Tuberculosis, Lung Diseases, HIV Infection最新文献

{"title":"Clinical effectiveness of bedaquilin and delamanid treatment of children and adolescents with drug-­resistant tuberculosis","authors":"M. Sakhelashvili, O. Kostyk, O. Sakhelashvili–­Bil, Z. Piskur, L. Rak, Z.R. Nakonechnyi, J.J. Didyk, R. M. Tupychak, M. Voitovych, N.S. Chursyna, S.H. Haivashchuk, V. Hamal","doi":"10.30978/tb2022-4-6","DOIUrl":"https://doi.org/10.30978/tb2022-4-6","url":null,"abstract":"Objective — to study the clinical effectiveness of chemotherapy using bedaquiline (Bdq) and delamanid (Dlm) in children and adolescents with multidrug-resistant (MDR) and extensive drug resistant (XDR) pulmonary tuberculosis of lungs (TBL). \u0000Materials and methods. A retrospective cohort analysis of the medical records of 40 patients with pulmonary tuberculosis (TB) with MDR/XDR was conducted in order to study the clinical effectiveness of chemotherapy with Bdq and Dlm. Among 40 patients were 25 (62.5 %) children aged 0 to 14 years and 15 (37.5 %) — teenagers aged 15 to 17; there were 18 (47.5 %) boys, 22 (52.5 %) girls. The patients were divided into two groups: the first group — 25 children and the second group — 15 teenagers. Microbiological research in children and adolescents included: detection of Mycobacterium tuberculosis (MTB) in sputum by smear microscopy, sowing of material on Levenstein—Jensen medium, typing of isolated mycobacteria on BACTEC MGIT 960, determination of the drug susceptibility test of strains of MTB to antituberculosis drugs (ATBDs) of first- and second-line, as well as molecular genetic research of sputum, in particular by GeneXpert MTB/RIF/Ultra and linear probe analysis. All children and adolescents received an individualized treatment regimen depending on the resistance of MTB to ATBDs or on the resistance of MTB at the source of infection. \u0000Results and discussion. Among the examined children (25), who were prescribed Bdq and Dlm, almost half (44.0 %) were aged from 0 to 4 years, 12.0 % — from 5 to 8 years and 44.0 % — from 9 to 14 years. Patients aged 17 years (46.7 %) prevailed among teenagers (15). MDR/RIF-TB was diagnosed in 10 (40.0%), XDR-TB determined in 3 (12.0 %) and risk of MDR-TB (RMDR-TB) — in 12 (48.0 %) children who were prescribed a new treatment regimen with Bdq and Dlm. At the same time, MDR-TB diagnosed 1.7 times more often, XDR-TB 2.8 times more often and RMDR-TB 3.3 times less often among adolescents compared to children.The primary tuberculous complex found in 12 (48.0 %) children, TB damage of lung and bone — in 4 (16.0 %), TB of the intrathoracic lymph nodes — in 3 (12.0 %), TB of the lungs and central nervous system — in 2 (8.0 %) and infiltrative TB of the lungs — in 3 (12.0 %). The infiltrative pulmonary TB was observed 7.5 times more often and the disseminated form 3.3 times more often in adolescents than in children.All children didn’t excretion of MTB after the two months of treatment with Bdq and Dlm. However, non-bacterial excretion in all adolescents was achieved within 3 months of chemotherapy (CT). Significant positive X-ray dynamics were found in 23 (92.0 %) children and 12 (80.0 %) adolescents during 9 months of CT. Lung changes remained in 2 (8.0 %) children and 3 (20.0 %) adolescents after 9 months of treatment. However, in both children and adolescents resolution of infiltration, densification of focies and formation of fibrosis in the lungs were confirmed radiologically at the","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"227 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122711918","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":"Factors influencing drug susceptible tuberculosis outcomes in Eastern Europe","authors":"L. Todoriko, I. Margineanu, I. Semianiv, F. Gafar, T. Butnaru, D. Baiceanu, R. Dragomir, F. Mihălţan, I. Munteanu, B. Mahler, O. Akkerman, J. Alffenaar","doi":"10.30978/tb-2022-4-13","DOIUrl":"https://doi.org/10.30978/tb-2022-4-13","url":null,"abstract":"Objective — to conduct a retrospective analysis of factors that affect the results of treatment of patients with tuberculosis. \u0000Materials and methods. A retrospective multi-center study was conducted on adult (> 18 years) patients diagnosed with drug-sensitive susceptible TB of any form and initiated treatment between 1st of January 2019 — 31st of December 2019. The Bucharest Marius Nasta Institute, the Iasi Lung Hospital in Romania, and Chernivtsi TB Centre in Ukraine participated in this study. The study was approved by the ethics committee of each centre (Iassi: 5483/2021, Bucharest: 10592/2019, Chernivtsi: 