[Role of social factors in the formation of life quality indices in patients with chronic obstructive pulmonary diseases].

The indices of life quality were estimated by the Seattle questionnaire in 140 patients aged 19 to 79 years who had chronic obstructive pulmonary diseases (COPD). The results of the study determined the lower life quality indices in patients with COPD according to a number of social factors: domicile, occupation, number of family members, living conditions, and medical care.

[Application of ammotherapy for the remedial treatment of patients with chronic obstructive pulmonary disease in the rehabilitative phase].

The objective of this study was to evaluate clinical and physiological efficiency of ammotherapy (PT) applied to the treatment of 112 patients in the phase of partial remission. It was shown that combination of standard baseline therapy and ammotherapy ensured positive dynamics of clinical symptoms and substantially improved parameters of external respiration and hemodynamics. It is concluded that ammotherapy can be recommended for a more extensive application to the management of chronic obstructive pulmonary disease.

[Detection of tuberculosis in the countries of Central Asia by the electronic monitoring system data].

The basic stages of putting into practice of tuberculosis monitoring systems in the Central Asian Region (CAC) (Uzbekistan, Kazakhstan, Kyrghyz, and Tajikistan) with the assistance of the USA Centers for Disease Control and Prevention, Central Asian Region Programs (CDC/CAR), and the USA Agency for International Development in 2000-2006 are considered. These stages comprised: 1) modification of accounting and reporting forms in accordance with the requirements of the uniform statistical tuberculosis registration system; 2) development, adaptation, and introduction of an electronic tuberculosis monitoring and management system (ETMMS) in the regions and countries of Central Asia; 3) epidemiological analysis of information of tuberculosis monitoring systems, by using the elements of evidence-based medicine. At present, policy electronic tuberculosis monitoring systems entirely cover the areas of three countries of the region. The quality of entries and their processing and analysis is assured by a wide training system set up by the CDC/CAR jointly with the leading national tuberculosis facilities of CAR with the support of the Global Fund for AIDS, Tuberculosis, and Malaria Control. The information obtained by ETMMS has permitted a detail comparative analysis of the structure of tuberculosis at the level of individual regions to identify characteristic groups of areas in the demographic and sociooccupational characteristics of new tuberculosis cases.

[Evaluation of nonspecific responsiveness from adaptive reactions in patients with destructive pulmonary tuberculosis].

The frequency and nature of adaptive reactions were studied by the procedure described by L. Kh. Garkavi in 308 patients with destructive pulmonary tuberculosis in relation to the carriage of different combinations of genetic markers. Reactions of the stress type were most frequently established in patients with caseous pneumonia and fibrocavernous tuberculosis (60.9+/-10.1 and 56.4+/-7.9%, respectively). Stress was significantly often seen in patients who carried unfavorable and relatively unfavorable combinations of genetic markers (66.6+/-8.2 and 42.8+/-3.7%, respectively) and their change during treatment was insignificant. At the same time, patients with a carriage of favorable and relatively favorable combinations of genetic markers showed adequate reactions of training and activation. The nature of adaptive reactions correlated with the pattern of pulmonary tuberculosis and the level of biochemical inflammatory markers.

[Relationship of the course of nephrotuberculosis in patients to various combinations of genetic markers].

To examine the body's responsiveness in different forms of nepthrotuberculosis, 237 patients underwent comprehensive clinical laboratory studies. To reveal various combinations of genetic markers, the authors determine the phenotypes of haptoglobin, the activity of red blood cell glucose-6-phosphate dehydrogenase, the type of inactivation of isonicotinic acid hydrazide. According to the combinations of a complex of these genetic markers, the authors identified 4 combinations: poor, good, relatively poor, and relatively good. The studies indicated the high incidence of common forms of nephrotuberculosis in subjects with poor and relatively poor combinations of genetic markers. The determination of various chronic renal failure-associated combinations of genetic markers may be used to identify risk groups for this disease.

[Ultrasound evaluation of intrahepatic hemodynamic disorders in patients with renal tuberculosis].

Seroechography, duplex, color, and energy Doppler studies were used to examine 50 patients with different forms of renal tuberculosis. The nature of renal blood flow was shown to depend on the magnitude of pathomorphological changes in tuberculous lesion. Spectral and energy Doppler studies revealed enhanced blood flow in the area of tuberculous infiltration. In all forms of nephrotuberculosis, there was an increase in peripheral vascular resistance, which was associated with vasoconstriction, obliteration, and diminished elasticity of vascular walls. Ultrasound angiography used in destructive forms of renal tuberculosis makes it possible to define treatment policy. The data of Doppler study were compared in relation to the glomerular filtration rate. The study ascertained that there was a reduction in glomerular filtration rates as the velocity characteristics of blood flow decreased and peripheral vascular resistance increased. The threshold values of renal hemodynamic parameters were determined to estimate renal filtration function. The reduction in end-diastolic blood flow velocity at different levels of the renal artery was of the greatest diagnostic informational value for diminished renal filtration function.

