Кафедра фтизіатрії та пульмонології
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Item COVID-19 та розлади ментальної сфери: механізми їхнього розвитку та можливості виявлення. Огляд літератури(2021) Шевченко, Ольга Станіславна; Тодоріко, Лілія Дмитрівна; Петренко, Василь Іванович; Киба, Віра Петрівна; Погорєлова, Ольга ОлександрівнаМета роботи — виділити основні COVID-19-асоційовані психічні порушення та механізми їхнього роз витку на основі аналізу літературних даних. Матеріали та методи. Для проведення зазначеної роботи нами було проаналізовано 112 літературних джерел з бази PubMed за запитами «Covid AND mental health», «Covid AND mental disorders» та 36 з них обрано для детального вивчення. Результати та обговорення. Було з’ясовано, що у хворих на COVID-19 часто виникають множинні неврологічні та психічні порушення, такі як збудження (69 %), ознаки ураження кортикоспінального тракту (67 %), сплутаність свідомості (65 %) і нейропсихологічні порушення (33 %). Серед психічних та психологічних, які спостерігаються після перенесеної коронавірусної хвороби, найчастіше трапляються безсоння (42 %), зниження концентрації та уваги (38 %), тривожність (36 %), розлади пам’яті (34 %), депресія (33 %), сплутаність свідомості (28 %) та інші розлади свідомості (21 %). Найуразливішими контингентами населення є діти, підлітки та особи літнього віку, які страждають не тільки від самої хвороби, а й від наслідків ізоляції. На окрему увагу заслуговують медичні працівники, у яких часто спостерігаються такі ментальні розлади, як тривожність (12—20 %), депресія (15—25 %), безсоння (8 %) та посттравматичний стресовий розлад (35—49 %). Висновки. Пандемія COVID-19 сильно вплинула на психічне здоров’я населення в цілому. Особливо це позначилося на таких групах населення, як хворі з психіатричною патологією, медичні працівники, особи похилого віку та люди у скрутному матеріальному становищі. Враховуючи можливість нових хвиль захворюваності на COVID-19 та посилення карантинних обмежень, а також можливість виникнення нових епідемій у майбутньому, наразі вкрай важливо створити чіткі керівні принципи та протоколи, які допоможуть пом’якшити наслідки пандемічної кризи та обмежувальних заходів і запобігти масовому погіршенню психічного здоров’я за збереження акценту на особистісно-орієнтованому піклуванні.Item Human-beta-defensin-1: prognostic marker of tuberculosis severity and treatment effectiveness in pulmonary tuberculosis(Wiadomości Lekarskie, 2021-08) Pohorielova, Olha; Shevchenko, OlgaThe aim: Was to investigate human-beta-defensin-1 level in blood serum depending on tuberculosis severity and treatment effectiveness. Materials and methods: 100 patients with pulmonary tuberculosis and 20 healthy persons were included to the study. HBD-1 level was measured by ELISA in all the healthy persons and in all the patients at the treatment onset and at the end of initial phase of treatment. Additionally, the patients were examined with chest X-ray, sputum microscopy and culture, blood test and blood biochemistry. Results: HBD-1 level was higher in patients with tuberculosis (21.5 ± 2.9 μmol/L) compared with healthy individuals (8.9 ± 2.5 μmol/L). A positive correlation of middle strength was found between the size of lung lesion and the level of HBD-1 and between the level of HBD-1 and the massiveness of bacterial excretion. We found weakly negative correlations between the level of HBD-1 at the beginning of treatment and parameters of life quality rated on sf-36 scale. Patients with initially high level of HBD-1 had preservation of bacterial excretion, as well as signs of inflammatory activity. In patients with an effective intensive phase of treatment, the initial level of HBD-1. Conclusions: The larger pulmonary tuberculosis lesion, as well as the more pronounced clinical manifestations lead to the higher level of HBD-1. The possibility of using humanbeta-defensin-1 as a prognostic