234/2021,). The need for written informed consent was waived due to the retrospective nature of this study. \u0000Results and discussion. It is important to study the factors that influence the course and effectiveness of TB treatment, as they can be useful for the development of new methods of diagnosis and treatment. Our retrospective study identified such factors in an Eastern European population. The risk of adverse consequences increases for the elderly, people without a permanent place of residence, patients with already diagnosed chronic kidney disease, the presence of cavities on a chest X-ray, rapid relapse of TB, under­weight or obesity.These factors may help tailor care to specific populations and may lead to improved TB scoring systems to identify patients at risk of treatment failure. \u0000Conclusions. Our study presented common risk factors for unfavourable outcomes with previous research, including age, sex, nutritional status, lifestyle, comorbidities, TB-related parameters, but introduced a new, paraclinical parameter, and highlighted differences for East Europe.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"93 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126430400","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":"Features of the long-term course of community-acquired viral pneumonia COVID-19 according to computed tomography (clinical cases)","authors":"O. Yakovenko, М. Lynnyk, V. Іgnatieva, V. Svyatnenko, V. Polischuk","doi":"10.30978/tb2022-3-52","DOIUrl":"https://doi.org/10.30978/tb2022-3-52","url":null,"abstract":"Objective — to study the dynamics of pathological changes of lungs in patients with a long course of viral pneumonia of COVID-19 by the analysis of data of a computer tomography (CT) of thoracic organs (ТО). \u0000Materials and methods. Analyzed in the dynamics of CT of TO patients with changes in the lungs with a long course of community-acquired viral pneumonia COVID-19. Patients were examined at the SI «National Institute of Tuberculosis and Pulmonology F.G. Yanovsky NAMS of Ukraine» (NIFP NAMS) on the CT scanner Aquilion TSX-101A «Tochiba» (Japan), as well as analyzed the archival data of the CT TO.The diagnosis of COVID-19 was established in accordance with the current protocols for the treatment of coronavirus disease «Provision of medical care for the treatment of coronavirus disease (COVID-19)», approved by the Order of the Ministry of Health of Ukraine dated April 2, 2020 N 762 ). \u0000Results and discussion. CT of TO was analyzed in 120 patients with community-acquired pneumonia of viral etiology (COVID-19), who were examined at various intervals for 6—12 months. It was found that in 30 patients (19 men and 11 women aged 24 to 72 years) with long-term pneumonia (COVID-19), there are significant structural changes in the lung parenchyma that are diagnosed on CT of TO.The ways of regression of the detected changes, as a result of which there is a resorption of pathological changes or the development of «disappearing lung syndrome», requires differential diagnosis and dynamic monitoring with densitometric studies using CT of TO. Clinical cases are given. The first case shows how after a mild acute period of COVID-19, developed more severe Long COVID with a long course of community-acquired viral pneumonia COVID-19. On the first CT of TO «fibrotic-like changes» were revealed, but at the subsequent monitoring (within 8 months) against the background of the carried-out pathogenetic treatment, there was a full restoration of pneumatization of a pulmonary parenchyma without formation of fibrosis. The second case demonstrates how after a severe course of acute COVID-19, developed Long COVID with a long course of community-acquired viral pneumonia COVID-19. The second case demonstrates how after a severe course of acute COVID-19, developed Long COVID with a long course of community-acquired viral pneumonia COVID-19. CT of TO after the acute period of the disease revealed changes that during monitoring (for 7 months) despite the treatment, led to the development of degenerative-destructive changes in the lungs and continue to progress. \u0000Conclusions. In patients with Long COVID -19 it is advisable to monitor CT of TO. The frequency of the study should be decided personally, taking into account the clinical course of the disease. Due to the high rate of degenerative pulmonary parenchymal COVID-19 viral pneumonia in patients with long-term nosocomial viral pneumonia, new methods of treating patients with «disappearing lung syndrome» need to be developed.