Tuberculosis, Lung Diseases, HIV Infection最新文献

{"title":"The Role of Cell-Mediated Immunity Deficiency in the Clinical Evolution of Patients with Tuberculosis Associated with HIV Infection","authors":"E. Lesnic, L. Todoriko, I. Semianiv, S. Ghinda","doi":"10.30978/tb2023-4-16","DOIUrl":"https://doi.org/10.30978/tb2023-4-16","url":null,"abstract":"HIV infection induces severe immunosuppression, considered the major risk factor for tuberculosis (TB). Objective — to evaluate the clinical characteristics of patients with TB-HIV co-infection based on the level of immune deficiency to establish recommendations for improving clinical case management. Materials and methods. A prospective, selective study included 86 TB patients, divided into the study group with 38 cases of TB evolved into acquired immunodeficiency syndrome (AIDS), established with a CD4+ level ≤ 200/μL and the control group with 48 TB cases having CD4+ ≥ 200/μL. Results and discussion. The study assessed the impact of the severity of the cell mediated immune deficiency associated with HIV infection on the clinical evolution of TB and the final therapeutic outcome. Laboratory indicators characterizing TB in AIDS included general leukocytosis, lymphocytopenia, eosino­philia, anemia and, in rare cases, thrombocytopenia. All AIDS patients were untreated with ARV, and only one-third were in the early stages of symptomatic HIV infection. Risk factors for TB in AIDS included rural residence, low education levels and mental disorders. Treatment success was low, and the death rate was high in both groups, emphasizing the impact of associated conditions. Despite differences in the serum level of CD4+ cells, the rate of therapeutic success was equally low in both groups, with one-third continuing antituberculosis treatment. The death rate was insignificantly higher in the TB on AIDS group (23.4 %) vs. 18.7 % in early HIV stages due to comorbidities associated with HIV infection. Conclusions. The study identified risk factors for TB in patients diagnosed with AIDS stage of symptomatic HIV infection, including residence in rural areas, low education levels and mental and behavioral disorders associated with multiple causes such as alcohol consumption, drug use and toxoplasmosis of the central nervous system. Recommendations include complex screening for TB and HIV in all socially vulnerable groups, reinforced by primary prevention and an individualized therapeutic approach.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139209051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community-Acquired Pneumonia Associated with COVID-19: Diagnostic Significance of Imaging Methods (CT, LUS) and Comparative Characteristics of CT- and LUS-Patterns","authors":"L. Konopkina, К.V. Rybalka","doi":"10.30978/tb-2023-4-39","DOIUrl":"https://doi.org/10.30978/tb-2023-4-39","url":null,"abstract":"Objective — to determine the imaging changes in community-acquired pneumonia in different severity of COVID-19; to define the diagnostic significance of CT, LUS, establish the correspondence of CT- and LUS-patterns. Materials and methods. We examined 22 patients (pts) (men — 11 (50.0 %), women — 11 (50.0 %), mean age — 67.0 (54.0; 74.0) years) with COVID-19 pneumonia. Clinical examination — general investigation, assessment of dyspnea severity (mMRC), pulse oximetry. The spread of lung lesions was determined by CT and LUS. Changes were described as CT- and LUS-patterns. Non-parametric. Results and discussion. In severe COVID-19 cases (end of the 1st week of illness), the extent of lung lesions aligned with CT-1, revealing bilateral subpleural «ground glass» opacities. Bilateral changes were observed in lung ultrasound (LUS), with a Lung Ultrasound Score (LUSS) of 2—4 points. The CT pattern of «ground glass» corresponded to LUS patterns indicating mild to moderate interstitial changes (IC).By the 2nd and 3rd weeks, the area of lung lesions corresponded to CT-1 and 2, and the CT pattern of «ground glass» became diffuse and bilateral. Bilateral LUS changes were noted, with LUSS ranging from 4 to 18 points. The CT pattern of «ground glass» aligned with LUS patterns indicating mild to moderate IC, pleural thickening, and the absence of A-lines. The CT pattern of consolidation corresponded to a similar LUS pattern.In patients with a critical course during the 2nd and 3rd weeks, the lesion area extended to 60–90 %. Bilateral LUS changes persisted, with LUSS ranging from 16 to 22 points. There was a significant correlation between the area of lung lesions observed on CT and LUS (p < 0.0001). Conclusions. In the 1st week of illness, verification of severe COVID-19 should be grounded in the presence of severe dyspnea and decreased saturation. During the 2nd and 3rd weeks, verification can be based on decreased saturation and the extent of lung lesions as assessed by CT and lung ultrasound (LUS). In critical patients, the area of lung lesions ranged from 60 to 90 % on CT and/or exceeded 15 points on the LUSS. The CT pattern of «ground glass» corresponded to interstitial changes (IC), pleural thickening, and the absence of A-lines on LUS. Similarly, the CT pattern of consolidation corresponded to a consolidation pattern on LUS.