Tuberculosis, Lung Diseases, HIV Infection最新文献

{"title":"Clinical use of densitometric analysis of lung pathology and digital data processing programs for determining surgical tactics in phthisiosurgical patients with HIV status","authors":"І.А. Kalabukha, E. Maietnyi, А.G. Vysotsky","doi":"10.30978/tb2023-2-36","DOIUrl":"https://doi.org/10.30978/tb2023-2-36","url":null,"abstract":"Objective — to determine the possibilities of using densitometric indicators of computed tomography (CT) and digital software processing of CT data in lung pathology for the formulation of personalized treatment tactics for phthisiosurgical patients with concomitant HIV pathology, and to justify the indications for surgical treatment. \u0000Materials and methods. A retrospective analysis was conducted on the results of the examination and treatment of 11 patients with specific tuberculous lesions of the lungs. Specific therapy was initiated 2—3 months after the initial visit to the medical institution, and immunochromatographic tests for HIV and hepatitis, which were performed in advance, yielded doubtful (questionable) or negative results. Patients underwent a general clinical examination, echocardiogram, fibrobronchoscopy with examination of bronchoalveolar lavage for Mycobacterium tuberculosis, and molecular genetic tests of sputum or bronchoalveolar lavage. Express tests for HIV, hepatitis B, and hepatitis C, as well as routine blood and urine tests, were carried out. The Aquilion TSX-101A Toshiba (Japan) tomography was used as the main research tool. Densitometric analysis of lung parenchyma was performed using DICOM-VIEWER PHILIPS in the areas of interest. Digital analysis of images obtained from CT slices was conducted using the Dragonfly program. \u0000Results and discussions. The clinical manifestation of patients’ «radiological findings» was asymptomatic in 81.8 % of cases and mostly perceived as a «post COVID-19 syndrome». The analysis of the laboratory data did not indicate specific signs of the disease in 72.7 % of cases. The study of the verified focal lesions without signs of destruction of the lung parenchyma during densitometric analysis of CT revealed densities that characterize exudative processes in the lung parenchyma (0—15 HU), which is a characteristic sign of a specific inflammatory process in the context of HIV infection. Histologically, high activity of a specific inflammatory process was detected in operated patients. During digital software processing, we observed a shift in densitometric indicators that are characteristic of the exudative phase of inflammation. Situations of HIV-associated infection and alteration-exudative reactions were noted, which were 100 % determined by densitometric analysis and digital software processing of the chest CT scan. Six patients underwent surgery on (2 lobectomies, 1 combined resection and 3 sublobar resections). Among the non-operated patients, 3 experienced a recurrence of a specific inflammatory process, and 1 patient still exhibits significant morphological changes in the parenchyma. \u0000Conclusions. Densitometric analysis and digital software processing of CT scan allows you to objectify the patient's condition and reasonably prescribe personalized therapy. Identified patients with X-ray lesions of the lungs require a mandatory consultation with a thoracic surgeon and consideration of the i","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"11 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":"129904465","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":"Ferritin, IL-6 and human-beta-defensin-1 as prognostic markers of the course severity and treatment effectiveness of pulmonary tuberculosis","authors":"O. Shevchenko, L. Todoriko, S. Matvyeyeva, I. A. Ovcharenko, O. Shvets, O. Pohorielova","doi":"10.30978/tb-2023-2-7","DOIUrl":"https://doi.org/10.30978/tb-2023-2-7","url":null,"abstract":"Current methods of investigation in TB patients, namely sputum microscopy, culture, and molecular genetic methods, although well-studied, have a number of disadvantages, such as low sensitivity, long time required to obtain results, or high cost. Because of this, the search for alternative diagnostic tools and methods for predicting the course and effectiveness of treatment in patients with tuberculosis becomes relevant. In this study, ferritin, interleukin-6 (IL-6), and human-beta-defensin-1 (HBD-1) were selected for comparison of prognostic performance. \u0000Objective — to investigate the dynamics of ferritin, IL-6, and human-beta-defensin-1 levels against the background of the intensive phase of pulmonary tuberculosis therapy and to identify the most effective marker for predicting the effectiveness of treatment. \u0000Materials and methods. 