Changes of serum adenosine deaminase level in new cases of pulmonary tuberculosis before and after intensive phase treatment

Despite the availability of medical services, timely detection of pulmonary tuberculosis, before the appearance of destructive changes, is often difficult. The management of patients with an infiltrative form in a hospital setting does not always guarantee the same positive effect and sometimes requires prolongation of therapy. The effectiveness of therapy can be associated with various factors and is of interest to study. The aim of this work was to study the effectiveness of standard therapy in patients with first diagnosed infiltrative pulmonary tuberculosis, clinical laboratory and radiological associations with prolongation of the intensive phase of treatment. Materials and methods. The study involved 109 men from 18 to 53 years old with first diagnosed infiltrative pulmonary tuberculosis with preserved MBT sensitivity to 1-st line anti-tuberculosis drugs. Patients were examined before and after 60 doses of the intensive phase of treatment, after which two groups were formed. Group 1 included patients with pronounced positive clinical and radiological dynamics, who entered the continuation phase of therapy. Group 2 included patients with insufficient clinical and radiological dynamics, for whom the intensive phase of treatment was extended to 90 doses. Results. Weak dynamics in patients who needed prolongation of treatment was associated with the characteristics of the initial data of patients in this group compared with similar indicators in Group 1. These were a reliably higher frequency of symptoms of intoxication and coughing, a reliably greater number of patients excreting mycobacterium tuberculosis in large quantities in sputum, with reliably high blood concentrations of haptoglobin and ceruloplasmin levels. Conclusions. Patients requiring prolongation of the intensive phase of treatment are characterized by an initially higher prevalence of infiltrative changes in the lungs, a small number of lung lesions limited to 2 segments, the presence of destructive changes in 100 % of cases, and a significant increase in the factors of the systemic inflammatory response

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ASUPAN ZAT GIZI MAKRO DAN MIKRO PENDERITA TUBERKULOSIS PARU RAWAT JALAN SEBELUM DAN SESUDAH TERAPI FASE INTENSIF DISERTAI KONSELING GIZI

Penelitian Gizi dan Makanan (The Journal of Nutrition and Food Research) ◽

10.22435/pgm.v41i1.1860 ◽

2019 ◽

Vol 41 (1) ◽

pp. 55-64

Author(s):

Made Dewi Susilawati ◽

Yunita Diana Sari ◽

Rika Rachmawati ◽

Elisa Diana Julianti

Keyword(s):

Vitamin D ◽

Vitamin E ◽

Pulmonary Tuberculosis ◽

Primary Data ◽

Nutrition Counseling ◽

Nutritional Counseling ◽

Intensive Phase ◽

Tuberculosis Patients ◽

Micronutrient Intake ◽

Before And After

ABSTRACT The highest tuberculosis (TB) mortality and morbidity occured in developing countries, including Indonesia. In terms of nutrition, WHO expects TB research conducted nationwide to provide scientific evidence that all important tuberculosis patients are assessed nutritional status and given nutritional counseling in all health facilities. There also need an operational standard in the treatment of malnutrition due to TB. The aims of this study were to identify nutrient intake and blood micronutrient level in TB patients before and after 2 months of therapy with nutritional counseling. The pre-experimental pretest posttest 1 group study was conducted in 10 Puskesmas in Bogor District in 68 pulmonary tuberculosis patients aged 15-55 years. Primary data were collected through interviews, anthropometric measurements and laboratory checks. Results of BTA examination showed that most patients were TB patients with BTA 1 + 49.1% and 35.8% with BTA 3 +, the rest of BTA 2+ and scanty. There were significant differences in macro and micronutrient intake before and after intensive phase therapy accompanied by nutritional counseling (p <0.05). The levels of retinol, selenium, vitamin D and vitamin E in the blood also showed significant differences before and after intensive phase therapy (p <0.05). The macro and micronutrient intake after intensive phase therapy was higher than before. Most of patients experienced an increase in dietary intake in almost all food group, as well as micronutrient levels (retinol, selenium, vitamin D and vitamin E) in the blood increased after intensive phase therapy with nutrition counseling. Keyword: nutrition intake, pulmonary tuberculosis, nutrition counseling ABSTRAK Angka kesakitan dan kematian TB tertinggi ada di negara berkembang, termasuk di Indonesia. Dari segi nutrisi, WHO mengharapkan penelitian TB yang dilakukan di seluruh negara dapat memberikan bukti ilmiah bahwa semua pasien TB penting dinilai status gizinya dan diberikan konseling gizi di semua sarana kesehatan dan perlunya ditetapkan standar operasional dalam penanganan malnutrisi akibat TB. Penelitian ini bertujuan untuk mengidentifikasi asupan gizi dan kadar mikronutrien pasien TB sebelum dan sesudah terapi 2 bulan dengan konseling gizi. Desain penelitian pra-eksperimental pretest posttest 1 kelompok dilakukan di 10 Puskesmas di Kabupaten Bogor pada 68 pasien TB paru, berusia antara 15-55 tahun. Data primer dikumpulkan melalui wawancara, pengukuran antropometri dan pemeriksaan laboratorium. Hasil pemeriksaan BTA menunjukkan bahwa pasien terbanyak adalah pasien TB dengan BTA 1 + sebesar 49,1 % dan 35,8 % dengan BTA 3 + sisanya BTA 2+ dan scanty. Terdapat perbedaan bermakna pada asupan makro dan mikronutrien sebelum dan setelah terapi fase intensif yang disertai konseling gizi (p<0.05). Kadar retinol, selenium, vitamin D dan vitamin E dalam darah juga menunjukkan perbedaan bermakna sebelum dan sesudah terapi fase intensif (p<0.05). Rerata asupan makro dan mikronutrien sesudah terapi fase intensif lebih tinggi dibandingkan sebelum terapi. Sebagian besar pasien mengalami peningkatan pola konsumsi makan pada hampir semua golongan bahan makanan, begitu juga dengan kadar mikronutrien (retinol, selenium, vitamin D dan vitamin E) dalam darah mengalami peningkatan sesudah terapi fase intensif yang telah disertai konseling gizi. Kata kunci: asupan gizi, tuberkulosis paru, konseling gizi