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139201964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peculiarities of Metabolism and Cardiac Electrical Activity in Patients with Chronic Obstructive Pulmonary Disease and Coronary Heart Disease in the Presence of Metabolically-Associated Liver Steatosis","authors":"O. Komarytsia, L. Pylypiv, O.M. Radchenko","doi":"10.30978/tb2023-4-10","DOIUrl":"https://doi.org/10.30978/tb2023-4-10","url":null,"abstract":"While the development of specific steatohepatitis-associated cardiomyopathy (SHACMP) in the context of fatty liver disease has been documented, it remains unclear whether any cardiac changes occur during the initial stage of fatty liver disease, known as metabolic-associated liver steatosis (LS). Objective — to evaluate the characteristics of metabolism and electrical activity of the heart in patients with chronic obstructive pulmonary disease and chronic forms of coronary heart disease and concomitant liver steatosis. Materials and methods. 35 patients with chronic obstructive pulmonary disease, respiratory insufficiency stages I and II, coronary heart disease, atherosclerotic cardiosclerosis, and heart failure functional classes I and II, were examined. Their diagnosis and treatment were conducted in accordance with established protocols and international recommendations. Depending on the occurrence of LS, patients, matched for age, gender and lung function parameters, were divided into two groups: those suffering from it (n = 26) or not suffering from it (n = 9). Additionally, leptin level was determined, body mass index (BMI), leptin to BMI ratio, De Ritis ratio, hepatic steatosis index, glomerular filtration rate (according to MDRD) were calculated, and automatic ECG test was run. The results were processed statistically; the significance assumed at р < 0.05. Results and discussion. It was established that LS was diagnosed in patients with a higher BMI and was accompanied by clear metabolic changes — higher values of leptin, leptin-to-BMI ratio, fasting blood glucose and total cholesterol levels. The criteria of LS are not only an increase in echogenicity and size of the liver, but also higher values of ALT, De Ritis ratio and hepatic steatosis index. According to the correlation analysis, the deterioration of the liver condition was accompanied by changes in the heart — tachycardia and a decrease in the angle of the QRS complex, which can be considered as signs of the development of SHACMP, characteri­zed by a prolongation of the PQ interval (р = 0.07) and a significant deviation of the angle of the QRS complex. Inflammation and endogenous intoxication are the leading mechanisms of progression of both LS and SHACMP. Conclusions. Patients with chronic obstructive pulmonary disease and chronic forms of coronary heart disease, alongside with liver steatosis, exhibit signs of steatohepatitis-associated cardiomyopathy caused by metabolic changes, inflammation and endogenous intoxication.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"69 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139205035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of the Acute Phase Inflammatory Marker — C-Reactive Protein in Patients with Chronic Bronchial Affections","authors":"U.I. Shevchuk–­Budz","doi":"10.30978/tb-2023-4-5","DOIUrl":"https://doi.org/10.30978/tb-2023-4-5","url":null,"abstract":"Chronic lung diseases, particularly those affecting the bronchial tree, are a leading cause of disability and mortality worldwide. This emphasizes the importance of addressing issues related to the prevention, timely detection and treatment of conditions such as chronic bronchitis (CB), chronic obstructive pulmonary disease (COPD) and COPD with bronchiectasis. The use of highly sensitive methods for monitoring likely exacerbations and predicting the development of comorbidities in this patient cohort is justified. Objective — to study the nature and severity of changes in the acute phase inflammatory marker — C-reactive protein (CRP) in patients with chronic lung diseases. Materials and methods. A total of 62 hospitalized patients with CB, COPD and COPD with secondary bronchiectasis were examined. All patients underwent clinical, laboratory and instrumental investigations. The serum CRP level was measured in peripheral blood. A control group comprised 15 practically healthy individuals. Results and discussion. It was found that chronic inflammatory lung diseases were more prevalent in men (in the CB group — 55.0 %, in the COPD group — 86.96 %, in the COPD with secondary bronchiecta­sis group — 93.7 %). The CRP level in peripheral blood serum was elevated in all groups: in the CB group — (5.5 ± ± 0.12) mg/l, in the COPD group — (7.54 ± 0.98) mg/l, in the COPD with secondary bronchiectasis group — (12.93 ± 1.23) mg/l. This indicator was statistically significantly higher by 4.0, 5.6, and 9.6 times, respectively (all p < 0.001) compared to the control group. The proportion of smokers was 60.0 % in the CB group, 73.9 % in the COPD group and 78.94 % in the COPD with secondary bronchiec­tasis group. Conclusions. Harmful habits, especially smoking, contribute significantly to the widespread occurrence of chronic lung diseases. Exacerbations and progression of chronic inflammatory processes in the bronchial tree are associated with an elevated level of CRP. The level of CRP significantly increases with the development of concomitant changes, particularly the presence of secondary bronchiectasis. There is a correlation between smoking and the severity of chronic inflammatory lung diseases, as well as a relation­ship between the severity of COPD and the duration of smoking.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"313 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139203548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphological Preconditions of Metabolic Disorders in the Comorbid Course of Inflammatory Processes in the Lungs and Type 2 Diabetes Mellitus in Rats","authors":"R.B. Aliіev, K. Rozova, M. Kozlovska, M. Vasylenko, M.G. Dubova, A. S. Shapovalova, A. Portnychenko","doi":"10.30978/tb2023-4-54","DOIUrl":"https://doi.org/10.30978/tb2023-4-54","url":null,"abstract":"Objective — to characterize ultrastructural changes in lung and liver cells associated with disturbances in energy metabolism during the comorbid course of inflammation in the lungs and type 2 diabetes mellitus (T2DM). Materials and methods. The study was conducted on adult Wistar rats, divided into four groups: 1) control; 2) rats with simulated inflammation by lipopolysaccharide (LPS) administration (0.5 mg/kg intraperitoneally); 3) rats with insulin resistance induced by a high-fat diet (58 % of total calorie intake from lipids) and LPS injection on the 24th day of the experiment; 4) rats with simulated T2DM by a high-fat diet, streptozotocin injection (25 mg/kg body weight) on the 14th day, and LPS injection on the 24th day of the experiment. The ultrastructure of lung and liver cells was evaluated by electron microscopy in tissue samples obtained from anesthetized animals three days after LPS administration. Results and discussion. In the simulation of inflammation induced by LPS-mediated cytokine mechanisms, inflam­matory symptoms were observed in the lungs, with alveolar type II cells showing mitochondrial dysfunc­tion, a large number of free and attached ribosomes, indicating disruptions in energy metabolism, and the development of compensatory-adaptive reactions (intensification of protein synthesis, reparative processes in mitochondria and their interaction with the endoplasmic reticulum). In the comorbid course of LPS-in­duced inflammation in the lungs and T2DM, enhanced inflammatory manifestations in the lungs were registered against the background of lipid infiltration, increased aero-hydrate barrier hydration, endothelial dysfunction and signs of mitochondrial dysfunction in alveolar type II cells. Compensatory protein synthesis increased, indicating the intensification of alteration processes, and worsening of energy and lipid metabolism. In the simulation of LPS-induced inflammation in the lungs with insulin resistance, pathological manifestations were less pronounced, and mitochondrial dysfunction was not observed, indicating the maintenance of energy metabolism under these conditions, with insulin resistance playing a partial role in the unfavourable course of comorbid pathology. In the liver, during the comorbid course of LPS-induced inflammation in the lungs and T2DM, increased steatosis, endothelial dysfunction, signs of mitochondrial dysfunction in hepatocytes, pronounced compensatory protein synthesis in bound ribosomes, and the formation of endoplasmic reticulum-associated membranes with mitochondria were detected. Conclusions. During the comorbid course of LPS-induced lung inflammation and T2DM, disruptions in energy metabolism intensify, mediated by respiratory and mitochondrial dysfunction, and compensatory protein synthesis and interaction of mitochondria with the endoplasmic reticulum are enhanced. The results suggest that the pathogenesis of comorbid inflammation in the lungs and T2DM or insulin resistance occurs thr","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139199555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of the Use of Modern Tobacco and Nicotine-Containing Products Among Students of Leading Universities in Lviv","authors":"L. Pylypiv, Z. Piskur, O.H. Pylypiv","doi":"10.30978/tb-2023-4-77","DOIUrl":"https://doi.org/10.30978/tb-2023-4-77","url":null,"abstract":"Objective — to analyze the prevalence of tobacco and nicotine-containing