[New approaches to formation of registration group of individuals followed up by antituberculosis institutions in Uzbekistan]. / Novye podkhody k formirovaniiu v Uzbekistane gruppy ucheta lits, nakhodiashchikhsia pod nabliudeniem protivotuberkuleznykh uchrezhdenii.

The paper presents the results of a three-year (2000-2002) follow-up of the movement of dispensary contingents registered in tuberculosis facilities in order to develop new dispensary groups. The dispensary groups of patients with active forms of tuberculosis have been ascertained to accumulate a great number of patients with its inactive forms due to the untimely of their transfer to the inactive groups in terms of effective treatment and the clinical forms of tuberculosis. New dispensary grouping will more definitely regulate the transfer of patients from active to inactive groups and strike from the list of dispensary patients. The proposed new grouping excludes registration Groups 0, II, and VII. If required, the persons struck from Groups III and VB and those followed up as Groups 0 and VII patients will be transferred to adult and pediatric polyclinics and followed up in recurrent tuberculosis risk groups.

[Use of lymphotropic therapy in the multimodality treatment of patients with pulmonary tuberculosis and comorbidity]. / Primenenie limfotropnoi terapii pri kompleksnom lechenii bol'nykh tuberkulezom legkikh s soputstvuiushchei patologiei.

Regional lymphotropic therapy involving 10% isoniazid administration was included into multimodality treatment in 250 patients with pulmonary tuberculosis and comorbidity. The findings have indicated that the lymphotropic therapy during the use of rifampicin, streptomycin, ethambutol enhances the efficiency of chemotherapy in different forms of pulmonary tuberculosis, including the latter concurrent with hepatic lesion or diabetes mellitus. Lymphotropic therapy is particularly beneficial to patients with poor drug tolerability. The use of lymphotropic isoniazid in the multimodality treatment of pulmonary tuberculosis leads to the earlier disappearance of the symptoms of tuberculous intoxication (by 1-1.5 months) in 80-92% of the patients, to abacillation in the same periods, to the increased frequency of decay cavity closure by an average of 15% as compared to the conventional treatment, and, in most cases, to the normalization of the biochemical parameters of hepatic function.

[Clinical features of male genital tuberculosis in Uzbekistan]. / Osobennosti klinicheskogo techeniia tuberkuleza muzhskikh polovykh organov v Uzbekistane.

The clinical course of genital tuberculosis was studied in 126 males treated at the Phthisiourology Unit (in 1992-1997). Case histories of 505 more patients (in 1974-1988) were examined. It was ascertained that there was an increase in the incidence of this disease in an old age group (51-60 years) from 9.7% (1974-1988) to 21.4% (1992-1997) and a reduction in a young age group (31-40 years) from 33.1 to 22.2%, respectively. Most (92.8%) patients aged 21 to 60 years had the greatest manifestations of the disease at the present-day stage while those (92.5%) aged 21 to 50 years fell ill with this disease in 1974-1988. There was an increase in the incidence of fistulous tuberculosis of the male genitals from 8.7% (in 1974-1988) to 20.6% (in 1992-1997), which confirms altered pathomorphism and deteriorated epidemiological situation. The diagnostic minimum which may render a great assistance to general practitioners in timely recognizing the disease and referring patients with this disease to a specialized facility.

[Prevalence of bronchial asthma in Uzbekistan]. / Rasprostranennost' bronkhial'noi astmy v Uzbekistane.

The prevalence of bronchial asthma has tended to increase in Uzbekistan. It is highest in the Republic of Karakalpakstan and least in the Samarkand Region. Its prevalence differs in some areas of Uzbekistan--highest in children in Karakalpakstan and in elderly persons in Tashkent. The prevalence of bronchial asthma is associated with smoking.

[Spinal and pulmonary tuberculosis]. / Tuberkulez pozvonochnika i organov dykhaniia.

The paper presents the results of a study of the clinical course of tuberculous spondylitis of combined pulmonary tuberculosis in 86 patients admitted from different areas of the Republic of Uzbekistan. Patients with tuberculosis of the spine and lung have been shown to have a more unfavourable course of a specific process in the bony tissue and lung. The tuberculous process is accompanied by severe intoxication, pain syndromes. The severity of the process is aggravated if there are extensive suppurative processes around an osseous focus. These patients have varying severe cerebrospinal disorders. Moreover, patients with combined forms of the process more frequently exhibit concomitant nonspecific visceral diseases.

[Genetic variants of haptoglobin in patients with nephrotuberculosis]. / Geneticheskie varianty gaptoglobina u bol'nykh nefrotuberkulezom.

Clinical, X-ray, ultrasound, and laboratory studies were made in 152 patients with nephrotic tuberculosis. Haptoglobin phenotypes were defined in the examinees. Nephorotic tuberculosis was found to occur in patients with haptoglobin 2-2 most commonly. There was a relationship between the carriage of a genetically determined haptoglobin phenotype and a difference in the clinical manifestations of hephrotic tuberculosis. The patients with haptoglobin 2-2 were seen to have more severe hephrotic tuberculosis.