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115080648","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":"Solitary focal lung lesions: modern views on the diagnosis and medical tactics of their management. Literature review","authors":"I. Liskina","doi":"10.30978/tb2022-3-68","DOIUrl":"https://doi.org/10.30978/tb2022-3-68","url":null,"abstract":"A review of the literature is devoted to highlighting of the main points relating to the modern actual multidisciplinary problem — single or solitary lung nodules with incidental detection. The main terms that are used in the study of such lesions or the more common term — nodules, as well as their definition are given. Known pathology causes for the development of solitary pulmonary nodules are also presented. The morphological characteristics of such nodules are described by X-ray or tomogram. The main problem if such nodules are detected is to establish their nature and, above all, their malignant or benign nature. Since the further medical tactic of their management are exactly different. Now the main attention is paid to malignant tumors, since they require the fastest most reliable identification and appropriate medical actions.It has been established that accurate determination of nodules etiology by the main indicators of their radiological images is impossible. Although certain dependences of the malignancy risk of nodules on their size, contours and features of optical density have been identified. And only a morphological study allows us to establish the true nature of the nodules. It is believed that over diagnostics of malignancy of pulmonary nodules leads to excessive use of expensive invasive diagnostic procedures, and to some extent harms the patient in cases of benign nodules. The review ends with a list of possible options for medical management when solitary lung nodules of unknown origin are detected. Their disadvantages and advantages are briefly presented.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"32 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125705981","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":"Impact of delayed initiation of antiretroviral therapy in patients with HIV infection","authors":"O. Shevelova, L. Shostakovich–­Koretska, K. Lytvyn, O. Kushnierova","doi":"10.30978/tb2022-3-34","DOIUrl":"https://doi.org/10.30978/tb2022-3-34","url":null,"abstract":"Objective — to analyze the effect of the duration of the period from the moment of infection to the appointment of antiretroviral treatment in patients with HIV infection as a predictor of an unfavorable course of the disease. \u0000Materials and methods. A retrospective and prospective study was conducted among a cohort of people living with HIV (PLHIV), which included 450 patients. The observation lasted 60 months. 63 patients died from HIV-related causes, 14 from non-HIV and immune reconstitution inflammatory syndrome (IRIS) causes, 69 patients interrupted antiretroviral therapy (ART) for various reasons during the follow-up period. By the end of the follow-up period, 304 patients remained on ART. Statistical processing of the results was carried out using the STATISTICA v. 6.1 application package. \u0000Results and discussion. Based on the results of a correlation analysis of clinical and laboratory parameters of a cohort of HIV-infected patients, 10 main risk factors were selected, including the delayed initiation of antiretroviral treatment. After 5 years of follow-up, the main reason for the loss of patients from the cohort was interruption of therapy — 69 (15.3 %) people, 63 (14.0 %) died from HIV-related causes, and 14 (3.1 %) died from causes unrelated to HIV and IRIS. Causes associated with the undesirable clinical outcomes of ART were noted in 30.4 % of people — allergic reactions, taking therapy together with anti-TB therapy, in turn, led to the development of IRIS and an increase in adverse events. \u0000Conclusions. The analysis shows that despite the high intensity of the prescribed primary treatment regimens for patients with HIV infection, such a factor as the delayed initiation of ART has a significant negative impact on the further course of HIV infection and the development of adverse events, worsening the prognosis of the disease.