smoking products (TNSP) among students of Lviv universities, the reasons for their popularity, factors influencing smoking cessation and awareness of the impact of these products on health. Materials and methods. An anonymous survey was conducted among students of leading universities in Lviv (273 participants, including 120 males and 153 females, average age — 20.0 years). A questionnaire was developed for the survey, consisting of 31 questions related to identifying harmful habits, type, onset and duration of smoking, motivation for starting and quitting, and awareness of the harmful effects of TNSP on health. Results and discussion. The prevalence of TNSP consumption among students was 40.7 %, with 63.1 % of smokers smoking daily. There were significantly more male smokers than female smokers (55.8% vs. 28.8 %; p < 0.01). 52.8 % of students experienced systematic passive smoking. Most respondents described their attitude toward smoking as neutral (56.0 %), while a third characterized it as negative (35.5 %). Meanwhile, 65.6 % of respondents noted that there were no positive aspects to smoking, but every third (34.4 %) believed there were. The formation of the harmful habit was driven by a desire to relieve stress (58.5 %), relax (51.5 %), and experience satisfaction (44.2 %). In 64.0 % of students, there are smokers in the family. Most surveyed smokers used electronic (69.4%) and regular cigarettes (54.1 %), less frequently hookah (42.3%) and tobacco products for electric heating (41.4 %). Women smoked regular cigarettes much less often than men (38.6 vs. 64.2 %; p < 0.01). According to the respondents, the main factors that could influence smoking cessation were the identification of health problems caused by smoking (52.3 %) and the appearance of children (40.9 %). Every second respondent (58.5 %) did not plan to quit smoking in the near future. Factors hindering students from quitting smoking were constant stress (39.6 %), the presence of smokers in the environment (30.6 %) and nicotine/psychological dependence (27.0 %). Despite more than 77 % considering themselves informed about the effects of TNSP, 52.8 % claimed that hookah use is safe for health, while 24.9 and 18.4 % lacked information on whether tobacco products for electric heating and electronic cigarettes are a safe alternative to regular cigarettes. According to 66.2 % of respondents, it is necessary to disseminate information about the health impact of modern TNSP among students. Conclusions. The obtained results indicate the need to develop effective strategies to influence student youth to prevent the use of TNSP. It is crucial to disseminate evidence-based information about the impact of TNSP on human health and address stress in universities.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"234 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139203587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Generalized Cryptococcal Infection in an HIV-Infected Patient with Coinfections of Cytomegalovirus and Tuberculosis","authors":"O.D. Nikolayeva, A.A. Sainchuk, I. Liskina, L. Zahaba","doi":"10.30978/tb2023-4-70","DOIUrl":"https://doi.org/10.30978/tb2023-4-70","url":null,"abstract":"This case report presents the observation of a patient with HIV infection diagnosed with a combination of several opportunistic infections, including cryptococcosis, cytomegalovirus infection and tuberculosis. The patient underwent treatment at the National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky NAMS of Ukraine and the Institute of Epidemiology and Infectious Diseases named after L.V. Gromashevsky NAMS of Ukraine.HIV infection was detected at the Institute of Phthisiology and Pulmonology during an examination for exudative pleuritis. Initial evaluation raised suspicion of tuberculous exudative pleuritis. Mycobacterium tuberculosis was not detected in the biopsy material using the Xpert MTB/RIF method. Morphological analysis indicated a rare variant of cryptococcal infection involving intrathoracic lymph nodes and pleura. Additional testing revealed a positive cryptococcal antigen. Cryptococci were also identified in the cerebrospinal fluid. Cytomegalovirus chorioretinitis was diagnosed. The patient was treated according to the opportunistic infection management protocol. Antiretroviral therapy (TDF, FTC, DTG — tenofovir, emtricitabine, dolutegravir) was initiated after six weeks. The patient received prophylaxis for Pneum­cystis pneumonia with cotrimoxazole and for tuberculosis with isoniazid. One month after starting antiretroviral therapy, the patient developed a febrile illness. Further examination revealed infiltrative pulmonary tuberculosis. Repeat bacteriological testing detected rifampicin-susceptible Mycobacterium tuberculosis. The patient received standard tuberculosis treatment (2HRZE/4HR) and achieved a cure.This case highlights the diagnosis and treatment of a patient with acquired immunodeficiency syndrome and multiple secondary infections. Despite advanced immunodeficiency, timely and adequate medical interventions resulted in high treatment efficacy, contributing to increased life expectancy and improved quality of life in individuals living with HIV.