[New-onset pulmonary tuberculosis in women].

A clinical pattern, a social portrait, and the efficiency of inpatient treatment were studied in females with new-onset pulmonary tuberculosis. Four hundred and twenty-eight cases of new-onset pulmonary tuberculosis in 18-85-year-old women admitted to a specialized hospital (95, 178, and 155 patients in 1990, 2001, and 2005, respectively). The pattern of clinical forms was found to become much worse under the present conditions of epidemiological ill-being. There was a rise in the incidence of the disseminated form from 10.5 to 23.9% with a drop in that of the focal form from 23.2 to 7.1%. Pulmonary tuberculosis is characterized with the great extent of involvement, the high rate of destructive changes, abundant bacterial excretion, the increase of drug resistance (DR), and worsening of its pattern due to polyresistance and multiple DR. The efficiency of inpatient treatment for pulmonary tuberculosis significantly decreased: bacterial excretion ceased in 52.4-52.9%, destructive changes were eliminated in 30.4-34.3%. Under the present conditions in combination with biomedical and social factors, the detected specific features of pulmonary tuberculosis affected the results of inpatient treatment.

Spontaneous hyperactivity in mutant mice lacking the NMDA receptor GluRepsilon1 subunit is aggravated during exposure to 0.1 MAC sevoflurane and is preserved after emergence from sevoflurane anaesthesia.

BACKGROUND AND OBJECTIVE: Patients who awake from sevoflurane anaesthesia with symptoms of agitation may have some underlying functional substrate that is sensitive to the low concentrations of anaesthetic encountered during emergence. One candidate for such a substrate could be neurocircuitry implied in the pathophysiology of both agitation and movement disorders with hyperactivity. We postulated that hyperactive animals would show a further increase in activity in the presence of low concentrations of volatile anaesthetics, such as sevoflurane. METHODS: To confirm our hypothesis, we examined the effects of two subanaesthetic concentrations of sevoflurane, isoflurane and halothane (0.1 and 0.2 MAC (minimum alveolar concentration)) on spontaneous activity in N-methyl-d-aspartate receptor GluRepsilon1 subunit knockout mice exhibiting locomotor hyperactivity in a novel environment and compared these results with those for wild-type controls. We also compared the effects of anaesthetic concentrations of sevoflurane (1.2 MAC) on mice activity during postanaesthesia recovery. RESULTS: Out of the three anaesthetics used, only sevoflurane administered at 0.1 MAC caused a significantly different response between the two experimental groups. Exposure to this subanaesthetic concentration of sevoflurane reduced the activity of wild-type mice, whereas mutant animals showed a further increase in hyperactivity. The effects of 1.2 MAC sevoflurane anaesthesia on mice activity during postanaesthesia recovery also differed significantly between the two genotypes. Exposure to anaesthetic concentrations of sevoflurane had a sedative effect on wild-type mice, whereas mutant mice preserved their high levels of activity upon emergence from the anaesthesia. CONCLUSIONS: The presence of an inherent anomaly in mutant mice that becomes more manifest during exposure to 0.1 MAC sevoflurane and is still present after the emergence from sevoflurane anaesthesia suggests the presence of and necessitates a search for some putative substrate that may, by analogy, underlie emergence agitation in the clinical setting.