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134434850","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 modern view on the mechanism of occurrence and development of latent tuberculosis infection. Literature review","authors":"V. Petrenko, S. Noreiko, Ya.V. Bondarenko, I. Galan, O.V. Stopolyanskyi","doi":"10.30978/tb2022-3-60","DOIUrl":"https://doi.org/10.30978/tb2022-3-60","url":null,"abstract":"Сonsider the modern concept of understanding of latent tuberculosis infection. To conduct this review, 64 literature sources were analyzed using electronic databases of medical publications, mainly PubMed.About a quarter of the world's population is infected with M. tuberculosis. Most of those infected are able to contain M. tuberculosis, that is, they are in a state of latent tuberculosis infection without any manifestations of active disease. At the present stage, it is impossible to detect persistent (latent) M. tuberculosis, which makes it impossible to identify those individuals who among likely infected and asymptomatic hosts cleared of M. tuberculosis, and those who remain latently infected or latent infected will progress to failure to control M. tuberculosis and eventually develop tuberculosis. The dogma of the binary nature of M. tuberculosis infection (active tuberculosis or latent tuberculosis infection) is an oversimplified and now outdated concept. Understanding all the immune components and responses that are the essence of latent tuberculosis infection or resistance to it, to the constant control of M. tuberculosis or even their elimination from the host is crucial for understanding protective immunity from M. tuberculosis.Studies of the immune response to M. tuberculosis in people resistant to latent tuberculosis infection may provide insight into alternative mechanisms of protection against M. tuberculosis, treatment of tuberculosis, and approaches to vaccine development.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123348628","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":"Solitary pulmonary nodules: etiology, sizes and topographical features","authors":"S. Kuzovkova, I. Liskina, L. Zagaba, O. Melnik","doi":"10.30978/tb-2022-3-11","DOIUrl":"https://doi.org/10.30978/tb-2022-3-11","url":null,"abstract":"Objective — determination of the size and localization of solitary pulmonary nodules (SPN) of various etiology and their qualitative-quantitative characteristics when separated into malignant and benign formations. \u0000Materials and methods. The randomized retrospective study involved 422 patients who were hospitalized in the National Institute of phthisiology and pulmonology named after F.G. Yanovsky from 2017 to 2021. Criteria for inclusion in the study group are focal lesions of the lungs of unclear etiology, the size of which did not exceed 3,0 cm, and the presence of no more than 3 foci in both lungs of one patient according to X-ray examination. The number, size and location of the SPN were determined according to X-ray examination or computed tomography of the chest organs.. A total of 473 nodules were found. The etiology of SPN was determined according to the results of histological and cytological examination of biopsy or operative material and/or microbiolo­gical data. All nodules were divided into three groups, depending on their size. \u0000Results and discussion. The etiological spectrum of all revealed SPN in the five-year period is determined. It was established that among all SPN malignant tumors (39.1 %) are dominated the average size of which was (2.14 ± 0.1) cm, on the second place in the number of observations were nodules of infectious origin (31.0 %), the average size — (1.97 ± 0.1) cm, and on the third — benign tumors (18.7 %). the average size — (1.57 ± 0.1) cm. The average size of malignant tumors and SPN of infectious origin was significantly larger than the size of benign tumors and vascular formations. It was shown that in a group with SPN sizes 0.3—1.0 cm malignant tumors amounted to 22.9 %. and in a group with a size from 2.1 to 3.0 cm — 51.5 %, respectively 55.3 % of all SPNs were found in the right lung, 44.7 % in the left. In the upper lobe of the right lung. 52.3 % of nodules were found. which is significantly more than in middle. 16.0 % of SPN (p < 0.001), and the lower lobe — 31.7 % (p < 0.001). In the upper lobe of the left lung. 59.4 % of SPN were diagnosed, and in its lower lobe — 40.6 % (p < 0.001). \u0000Conclusions. Among all solitary pulmonary nodules of various etiology. the largest specific gravity have malignant nodes — 39.1 % and nodules of infectious genesis — 31.0 %. and the average size of these SPN is essentially larger than the size of benign tumors and vascular formations. The percentage of malignancies increases from 22.9 to 51.4 % with an increase sizes of SPN from 1.0 to 3.0 cm. Significant predominance by the number of nodules in size from 1.1 cm to 3 cm is evidence of improper level of detection SPN in Ukraine. Solitary pulmonary nodes are significantly more often found in the right lung. Moreover, lesions of the upper lobes of the right and left lungs are observed more often than the lower lobes of the lungs.