100 patients with pulmonary tuberculosis and 20 healthy individuals were included in the study. Examination of patients was carried out according to the current standards of providing medical care to tuberculosis patients. In addition, the patients' fasting blood ferritin, IL-6 and HBD-1 levels were determined at the beginning of treatment and after 60 days. Healthy individuals from the control group had a single determination of ferritin, IL-6 and HBD-1 blood levels on an empty stomach. \u0000Results and discussion. At the beginning of treatment, the ferritin level was significantly lower (95.95 ± ± 8.68) ng/ml in patients who later effectively completed the intensive phase of anti-tuberculosis treatment than in patients with ineffective intensive phase of treatment (152.27 ± 8.85) ng/ml. The same trend persisted after 60 days: in the effective intensive phase — (123.87 ± 13.39) ng/ml, in the ineffective one — (239.76 ± 12.91) ng/ml, p < 0.05. In effective intensive phase of antituberculosis treatment, the level of IL-6 was significantly lower. Thus, at the beginning of treatment, it was (82.59 ± 6.89) pg/ml in patients with an effective intensive phase of treatment and (146.42 ± 8.04) pg/ml in patients with ineffective intensive treatment phase. After 60 days, it was (48.88 ± 4.19) pg/ml in patients with an effective intensive phase of treatment and (142.89 ± 9.11) pg/ml in patients with ineffective intensive treatment phase, p < 0.05. The level of HBD-1 was higher when the intensive phase of antituberculosis therapy was ineffective, as when measured at the beginning of treatment (effective intensive phase — (18.71 ± 3.31) pg/ml, ineffective intensive phase — (32.79 ± 8.31) pg/ml), as well as when measured after 60 days (effective intensive phase — (19.93 ± 3.58) pg/ml, ineffective intensive phase — (42.92 ± 12.99) pg/ml, p < 0.05). \u0000Conclusions. Levels of ferritin, IL-6 and HBD-1 are significantly increased in tuberculosis patients compared to healthy individuals, which allows them to be considered as markers of tuberculosis inflammation. Higher concentrations of these markers, both at the beginning of treatment and ","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"16 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":"128828780","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":"Prospects for the use of artificial intelligence to predict the spread of tuberculosis infection in the WHO European Region","authors":"L. Todoriko, O. Andriiets, Y. Vyklyuk, I. Semyaniv, I. Margineanu, E. Lesnic, D.V. Nevinsky, I. Yeremenchuk","doi":"10.30978/tb2023-2-86","DOIUrl":"https://doi.org/10.30978/tb2023-2-86","url":null,"abstract":"Objective — to analyze the prospects of using artificial intelligence and neural networks to create a geospa­tial model of TB transmission and forecast its spread in the WHO European Region using available analytical databases. \u0000Materials and methods. The research was carried out for the period October 2022 — March 2023. Digital access to the following full-text and abstract databases was used as the main source of research: the EBSCO Information Base Package, the world’s largest single abstract and scientific metric platform Scopus, the freely accessible search system Google Scholar, MEDLINE with Full Text, Dyna Med Plus, EBSCO eBooks Clinical Collection, the abstract and scientific metric database of scientific publications of the Thomson Reuters Web of Science Core Collection WoS, statistical data from the Ministry of Health of Ukraine and the Public Health Center, SCIE, SSCI, the online database of the National Scientific Medical Library of Ukraine, AHCI. \u0000Results and discussion. Migration processes in Europe still remain a global trend and create difficulties for countries that receive migrants. Adverse living conditions, close contact, poor nutrition, mental and physical stress are what refugees and migrants face. The combination of these risk factors and insufficient access to health services increases the vulnerability of refugees to TB infection. In addition, a delay in diagnosis leads to poor treatment outcomes and continued transmission of the infection to other people.The optimal way to predict the spread of TB infection in European cities, where a significant number of migrants from Ukraine arrived, is to create a mathematical model using the analytical technology of neural networks and artificial intelligence. By analyzing a large amount of data, artificial intelligence can quickly and efficiently identify connections between various factors and predict the future development of the epidemic. For example, artificial intelligence can analyze data on the incidence of TB in different regions of the world, as well as data on the number of patients with other diseases that can affect the human immune system, and make a forecast about the development of the epidemic in the future. \u0000Conclusions. Today, the creation of a mathematical model and the development of a simulator program for the geospatial functioning of the city and the interaction of people during the day are relevant. Understanding the natural history of TB among recently arrived migrants is important as we consider how best to implement TB control in such populations.