymorphic variants of the LCT gene. Almost a third of patients (35.7%) had osteopenic states, but they were not associated with the lactase gene polymorphism. Comparing the pathological VDR and LCT genes of the entire sample of patients (188 people), we obtained the frequency distribution of a statistically significant nature (CCP, χ2=21.92547, df=4, p=0.00021). Namely, the coincidence of Bb and CT heterozygotes was 37.88%, and that of BB and CC homozygotes was 45.57%. The coincidence of Bb and CC was 21.21%, BB and CT — 31.65%. Frequency distribution in patients with isolated CP (40) also had a statistically significant character (CCP, χ2=10.69637, df=4, p=0.03020). Coincidence in the heterozygote of Bb and CT was 25%, and that of homozygotes for BB and CC — 60%. Distribution of BB and CC corresponded to 31.25%, BB and CT — 33.33%. Conclusion. It was stated that upon CP, as well as in its comorbidity with hypertension, osteoporotic conditions might be formed. Combination of calcium-dependent diseases (CP and hypertension) and the vitamin D receptors gene polymorphism with a predominance of unfavorable B-allele could be the cause of such conditions. At the same time, the risk of developing osteoporotic conditions increases 4 times. Course of CP is often accompanied by LI, which may be the result of both gene aberrations and loss of lactase-secreting function in a given disease.

STUDY OF GHRELIN LEVELS IN HYPOTHYROID PATIENTS BEFORE AND AFTER TREATMENT

2021 ◽  
pp. 52-54
Author(s):  
Peeyush Yadav ◽  
G. G. Kaushik
Keyword(s):  
Treatment Group ◽  
Thyroid Hormones ◽  
Hdl Cholesterol ◽  
Metabolic Disturbances ◽  
Free T4 ◽  
Before And After ◽  
Group A ◽  
Group B ◽  
Serum Ghrelin ◽  
Hypothyroid Patients

Objective: Aim of the present study was to evaluate the levels of ghrelin in hypothyroid patients before and after treatment with L-thyroxine and to nd a possible relationship between ghrelin and thyroid hormones. Material & Methods: The present study was conducted on 100 hypothyroid patients (44 Males & 56 Females) before treatment (Group A) and after treatment (Group B) attending the outpatient clinics or admitted in wards of J.L.N. Hospitals, Ajmer. 100 healthy control subjects (Group C) of same age group of either gender were selected for the study. Blood samples were drawn from patients and controls, after overnight fast of at least 8 hours. Estimation of Serum Ghrelin, free T3, free T4, and TSH was done by using Enzyme- Linked Immunosorbant Assay (ELISA) technique. Total Cholesterol, Triglyceride, HDL – Cholesterol were measured by automated analyser (Beckman & Coulter's AU680). VLDL – Cholesterol, LDL – Cholesterol were calculated by Friedwald's formula. Differences in the parameters among the groups were analyzed by ANOVA test followed by its Tukey HSD post hoc analysis. Correlations between variables were tested using the Pearson rho (r: Correlation coefcient) correlation test. Results: Findings of the present study shows that the levels of serum fT3 (1.79 ± 0.29 pg/mL) and serum fT4 (0.34 ± 0.11 ng/dL) were signicantly lower in Group A compared to Group B (fT3 = 3.00 ± 0.32 pg/mL & fT4 = 0.81 ± 0.15 ng/dL) and Group C (fT3 = 3.12 ± 0.31 pg/mL & fT4 = 0.85 ± 0.11ng/dL) whereas serum TSH levels were signicantly higher in Group A (40.59 ± 13.55 μIU/mL) compared to Group B (5.34 ± 1.47 μIU/mL) and Group C (3.23 ± 1.04 μIU/mL). Levels of serum Ghrelin were signicantly higher in Group A (918.19 ± 48.47 pg/mL) compared to Group B (700.34 ± 46.35 pg/mL) and Group C (681.49 ± 35.80 pg/mL). A non signicant correlation of Ghrelin with S.fT4 and TSH was found in both Group A and Group B whereas S.fT3 and BMI shows a non signicant correlation in Group A in comparison to a signicant correlation in Group B. Conclusion: There is a reversible increase in the levels of serum ghrelin which became normalized after L-thyroxine substitution in hypothyroid patients. Alteration in the levels of serum ghrelin in thyroid disorders indicates a compensatory role of ghrelin in metabolic disturbances and also suggests a possible association between thyroid hormones and serum ghrelin levels.

scholarly journals The role of multistraine probiotics in non-specific seasonal prevention of acute respiratory infections in children with recurrent URTI in organized teams