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"77 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132576613","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":"Experience of primary thoracoplastics in the treatment of resistant tuberculosis of the lungs","authors":"M. Opanasenko, O. Tereshkovych, B. Konik, S. Shalagay, O. Shestakova, M. Kalenychenko, A. Stepaniuk, V. Lysenko, L. Levanda, S. Bilokon","doi":"10.30978/tb2022-3-18","DOIUrl":"https://doi.org/10.30978/tb2022-3-18","url":null,"abstract":"Objective — to present the own results of the use of extrapleural thoracoplasty (ET) for the treatment of resistant pulmonary tuberculosis. \u0000Materials and methods. A retrospective analysis of the results of the use of extraleural thoracoplasty (EPTP) in patients with multidrug-resistant pulmonary tuberculosis and tuberculosis with extensively drug resistance, operated in the NIFP clinic of NAMNS in the period from 01.01.2004 to 01.07.2022 was conducted. Patients were divided into two clinical groups: the main — 28 patients who underwent a modified EPTP technique, and the control group — 13 patients who underwent EPTP according to the traditional Bogush technique. When evaluating the results of surgical treatment, each group was divided into subgroups according to the resistance profile of Mycobacterium tuberculosis: A — patients with multidrug-resistant pulmonary tuberculosis, B — patients with tuberculosis with extensively drug resistance. Male patients predominated in both groups. The age range of patients is from 21 to 44 years. The groups did not differ statistically significantly in terms of mean age. Operative treatment was more often performed on the right side. The duration of the period from the onset of the disease to the operation varied from 16 to 60 months (main group — (24.6 ± 1.1) months, control group — (22.8 ± 2.6) months). \u0000Results and discussion. Extrapleural thoracoplasty (EPTP) is a rather traumatic surgical intervention with a significant cosmetic defect and certain functional losses. Recently, such operations are performed less often, thanks to the development of new schemes of anti-tuberculosis therapy, and the associated better outcome of treatment of patients with resistant forms of tuberculosis. But if there are indications, the use of EPTP makes it possible to achieve results unattainable when using only conservative treatment. When performing EPTP, a complex of preoperative preparation measures, operational and technical features of the modified EPTP technique, measures to prevent postoperative complications and recurrences of TV was developed, which allowed to improve the results of surgical treatment in patients of the main group compared to the control group by 12.9 and 11.8 % and reduce the level of postoperative mortality. \u0000Conclusions. Performing EPTP, in the presence of widespread forms of tuberculosis, when it is not possible to perform resection interventions, is the method of choice, which allows improving the effectiveness of treatment of this category of patients.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"95 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129192852","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":"Thyroid tuberculosis: rare location or rarely diagnosed? Literature review","authors":"S. Matvyeyeva, O. Shevchenko","doi":"10.30978/tb-2022-3-78","DOIUrl":"https://doi.org/10.30978/tb-2022-3-78","url":null,"abstract":"Objective — to study of the frequency, clinical picture, diagnosis and treatment of tuberculosis of thyroid gland. \u0000Materials and methods. Analyses the date of the world experience and own observations. \u0000Results and discussion. Thyroid tuberculosis is a less frequent localization of this disease. Currently, most authors believe that thyroid tuberculosis is diagnosed in 0.1–1 % of all known cases of tuberculosis. Clinical observations have found that the thyroid gland is more often involved in the tuberculous process with a generalized miliary process, and, as previously thought, in this case there are no clinical signs of damage to the thyroid gland. A variable clinical presentation of thyroid tuberculosis was demonstrated. It is usually presented with local symptoms associated with diffuse enlargement of the thyroid gland. It is difficult