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"33 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":"115329065","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":"Penetrating combat-related thoracic trauma (review)","authors":"O. Shevchenko, V. V. Makarov, R. Shevchenko, L. Todoriko, V. Petrenko, K.M. Smolianyk, O. Pohorielova","doi":"10.30978/tb2023-2-68","DOIUrl":"https://doi.org/10.30978/tb2023-2-68","url":null,"abstract":"Objective — to study in detail the mechanisms and to investigate the imaging manifestations of combat-related penetrating thoracic injuries. \u0000Materials and methods. To perform the work, a literature search was provided according to the criterion «Thoracic penetrating combat-related trauma». 32 literary sources were selected for this request. Frag­ments of the clinical experience described in the literature according to the selected sources were illustrated by our own clinical cases of patients who were treated in Kharkiv medical institutions in 2022 for penetrating combat-related thoracic injuries. \u0000Results and discussion. Among victims who received chest injuries, polytrauma was most often diagnosed, complicated by several mechanisms of injury associated with penetrating, blunt, and explosive injuries. Pneumothorax and pulmonary contusion were the most common chest injuries. Thoracic injuries, thoracic vascular injuries, and lung ruptures were associated with the highest mortality rates, whereas pulmonary contusions, pneumothorax, and chest wall injuries were associated with relatively lower mortality rates. Chest X-ray is the first-line imaging method during the initial assessment of thoracic trauma in combat and non-combat situations. Such an examination is particularly important in polytrauma situations where multiple fatal injuries can be rapidly diagnosed in order to rapidly triage and include such an injury in the initial evaluation. Tension pneumothorax, large hemothorax, chest fragmentation, and some other lesions can be quickly diagnosed with a portable chest X-ray. Computed tomography (CT) of the chest is an important component of the comprehensive trauma evaluation, which allows to diagnose life-threatening injuries in hemodynamically stable patients with suspected multiple injuries not identified on chest X-ray. Chest CT detects 20 % more pathologies compared to chest X-ray. \u0000Conclusions. Combat-related thoracic trauma continues to be a significant contributor to the mortality rates of those injured in military operations. A clear injury pattern and atypical imaging manifestations of thoracic trauma are important to recognize at an early stage because of the acuteness of this category of patients and the impact of an accurate diagnosis on clinical management. Chest X-ray remains the main diagnostic tool. However, in modern and well-equipped institutions, chest CT, video-assisted thoracoscopy, and ultrasound scanning of the abdominal and chest cavity play an important role in the diagnosis of thoracic trauma. Quick and high-quality diagnosis and treatment are possible only in direct cooperation between surgeons and radiologists.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"7 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":"132798174","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":"Distance learning in the context of the COVID-19 pandemic and war in Ukraine according to medical university students","authors":"Z. Piskur, O. Kostyk, U. Chulovska, N.M. Halyshych, O.I. Sahelashvili­–Bil","doi":"10.30978/tb2023-2-98","DOIUrl":"https://doi.org/10.30978/tb2023-2-98","url":null,"abstract":"Objective — to investigate the personal attitude of 5th and 6th year students of the medical faculties of Danylo Halytskyi Lviv National Medical University to mixed forms of education, including distance learning, in the context of quarantine of the COVID-19 pandemic and martial law. \u0000Materials and methods. A questionnaire was conducted to study the personal attitude of the 5th and 6th year students of the medical faculties of Danylo Halytskyi Lviv National Medical University to the study of curricula in a mixed form of education during the autumn semester of the 2022—2023 academic year. \u0000Results and discussion. Among the survey participants, a third (33.7 %) noted that they felt more responsible for their studies, realised the opportunity to be in the learning process, i.  e. noted a change for the better, in general. However, 18.5 % of the respondents indicated a negative change, feeling indifferent. One third of students (39.1 %) rated their level of anxiety as high, and one third (33.7 %) as very high. It has been found that 30.4 % of students are engaged in volunteer activities alongside their studies, and more than half (53.2 %) are employed, including 30.4 % of all survey participants working in the medical field. Among the 6th year students, participation in volunteer activities increased compared to the 5th year students, and 39.7 % were engaged in it, and