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The Differences of TNF-α Levels and BMI in Diabetic Patients with Pulmonary Tuberculosis After Intensive Phase of Tuberculosis Treatment

Journal of Endocrinology, Tropical Medicine, and Infectiouse Disease (JETROMI) ◽

10.32734/jetromi.v2i2.3873 ◽

2020 ◽

Vol 2 (2) ◽

pp. 87-95

Author(s):

Wika Lydia ◽

Melati Silvanni Nasution ◽

Dian Anindita Lubis

Keyword(s):

Blood Glucose ◽

Pulmonary Tuberculosis ◽

Fasting Blood Glucose ◽

Treatment Method ◽

Diabetic Patients ◽

Intensive Phase ◽

Pulmonary Tb ◽

Antituberculosis Treatment ◽

Tnf Α ◽

Before And After

Abstract. Introduction. Diabetes Melitus (DM) can cause complications, such as pulmonary tuberculosis (TB). Metabolic disorders are thought to be related to Tumor Necrosis Factor-α (TNF-α) metabolism, adipocytokines secreted by macrophages, which inhibit insulin transduction, has anti-mycobacterial activity, however, also negatively affect pathological TB process. This study aims to determine differences in TNF-α levels and Body Mass Index (BMI) in DM with pulmonary TB after intensive phase of antituberculosis treatment. Method. This prospective comparative analytical study with one-group pretest-posttest design, conducted during August 2019-September 2019 in outpatient of Type 2 DM with pulmonary TB at USU Hospital, Madani Medan Hospital, Teladan Health Center and Laboratory of Haji Adam Malik Medan after approval from the Health Research Ethics Commission. Data were analyzed after normality test, then mean difference and correlation test by using the SPPS program where p <0.05 was considered significant. Results. This study showed an increase BMI, and decrease of fasting blood glucose, 2-hour post-prandial blood glucose, HbA1C and TNFα levels before and after intensive phase of antituberculosis treatment (p = 0,000; p = 0,000; p = 0,000; p = 0,000). Conclusion. There was a significant increase of BMI and decrease of TNFα level after intensive phase of antituberculosis treatment.

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The system of matrix metalloproteinases and their role in patients with pulmonary tuberculosis

Biomeditsinskaya Khimiya ◽

10.18097/pbmc20166205593 ◽

2016 ◽

Vol 62 (5) ◽

pp. 593-598 ◽

Cited By ~ 3

Author(s):

D.S. Esmedlyaeva ◽

N.P. Alexeyeva ◽

N.V. Sapozhnikova ◽

M.E. Dyakova ◽

T.L. Perova ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Acute Phase Proteins ◽