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"490 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139204105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Characteristics of Granulomatous Lesions in the Lungs in Tuberculosis, Talcosis, and Cryptococcosis in Patients with HIV Infection/AIDS","authors":"S.Z. Baran, O.O. Dyadyk, V. Zaritska","doi":"10.30978/tb-2023-4-31","DOIUrl":"https://doi.org/10.30978/tb-2023-4-31","url":null,"abstract":"Objrctive — to refine the process of differential diagnosis of morphological and immunohistochemical manifestations of granulomatous inflammation in the lungs of patients with tuberculosis, cryptococcosis and talcosis in conjunction with infection caused by the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Additionally, to compare the morphological features of inflam­matory cell reactions. Materials and methods. A retrospective cohort analysis of 400 medical records of hospitalized patients was conducted from 2010 to 2022. Based on inclusion criteria, 75 patients with laboratory-confirmed HIV infection, aged 25 to 75 years, were selected. Protocols of pathological studies were analysed, histological specimens were reviewed, and additional investigations were conducted. Depending on clinical data and autopsy results, patients were divided into three groups: 30 with tuberculosis in conjunction with HIV infection/AIDS, 25 with talc granulomatosis and HIV infection/AIDS and 20 with cryptococcosis in conjunction with HIV infection/AIDS. General morphological, histochemical and immunohistochemical features of lung lesions, as well as the nature and manifestations of the inflammatory cell reaction, were determined using standard histological staining (hematoxylin and eosin), polarization microscopy, histochemical methods (van Gieson staining, PAS reaction) and immunohistochemical analysis (deter­mination of CD4, CD8, CD68, CD20 marker expressions). Results and discussion. The pathomorphological characteristics of lung lesions in groups 1 and 3 are polymorphic and represented by multiple foci of necrosis, focal fibrosis, a weak inflammatory cell reaction, as well as the accumulation of an alteration agent, in group 2 — in the form of an inflammatory cell reaction with the formation of a granulomas. Weak small-focal diffuse expression of CD4 and CD8 markers was determined in all studied samples, different large-focal expression of CD20 and CD68 markers was observed, localized mainly around the inclusion talc in group 2. Conclusions. The application of a comprehensive approach (histological, histochemical, immuno­histochemical investigation and polarization microscopy) in diagnosing granulomatous lung lesions in patients with HIV infection/AIDS enhances the verification of the etiological factor and expands diagnos­tic capabilities. The spectrum of morphological changes in patients with granulomatous lung lesions is polymorphic and depends on various factors. Significant differences are observed in the manifestations of alterative-necrotic, fibrotic changes and immune reactions both within and between groups, justifying the need for an individualized approach in the diagnostic and therapeutic process.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"48 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139206492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical effectiveness of phospholipids in patients with restrictive respiratory failure due to lung tissue inflammation","authors":"K. Rozova, A. S. Shapovalova","doi":"10.30978/tb-2023-2-15","DOIUrl":"https://doi.org/10.30978/tb-2023-2-15","url":null,"abstract":"Objective — to analyze the clinical effectiveness use of phosphatidylcholine liposomes in the treatment of patients with restrictive respiratory failure caused by acute pneumonia and pneumonia with a prolonged course. \u0000Materials and methods. A prospective cohort study of 68 people was conducted on the basis of the pulmonology department of the Kirovohrad Regional Hospital of the Kirovohrad Regional State in 2020—2021. The people were divided into two groups: I (n = 20) — control group, II (n = 48) — experimental group. They were composed of men aged 25 to 40 years. The first group consisted of healthy individuals who underwent a preventive examination. The second group included patients who, in addition to the traditional treatment of pneumonia, were treated with phospholipids in liposomal form. The drug was used by inhalation according to the instructions. In the course of the experiment, the volume-time indicators of external respiration and gas exchange of the body were studied in dynamics. \u0000Results and discussion. The introduction of phospholipids in liposomal