more 6th year students were also employed — 56.4 %. Among the negative factors for 80.4 % of the surveyed 5th year medical students, the priority was the lack of acquisition and improvement of practical skills, which is obvious. «Technical difficulties» came second. Distance learning had no impact on the desire to acquire knowledge in 72.3 % of students, and 27.7 % said they felt a lack of motivation to study after switching to distance learning. \u0000Conclusions. The war and martial law in Ukraine have become a source of stress for all participants in the educational process, so understanding students’ personal attitudes to learning is relevant and necessary in modern conditions. The use of information technology tools increases opportunities for both education and science. During the quarantine caused by the COVID-19 pandemic and martial law in Ukraine, the educational process did not stop, and the distance learning format, according to the vast majority of students surveyed, made it possible to continue studying medicine in relatively safe places.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"1 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":"129930653","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":"Markers of quality of life in patients with nosocomial pneumonia caused by SARS-CoV-2","authors":"T. Homeliuk, M. Marushchak","doi":"10.30978/tb2023-2-44","DOIUrl":"https://doi.org/10.30978/tb2023-2-44","url":null,"abstract":"Objective — to investigate and analyze total white blood cell count and leukogram in an order with community-acquired pneumonia caused by SARS-CoV-2 and to establish their relationship with subjective health assessment using the SF-36 tool 1 year after hospital discharge. \u0000Materials and methods. A retrospective study of the medical records of 208 patients who were hospitalized for community-acquired pneumonia with a negative smear test for the SARS-CoV-2 virus was conducted. The main group consisted of patients with SARS-CoV-2 nucleic acid identification and signs of pneumonia. According to the severity of pneumonia, patients were divided into three groups: II group —patients with pneumonia of category 2 of complexity (n = 124), group III — patients with pneumonia of category 3 of complexity (n = 68), group IV — patients with pneumonia of category 4 of complexity (n = 16). The comparison group consisted of patients with SARS-CoV-2 nucleic acid identification and the absence of pneumonia. Charlson’s comorbidity index (Charlson Comorbidity Index) for the general prognosis of mortality was calculated using a special computer program. The general questionnaire SF-36 was used to assess the quality of life. Statistical analysis of data was carried out using the Statistica 7.0 software. \u0000Results and discussion. Probably higher values ​​of the total number of leukocytes were established in the patients of the studied groups compared to the comparison group. At the same time, this indicator in patients of the IV group statistically significantly exceeded the similar data of the II and III groups. The increase in leukocytes as the complexity of pneumonia progressed was mainly due to segmented neutro­phils. In patients with acquired pneumonia of the 3rd and 4th severity category caused by SARS-CoV-2 1 year after discharge from the hospital, the indicators of physical and psychological components of health are likely to be lower, while increasing age is likely to be associated with a decrease in quality of life. \u0000Conclusions. In patients with community-acquired pneumonia caused by COVID-19, an increase in the content of leukocytes upon admission to the hospital is associated with a decrease in indicators of physical and psychological components of health 1 year after discharge from the hospital.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"16 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":"121127390","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":"Ways of transformation of typical X-ray signs of community acquired pneumonia of viral etiology (COVID-19) according to radiomics data","authors":"М. Lynnyk, V. Іgnatieva, G. Gumeniuk, O. Yakovenko, V. Svyatnenko","doi":"10.30978/tb2023-2-28","DOIUrl":"https://doi.org/10.30978/tb2023-2-28","url":null,"abstract":"For 3 years since the announcement of the coronavirus disease (COVID-19) pandemic, doctors around the world have been studying the complications caused by different strains of SARS-CoV-2. To study the structure of the lung parenchyma in patients with a complicated course of community acquired viral pneumonia of COVID-19 and different ways of transformation, the most informative is the digital software processing of computed tomography (CT) images of the chest organs (CT). \u0000Objective — to investigate the ways of transformation of typical radiological signs in patients with community-acquired pneumonia of viral etiology (COVID-19) and the possibility of their transformation into bronchioloalveolar cancer (BAC) by the