Serum Levels ◽

Intensive Phase ◽

Mmp Inhibitors ◽

Mmp Inhibitor ◽

Before And After ◽

Reparative Process ◽

The Relationship ◽

Reparative Changes

The aim of this study was to examine the relationship between serum levels of parameters of the system metalloproteinase (MMP)/inhibitors with severity of infiltrative pulmonary tuberculosis (ITL), changes in examined parameters during the intensive phase treatment (IPT), as well as possibility of their use for prediction of IPT effectiveness, along with acute-phase proteins (AFP). The study included ITL patients which were subdivided into two groups (I and II) with different rates of reparative changes. It was shown that: 1) ITL is characterized by impairements in the system MMP/inhibitors: the levels of MMP-1, -9 increased, MMP-3, -8, TIMP-1 remained at the reference values and a 2-macroglobulin was low. 2) Changes of the parameters of the system MMP/inhibitors were associated with markers of severity and activity of the process: MMP-1, with the presence of destruction and sensitivity of the pathogen (Mycobacterium tuberculosis; MBT) to anti-TB drugs, MMP-9, with the volume of destruction, MMP-8 – with activity of tuberculosis. 3) TIMP-1 and MMP-9 concentrations decreased during treatment in groups with different rates of reparative process, whereas proMMP-1, MMP-3,-8 remained unchanged. 4) Before and after IPT, the level of TIMP-1 was higher in the group of patients with slower rate of reparative processes. 5) After IPT the imbalance in the system MMP/inhibitor preserved thus suggesting continuation of the reparative process. 6) Use of combination of MMP and AFR is more informative in predicting efficacy of IPT.

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Study of the functional state of liver in HIV-infected persons with the first diagnosed pulmonary tuberculosis

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2018-22(1)-26 ◽

2018 ◽

Vol 22 (1) ◽

pp. 140-145

Author(s):

O.P. Nezgoda ◽

M.A. Thorovsky ◽

V.V. Stryzhalkovska ◽

S.O. Suchоk ◽

A.A. Kushnir ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Functional State ◽

Liver Damage ◽

Total Bilirubin ◽

Clinical Symptoms ◽

Control Group ◽

Intensive Phase ◽

Ultrasound Evaluation ◽

Ultrasound Study ◽

Before And After

Simultaneous administration of anti-TB and antiretroviral therapy to patients with HIV contributes to the development of hepatotoxicity, which may be accompanied by a change in the laboratory and functional parameters of the liver. The purpose of the work is to investigate the functional state of the liver in HIV-infected persons with the first diagnosed pulmonary tuberculosis without combining with chronic hepatitis C. 49 patients were examined. The control group consisted of 25 patients with the first diagnosed pulmonary tuberculosis, the main – 24 patients with VDTB/HIV co-infection. The data of clinical, laboratory (ALT, AST, total bilirubin and its fractions, total protein of blood) and ultrasound examination before treatment and after the completion of the intensive phase of anti-TB therapy were evaluated. Clinically manifestations of intoxication were regressed more quickly in the control group. There was a statistically significant increase ALT in the main group compared to the control group after the intensive phase of treatment (p<0.05). Levels of total bilirubin and protein in both groups were not statistically different (p>0.05). The level of total bilirubin in both groups remained within the limits of physiological norm both before and after therapy. There was no significant increase those indicators, which could show the development of cholestasis syndrome. In the routine ultrasound study, conducted before and after the intensive phase, increased echogenicity of the liver, heterogeneity of the structure of the organ parenchyma, expansion of the intrahepatic ducts, hepatosplenomegaly. The presence of liver damage in patients with HIV/TB-co-infection was established at the pre-treatment stage, which wasn’t accompanied by severe clinical symptoms, consequently, in patients with HIV/TB co-infection it is expedient to conduct active monitoring of marker enzymes for cytolysis and ultrasound evaluation of liver status. The prevention of the development of medical liver damage in patients with HIV/TB co-infection contributes to the adequate implementation of an intensive phase of TB treatment.

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On the issue of post-tuberculosis lesions of the larynx in pulmonary tuberculosis

Kazan medical journal ◽

10.17816/kazmj46911 ◽

1901 ◽

Vol 1 (3) ◽

pp. 195-196

Author(s):

A. T. Ostrovskiy

Keyword(s):

Pulmonary Tuberculosis ◽

Mucous Membrane ◽

The Third ◽

Before And After

Abstracts. Internal diseases.A. T. Ostrovsky. To the question of post-tuberculosis lesions of the larynx in pulmonary tuberculosis. Diss. S.-PB.1900 g.The author cites the literature that exists on the issue of interest to him, before and after the discovery of tuberous sticks by prof. Kos'om. At the present time, regarding the secondary tubercle of the larynx, there are already not at all many, each having its own supporters, from which some admit the penetration of tuberous sticks from the epithelial cover of the mucous membrane of the larynx, others hold the view that the vessels for the lymph from the inside through the third In view of the fact that up to the present time the issue of post-tuberculosis lesions of the larynx remains not fully clarified, the author decided to take on his work as much as possible.

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