[Ultrasonic diagnosis of tuberculosis of major joints in children and adolescents]. / Ul'trazvukovaia diagnostika tuberkuleza krupnykh sustavov u detei i podrostkov.

Results of ultrasonic echotomography (UET) are available for 42 patients with affection of major joints. Provocation with tuberculin (20 TU) was made. UET data before and 3-5 days after the provocative test were compared. Reactive inflammation at the site of tuberculosis-affected joint caused by the provocation test was reflected by UET. This method detected early tuberculous lesion of the joints in 34 examinees.

[Analysis of bronchial hypersensitivity in patients with bronchial asthma]. / Analiz sostoianiia giperchuvstvitel'nosti bronkhov bol'nykh bronkhial'noi astmoi.

AIM: To analyse correlation between bronchial hypersensitivity in bronchial asthma (BA) and environmental factors; to propose methods of relevant correction. MATERIAL AND METHODS: The trial included 97 BA patients (42 males, 55 females) aged 17-79 years. Bronchial sensitivity was studied by means of dose-dependent bronchial resistance curve (Rrs) plotted by the unit Masterlab (Germany) in the course of long-term inhalation of a gradually rising dose of methacholine. A regression analysis was made of the dependence of fluticasone bipropionate effectiveness on clinical symptoms of the disease. RESULTS: Bronchial hypersensitivity depends on initial clinical symptoms of BA, in a less degree on bronchial permeability, severity of inflammation of bronchial mucosa. CONCLUSION: Local corticosteroid fluticasone propionate is a drug of choice in the treatment of mild and moderate BA.

[Tuberculosis epidemiology and disease control in Uzbekistan]. / Epidemiologiia tuberkuleza i organizatsiia protivotuberkuleznoi raboty v Uzbekistane.

The tuberculosis situation is complicated in Uzbekistan and in other countries of the world. In the past 5 years, due to the transition from mass prophylactic examinations to the differential surveys of population groups, the annual coverage of the population to be examined by fluorographic studies has reduced from 6 to 3.5 million along with a simultaneous rise in tuberculosis detection rates from 0.1 to 0.24% and in its incidence by 33.3%. Searches for new organizational forms of tuberculosis control work are under way. The State programme on tuberculosis control and the draft law of the Republic of Uzbekistan, which regulate associated measures have been developed.

[Manifestations of pulmonary tuberculosis concurrent with diabetes mellitus and various haptoglobin phenotypes]. / Proiavlenie tuberkuleza legkikh pri sochetanii s sakharnym diabetom i raznykh fenotipakh gaptoglobina.

For diagnosis, detection of the specific manifestations of pulmonary tuberculosis (PT) concurrent with diabetes mellitus, 48 patients with insulin-dependent diabetes (IDD) and 132 with noninsulin-dependent diabetes (NIDD), who carry various haptoglobin (Hp) phenotypes were studied. It has been found that PT develops in IDD mainly in 5-10 years and in NIDD in 1-4 years. The gravest course of both types of diabetes is frequently encountered in those having Hp 2-2 phenotypes and slightly less frequently in those with Hp 1-1. The patients having these phenotypes have abnormalities in the levels of glycaric hemoglobin, 2.3-diphosphoglycerol phosphate, in the activity of the enzymes lactate dehydrogenase and glucose-6-phosphate dehydrogenase and acid-alkali imbalance. It is expedient to determine Hp phenotypes to evaluate the severity and prognosis and to choose a treatment policy for comorbidity and the proposed biochemical indices should be more widely used to evaluate carbohydrate metabolic disturbances in PT concurrent with diabetes mellitus.

[Effectiveness of lymphotropic therapy in patients with tuberculosis in relations to genetic markers]. / Effektivnost' limfotropnoi terapii u bol'nykh tuberkulezom legkikh v zavisimosti ot geneticheskikh markerov.

To study whether a combination of the carriage of genetic blood markers: haptoglobin phenotypes and red blood cell glucose-6-phosphate dehydrogenase, 60 patients with destructive tuberculosis were given a new drug treatment regimen by using regional lymphotropic therapy with 10% isoniazid. The efficiency of the treatment and residual changes were found to be directly related to what a patient has as genetic background. Defining the types of combinations of genetic markers may predict the course of disease, the efficiency of treatment, and outcomes.

[Differential x-ray and ultrasound diagnosis in cavernous renal tuberculosis]. / Differentsial'naia rentgenologicheskaia i ul'trazvukovaia diagnostika kavernoznogo tuberkuleza pochek.

It is virtually very difficult to make a differential diagnosis of cavernous nephrotuberculosis and caliceopyeloectasia (CPE), as well as a combination of caverns and CPE at primary renal ultrasound scanning. Therefore, a complex of diagnostic methods for nephrotuberculosis should include drug echography with a diuretic. Comparing X-ray findings, ultrasound and drug echography with a diuretic allows one to differentiate cavernous nephrotuberculosis from CPE and their combinations with confidence.