radiomics method. \u0000Materials and methods. Chest CT data in the dynamics of 112 patients with a complicated course of community-acquired viral pneumonia COVID-19 were analyzed. Chest CT was performed on an Aquilion TSX-101A Tochiba scanner (Japan) with subsequent digital software processing of CT images using the Dragonfly program from Obyect Research Systems (ORS), Montreal, Canada. The diagnosis of BAC was made based on the data of the pathomorphological examination. Transbronchial biopsy of lung tissue was performed during diagnostic fibrobronchoscopy. \u0000Results and discussion. As a result of the analysis of possible ways of transformation of typical X-ray changes of COVID-19 community-acquired pneumonia, we identified 3 main ways. In 71 (64.0 %) subjects, according to the chest CT scan, there was gradual resorption of pathological changes and recovery of the lung parenchyma. In 35 (31.2 %) patients, the formation of signs of «vanishing lung syndrome» was detected. 5 (4.5 %) patients were diagnosed with BAC according to the CT scan and pathomorphological examination. Digital software processing of chest CT in dynamics allows to track the process of transformation of the lung parenchyma structure in patients with a complicated course of COVID-19 community-acquired viral pneumonia into BAC and in some cases to confirm the secondary nature of the oncological process. \u0000Conclusions. Digital software processing of the chest CT data is a highly informative research method that clearly reflects the morphological structure of the lung parenchyma and allows diagnosis and differential diagnosis of diseases.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"4 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":"128459140","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":"The Strategy for overcoming the HIV/AIDS epidemic in Ukraine (review)","authors":"S. Ivanov, V. Stepanenko, S.G. Svyrid, R. Stepanenko, T. Lytynska, O. Fedorenko, T. Konovalova","doi":"10.30978/tb-2023-2-79","DOIUrl":"https://doi.org/10.30978/tb-2023-2-79","url":null,"abstract":"The HIV epidemic in Ukraine remains a national problem. Significant difficulties due to the crisis of socio­economic phenomena, caused by the COVID-19 epidemic and russia’s full­-scale military aggression against Ukraine, significantly complicate the forecasting of the further development of the HIV/AIDS epidemic.\u0000Objective — to substantiate the ways of implementation of monitoring, modern diagnostics and principles of treatment and prevention of HIV infection as the basis of the strategy to overcome the HIV/AIDS epidemic in Ukraine, as well as to determine the volumes and algorithms of cooperation of specialists of different levels for the provision of medical services to patients with skin diseases and sexually transmit­ted infections.\u0000Materials and methods. The analysis of international policy documents in the field of health care and public health was carried out; recent changes in the documents of state policy in the field of health care of Ukraine; international strategies and approaches to overcoming the HIV epidemic; review of the dynamics of morbidity of skin and venereal diseases in Ukraine.\u0000Results and discussion. During the review of the remaining statistical information, key recom­mendations are presented for the near future of the monitoring system and implementation control of HIV infection in Ukraine. These recommendations serve as the basis for optimizing healthcare visits and specialized interventions in light of the large-scale military invasion by russia in Ukraine.\u0000Conclusions. In order to overcome the HIV/AIDS epidemic in Ukraine, it is necessary to revise a number of regulatory and methodological documents based on the principles of evidence-based medicine and WHO recommendations, adapt them to the current emergency situation, develop operational approaches and clinical pathways that will ensure that HIV-positive patients, pregnant women and children born to HIV-positive women receive timely comprehensive medical services.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"294 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125983435","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":"Bening solitary pulmonary necrotic focal lesions: possibilities of morphological diagnostics","authors":"I. Liskina, O. Melnyk, S. Kuzovkova, L. Zahaba","doi":"10.30978/tb-2023-2-21","DOIUrl":"https://doi.org/10.30978/tb-2023-2-21","url":null,"abstract":"Objective — to analyze the diagnostic possibilities of histological examination of single necrotized focal lung lesions by determining their histological features and etiology.