to estimate the quantity of diagnosed cases due to insufficient knowledge of the doctors about this pathology and difficulties of tuberculosis etiology diagnosis. Tuberculous etiology must be ruled out in all lesions on the median surface of the neck. Fine-needle biopsy can help to confirm the diagnosis of thyroid tuberculosis, but the final diagnosis is possible only with histological or cytological studies. The diagnosis of thyroid tuberculo­sis requires the use of most of all the methods used in the diagnosis of tuberculosis: from the simplest (such as X-ray or Mantoux test (with 2 international units of tuberculin) methods to modern rapid molecule-genetic tests XpertMTB/Rif that detect specific fragments of MTB DNA in serum or plasma). Ultrasound and computer tomography also help the clearing of the diagnosis. Surgical treatment in combination with antimycobacterial chemotherapy is effective. \u0000Conclusions. Further investigations are needed to understand the definition, diagnosis and treatment of tuberculosis among other diseases of thyroid.","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"322 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126027769","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":"Structure of the incidence of extrapulmonary tuberculosis in Sumy region","authors":"I. Duzhiy, G. P. Oleshchenko, Yuri Shevchenko, M. Shevchenko, N.V. Yarkova","doi":"10.30978/tb-2022-3-85","DOIUrl":"https://doi.org/10.30978/tb-2022-3-85","url":null,"abstract":"Objective — to clarify the peculiarities of the course of extrapulmonary tuberculosis to improve its diagnosis by studying the trend of this form of tuberculosis in Sumy region. \u0000Materials and methods. The structure of the incidence of extrapulmonary tuberculosis of the Sumy region among residents during 2004—2020 was analyzed. \u0000Results and discussion. During the period from 2004 to 2020, 1414 new cases of extrapulmonary tuberculosis were registered in the region. The largest number of patients with this form of tuberculosis — 142 (24.3 %) was registered in 2004. The lowest — in 2020 — 33 (9.8 %) patients, ie decreased by 2.5 times. In the study period in Sumy in 2020, 3.1 patients per 100,000 population were diagnosed with extrapulmonary tuberculosis, which is almost 3 times less than in 2004 (11.3 patients per 100,000 population). 68 % of cases were registered in children. Among children with extrapulmonary tuberculosis, the incidence ranged from 13 cases per 100,000 children in 2004 to 0.7 per 100,000 in 2020. At the same time, the decrease in the incidence of extrapulmonary tuberculosis occurred with a sharp decrease to 0.7 per 100,000 in 2013—2014 and increase to 4.8 per 2015 and 7.0 per 100,000 children in 2016. And in 2020 again a sharp drop to 0.7 per 100,000 children. Compared to 2019, when the incidence of extrapulmonary tuberculosis was 6.3 per 100,000 children, this figure decreased by 9 times. The reduction in the number of BCG vaccinations in the region during the study period more than 2 times (in 2004 — 14,564 vaccinations, and in 2019 — 6,154) has an impact on changing the incidence of extrapulmonary tuberculosis among children. \u0000Conclusions. The number of patients with extrapulmonary tuberculosis decreased 3.6 times during 2004—2020: from 11.3 to 3.1 patients per 100,000 population. Extrapulmonary forms of tuberculosis predominated in children (68 %). The incidence of such forms of tuberculosis at the age of 0—14 years during 2004—2020 decreased from 13 to 0.7 cases per 100,000.Extrapulmonary tuberculosis of the respiratory organs accounted for 57.4 %, tuberculosis of the bones and joints — 21.6 %, tuberculosis of the genitourinary system — 15.1 %.The incidence of osteoarticular tuberculosis in children (30.6 %) exceeded the corresponding figure in adults (21.1 %) and was 2.6 higher than the corresponding figure in Ukraine (11.7 %). Detection of peripheral lymph node tuberculosis in children of Sumy region (0.7 %) was significantly lower than in Ukraine (7.3 %).In adolescents, extrapulmonary respiratory tuberculosis significantly prevailed between all localiza­tions — 82.2 %. The incidence of tuberculosis of bones and joints was 4.4 %, which is 4.8 times less than in adults and 7 times less than in children. The last indicator in Sumy region was 2 times less than the corresponding indicator in Ukraine (9.0 %).","PeriodicalId":292478,"journal":{"name":"Tuberculosis, Lung Diseases, HIV Infection","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127722782","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}