2021 ◽  
pp. 220-226
Author(s):  
Lyudmila D. Panova Lyudmila D. Panova Lyudmila D. Panova
Keyword(s):  
Treatment Group ◽  
High Risk ◽  
Randomized Clinical Trials ◽  
Comparison Group ◽  
Respiratory Infections ◽  
Evidence Base ◽  
Acute Respiratory Infections ◽  
Infection Period ◽  
Study Results

Introduction. A broad evidence base of numerous randomized clinical trials and meta-analyses asserts the role of intestinal microbiota dysbiosis in the development of various diseases, including those of infectious origin, in infancy and later stages of life.Purpose. Assessment of the efficacy of a multi-strain immuno-probiotic during rehabilitation of frequently ill children visiting organized groups during the period of epidemiological distress for acute respiratory diseases.Materials and methods.93 children older than 3 years of age were enrolled in an open comparative prospective clinical observation during the high-risk respiratory infection period  – November, December. Children were observed for 1.5 months during administration of the multi-strain probiotic and 1 month after discontinuation of the probiotic. The subjects were randomized into two groups: the treatment group (60 children) received the multi-strain probiotic in the maximum age-specific dosage variances (children aged 3 to 12 years old – 1 capsule, older than 12 years of age – 2 capsules) once a day in the morning for 14 days and the comparison group (33 children) did not receive the multi-probiotic for the same period.Results and discussion. It was found that the incidence of disease in children receiving the multi-probiotic (the treatment group – 60 children) was statistically lower, and the disease severity was milder than in the group of children, who did not receive the probiotic (the comparison group – 33 children). Not a single child who received the multi-probiotic in the course of disease did not require antibiotic therapy during the entire observation period. Moreover, the incidence of respiratory infections in the treatment group within a month after discontinuation of the probiotic was 4.6 times lower than in the comparison group. No side effects were reported.Conclusions. The study results allowed the author to recommend the use of a multi-strain immuno-probiotic as a nonspecific immunomodulatory supplement for the seasonal prevention of acute respiratory infections, especially in frequently ill children at a high risk of infections.

THE USE OF THORACOPLASTY IN THE TREATMENT OF DESTRUCTIVE PULMONARY TUBERCULOSIS

2021 ◽  
pp. 18-28
Author(s):  
Andrey V. Ivanov ◽  
Alexey A. Malov ◽  
Vadim A. Kichigin ◽  
Vasily A. Ivanov ◽  
Larisa V. Tarasova
Keyword(s):  
Drug Resistance ◽  
Body Weight ◽  
Surgical Treatment ◽  
Treatment Group ◽  
Pulmonary Tuberculosis ◽  
Comparison Group ◽  
Main Group ◽  
Negative Reaction ◽  
Normal Body ◽  
Normal Body Weight

Despite a decrease in the incidence of pulmonary tuberculosis in the Russian Federation in recent years, among the newly diagnosed patients there remains a significant proportion of patients with bacterial excretion and destructive pulmonary tuberculosis. In patients with destructive pulmonary tuberculosis, surgical treatment is often the only possible method for saving lives. We studied the results of extrapleural posterosuperior thoracoplasty in 42 patients with destructive pulmonary tuberculosis. The comparison group consisted of 30 patients who received medicamentous therapy. The mortality rate for 3 years of follow-up in the conservative treatment group was 36.7%, in the surgical treatment group it was 23.8%, p = 0.237. Among patients with more than 2 years of disease experience, mortality was 45% in the main group, 88% in the comparison group, p = 0.070. In the absence of drug resistance, mortality in the main group was 4%, that in the comparison group – 14.2%, p = 0.283. Mortality in individuals with normal body weight was lower in the group of patients who underwent thoracoplasty than in the comparison group: 17.6% vs. 33.3% (p = 0.202). Among those who did not achieve sputum negative reaction, mortality was lower, and passing to the 3rd group of dispensary care was more common in the surgical treatment group – 41.7% vs. 71.4% (p = 0.077) and 33.3% vs. 21.4% (p = 0.426). Among patients with drug resistance or low body weight or unachieved sputum negative reaction, mortality rates were comparable in both groups. Thus, thoracoplasty, in comparison with conservative therapy, makes it possible to improve treatment results in patients regardless of the length of the disease in groups with Mycobacterium tuberculosis sensitive process, with normal body weight, with preservation of elimination of bacilli. The effectiveness of thoracoplasty decreases in patients with an increase in the disease duration.

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