\u0000Materials and methods. The study was conducted as a cohort, retrospective. The group included 68 patients with solitary focal lesions of the lungs (from 1 to 3), the size of each focus did not exceed 3 cm. The size, shape and contours of the detected foci were evaluated based on the results of radiographs or tomograms. Morphological diagnostics included cytological and histological examination. The results of microbiological examination of operative material for the presence of mycobacteria and non-specific microorganisms, the results of molecular genetic analysis for the presence of tuberculosis mycobacteria must be taken into account; as well as a number of indicators of clinical-biochemical and immunological studies of biological fluids, clinical data as needed. Histological findings, preliminary and final clinical diagnoses were compared.\u0000Results and discussion. According to the results of X-ray analysis and traditional histological examination, a number of signs of solitary necrotic foci-nodules were identified and compared with the results of histochemical, microbiological and molecular genetics examination. It was established that solitary necrotic nodules (78.0 %), larger than 1 cm (81.0 %) of irregular shape predominate. In two-thirds of cases (62.0 %), a granulomatous process was observed, and namely in these cases mycobacteria were detected during microbiological examination. Also, only in cases of histological diagnosis of caseous necrosis or necrosis of mixed type, positive results of microbiological examination for the presence of MBT were obtained. Final histological conclusions with an accurate formulation of the pathological process were obtained in 88.2 %, while the etiology was established in 85.3 % of cases. The final clinical diagnoses had differences compared to the histological conclusions because they have a different formulation principle.\u0000Conclusions. A complex histological study in combination with microbiological and molecular genetic studies plays a decisive role in establishing of the etiology of solitary necrotic pulmonary foci. According to the results of our work, the dominated etiology of nodules was foci as a result of limited disturbances in the pulmonary blood circulation system (infarcts and focal thrombus, infarct pneumonia), tuberculous and fungal nature. The overall diagnostic efficiency of morphological diagnostics was 85.3 %.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128583352","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":"Pathology of carotid triangle of the neck as one of the extra-respiratory causes of chronic cough (clinical case)","authors":"N. Vasyliuk, I.V. Dmytriv","doi":"10.30978/tb-2023-2-63","DOIUrl":"https://doi.org/10.30978/tb-2023-2-63","url":null,"abstract":"One of the extra-respiratory causes of chronic hacking cough is a tumorous pathological process in the carotid triangle of the neck. A 41-year-old patient sought medical assistance for a hacking cough that worsened in the evening and had lasted for more than 8 weeks. After treatment prescribed by the primary care physician, the patient noticed a short­term improvement. However, shortly after discontinuing the therapy, the cough resumed and intensified. The patient was referred for a consultation with an otolaryngologist. During the examination, an elastic, condensed formation with somewhat limited mobility and a smooth surface measuring 2.5 × 3.0 cm was found in the area of the carotid triangle of the neck. Ultrasound examination of the soft tissues of the neck and ultrasound Dopplerography of the neck vessels were performed. An entity was detected that, based on all ultrasound characteristics, appears to be a carotid paraganglioma on both sides. The diagnostic conclusion was confirmed by the result of neck magnetic resonance imaging, which described carotid paragangliomas. After establishing the diagnosis of carotid chemodectoma in the neck, the patient was consulted by an oncologist and referred to a specialized department, where they underwent successful surgical treatment. Following the surgical intervention, the patient remained under the dispensary observation of an otolaryngologist and a vascular surgeon for the next 12 months. During this period, there were no complaints of cough recurrence. The cessation of the triggering factor in the afferent pathway of the neuroreflex arc of the cough reflex, achieved by removing the carotid paraganglioma, contributed to the disappearance of the cough — a symptom that had negatively impacted the patient's quality of life.The clinician should be highly vigilant if an initiated cough persists for several weeks or months and the patient demonstrates an excessively sensitive cough reflex. It is important to remember that chronic idiopathic cough can be a distinct clinical entity with an unidentified underlying pathology, and it can also contribute to the identification of a clinical pattern different from cough-associated diseases. In cases of persistent idiopathic cough that is unresponsive to treatment, the concept of distinct afferent pathways and an «anatomical diagnostic protocol» should be employed to determine the pathology and guide patient management.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126691144","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}