form had a positive effect on the restoration of the function of external respiration from the 5th day of treatment of the disease. This is evidenced by the gradual normalization of breathing rate and respiratory volume. It was shown that the ratio of alveolar ventilation and minute respiratory volume was significantly lower and ranged from 60.3 to 72.7 % (with a control value of 72.2 to 77.4 %). Oxygen consumption increased by approximately 76 % on the 5th day of the disease, which indicates a pronounced increase in the level of oxidative metabolism in the body during this pathological process. Recovery could be observed due to optimization of the body’s oxygen supply. Regarding carbon dioxide release, this indicator was almost 2.3 times higher than the control values ​​on the 5th day of the disease. This contributes to the development of metabolic acidosis, which in turn leads to respiratory alkalosis. Against the background of phosphatidylcholine liposomes treatment, this indicator gradually decreased and had a tendency to approach control values ​​a month after treatment (0.216 ± ± 0.042) l/min). Another of the studied indicators is the dead breathing space. According to this indicator, the efficiency of external breathing also increased. The minute volume of blood flow in healthy individuals was (6.5 ± 0.7). During the disease, it decreased to (4.7 ± 0.8) with gradual recovery, starting from the 10th day of treatment with phospholipids. There is also a decrease in the oxygen saturation of the arterial blood and a decrease in the use of oxygen, which can be judged by the characteristics of the venous blood; at the same time, the determined oxygen consumption increases due to hyperventilation. One month after the treatment, these indicators were no longer significantly different from the control values. A similar trend is noted in the analysis of oxygen tension in arterial and venous","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115438176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of malignant transformation of recurrent respiratory papillomatosis","authors":"M. Opanasenko, O. Tereshkovych, S.M. Shalahay, B. Konik, O. Shestakova, M. Kalenychenko, A. Stepaniuk, V. Lysenko, L. Levanda, M. Shamray","doi":"10.30978/tb-2023-2-51","DOIUrl":"https://doi.org/10.30978/tb-2023-2-51","url":null,"abstract":"Recurrent respiratory papillomatosis (RRP) is a rare, difficult to treat benign tumor disease of the respira­tory tract with a progressive course caused by human papillomavirus and most often occurs in the larynx in the form of papillomas. They may be present at any age, but most often between the ages of 1 and 4. They can recur after treatment, undergo malignant transformation, and spread to the vocal cords, trachea, or lungs. \u0000Objective — to present our own observation of the malignant transformation of RRP in a young man of 23 years old, who was diagnosed and treated at the SI «National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky of the NAMS of Ukraine». \u0000Materials and methods. Prior to this non-systematic review, information was searched in MEDLINE/PubMed for systematic reviews, meta-analyses, and randomized controlled trials published in the past 5 years using such terms as human papillomavirus, recurrent respiratory papillomatosis, and malignant transfor­mation. \u0000Results and discussion. Patient H. 23 years old. From the anamnesis, it is known that the diagnosis of RRP was made at the age of 4, since then he regularly noticed the appearance of dry wheezing, shortness of breath, hoarseness, and sometimes its disappearance. Since childhood, the patient has been under the supervision of a pediatric otolaryngologist. The papillomas were localized on the vocal cords. It is known that more than 100 procedures were performed to remove papillomas using electrocoagulation under general anesthesia. For morphological verification of the diagnosis, it was decided to perform a video-assisted thoracoscopic surgery of the right lung.Pathological examination findings: «Respiratory papillomatosis with a tendency to malignant transforma­tion». The biopsy material was sent for the immunohistochemical examination. Findings: «G2 Non-keratinizing squamous cell lung carcinoma. There are signs of lymphovascular, perineural invasion, there are signs of pleural invasion, the immunohistochemical study shows that tumor cells are positive for p40, which allows to confirm the diagnosis». After that, the patient was consulted by an oncologist and an immunologist. A 2-component chemotherapy with Carboplatin and Paclitaxel was prescribed. \u0000Conclusions. RRP is a rare disease that can become malignant in case of untimely diagnosis and inadequate screening. Great attention should be paid to complementing of the surgical treatment with vaccination and immunotherapy.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133805247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}