marker of treatment effectiveness is confirmed by the fact that human-beta-defensin-1 level prevails at the beginning of treatment in patients with subsequently non-effective intensive phase of treatment.Item The effect of prescribing a complex of essential amino acids on the level of human-beta-defensin-1 in patients with drug-susceptible and drug-resistant pulmonary tuberculosis(Deutscher Wissenschaftsherold, 2021) Pohorielova, Olha; Shevchenko, OlgaWith the expansion of M. tuberculosis resistance, more and more attention is being paid to alternative pathogenetic therapies that can stimulate the host's immune response. The purpose of the study was to determine the effect of prescribing a complex of essential amino acids on the level of Human-beta-defensin-1 in patients with drug-susceptible and drug-resistant pulmonary tuberculosis. Materials and methods. 50 patients with drug-susceptible tuberculosis (TB) and 50 patients with drugresistant TB (multidrug-resistant and extensively drug resistant TB) were included to the study. The patients with were divided into 3 groups: patients in Group 1 did not receive additional treatment, patients in Group 2 received essential amino acids in tablets for 30 days, patients in Group 3 received injectable essential amino acids for 10 days and after that they received essential amino acids in tablets for 20 days. HBD-1 level was measured in blood serum by ELISA at the treatment onset, after 30 and after 60 days in all the patients. Results. Comparison of the HBD-1 level in patients with susceptible TB after 30 days of treatment showed its highest level in Group 3 (21.59±5.33 μmol/L, median – 17.14 μmol/L), lower level in Group 2 (19.41±3.66 μmol/L, median – 20.17 μmol/L) and the lowest level in Group 1 (9.25±1.95 μmol/L, median – 4.42 μmol/L), p<0.05. After 60 days of treatment, patients with drug susceptible TB showed the opposite results with the highest level of HBD-1 in Group 1 (26.18±2.82 μmol/L, median – 29.17 μmol/L), lower level in Group 2 (16.57±3.95 μmol/L, median – 11.11 μmol/L) and the lowest level in Group 3 (6.32±1.44 μmol/L, median – 3.99 μmol/L). Comparison of the HBD-1 level in patients with drug resistant TB after 30 days of treatment also showed its highest levels in Group 2 (21.65±3.27 μmol/L, median – 20.19 μmol / L) and Group 3 (20.98±7.91 μmol/L, median – 11.01 μmol/L), and significantly lower level in Group 1 (10.79±2.91 μmol/L, median – 4.09 μmol/L), p<0.05. After 60 days of drug resistant TB treatment, the highest HBD-1 level was observed in Group 1 (63.24±9.73 μmol/L, median – 58.15 μmol / L), its lower level was in Group 2 (18.99±2.09 μmol/L, median – 20.26 μmol/L) and the lowest level was in Group 3 (13.86±3.63 μmol/L, median – 13.97 μmol/L), p<0, 05. Conclusions. The appointment of the complex of essential amino acids in the pathogenetic therapy of tuberculosis allows to increase the production of Human-beta-defensin-1 in both patients with drug susceptible and drug resistant tuberculosis, which leads to a more balanced immune response and an increase in the effectiveness of anti-tuberculosis therapy. Key words: tuberculosis, amino acids, MDR-TB, treatmentItem Dynamics of life quality in patients with pulmonary tuberculosis against the background of the appointment of an essential amino acids complex(2021) Shenchenko, Olga; Pohorielova, OlhaObjective — to investigate the dynamics of life quality in patients with pulmonary tuberculosis against the background of the appointment of an essential amino acids complex. Materials and methods. The study included 100 patients with pulmonary tuberculosis who received treatment and diagnosis in accordance with the WHO recommendations and current state protocols. The patients were divided into 3 groups: group 1 (n = 50) did not receive additional complex of amino acids in pathogenetic therapy; group 2 (n = 25) received a complex of amino acids in tablet form for 30 days; group 3 (n = 25) received injectable amino acids complex for 10 days and then was transferred to tablet form for 20 days. At the beginning of treatment, after 30 days and after 60 days, the patients were interviewed using the SF-36 questionnaire. Also, the patients were measured the level of Human-beta-defensine-1 in the blood plasma by ELISA at the beginning of treatment. Results and discussion.Item Treatment effectiveness and outcome in patients with a relapse and newly diagnosed multidrug-resistant pulmonary tuberculosis(Medicinski glasnik, 2020-05) Butov, Dmytro; Myasoedov, Valery; Gumeniuk, Mykola; Gumeniuk, Galyna; Choporova, Oleksandra; Tkachenko, AntonStandard treatment effectiveness in patients with newly diagnosed MDR-TB manifested by faster improvement and stabilization of health, earlier sputum culture and smear conversion, higher frequency of cavity closure and achievement of certain clinical and radiographic improvement against the background of fewer cases of treatment failure and a higher number of cured patients compared with MDR-TB relapse.Item Changes of vitamin B1, B12 as predicting factors of peripheral polyneuropathy in pulmonary tuberculosis patients(2020-03) Shvets, Olga; Schevchenko, Olga; Todoriko, Olga; Tovazhnyanska, Olena; Dubynska, Olga; Ostrovskyi, Mycola; Makoyda, IrynaItem Clinical effeciency of sodium selenite in treatment of tuberculosis patients with autoimmune thyroiditis(2019) Matvyeyeva, Svitlana; Schevchenko, OlgaItem Состояние метаболизма соединительной ткани у пациентов с туберкулезом легких с различной чувствительностью возбудителя к антимикобактериальным препаратам(2019) Овчаренко, Ирина Анатольевна; Шевченко, Ольга Станиславна; Потейко, Петр Иванович; Степаненко, Анна Леонидовна; Полуектова, Ирина ВалентиновнаItem Вплив протитуберкульозної терапії на динаміку показників вуглеводного та ліпідного обміну(2019) Швець, Ольга Миколаївна; Шевченко, Ольга СтаніславнаItem Effectiveness of Intravenous Isoniazid and Ethambutol Administration in Patients with Tuberculosis Meningoencephalitis and HIV Infection(2019-08-31) Butov, Dmytro; Feshchenko, Yurii; Kuzhko, Mykhailo; Gumeniuk, Mykola; Yurko, Kateryna; Grygorova, Alina; Tkachenko, Anton; Nekrasova, Natalia; Tlustova, Tetiana; Kikinchuk, Vasyl; Peshenko, Alexandr; Butova, TetianaBackground. The aim of this study was to investigate the effectiveness of intravenous isoniazid (H) and ethambutol (E) administered in patients with new sputum positive drug-susceptible pulmonary tuberculosis (TB) with tuberculous meningoencephalitis (TM) and human immunodeficiency virus (HIV) co-infection in the intensive phase of treatment. Methods. Fifty-four patients with TB/TM and HIV co-infection were enrolled for this study. Group 1 comprised of 23 patients treated with E and H intravenously, while rifampicin and pyrazinamide were prescribed orally. Group 2 consisted of 31 patients treated with the first-line anti-TB drugs orally. The concentrations of H and E in blood serum were detected using a chromatographic method. Results. A significant improvement in the clinical symptoms and X-ray signs in patients treated intravenously with H and E was observed and compared to group 2. The sputum Mycobacterium tuberculosis positivity was observed during the second month of the treatment in 25.0% of patients from group 1 and 76.1% of the patients from the control group (p=0.003). In addition, nine patients (39.1%) died up to 6 months when H and E were prescribed intravenously compared with 22 (70.9%)in group 2 (p=0.023). Conclusion. In TB/TM with HIV, the intravenous H and E treatment was more effective than oral H and E treatment at 2 months of intensive treatment in sputum conversion as well as in clinical improvement, accompanied by significantly higher mean serum concentrations. In addition, the mortality rate was lower in intravenous H and E treatment compared to oral treatment.