The relevance of the research is determined by the growth of cases of abdominal tuberculosis (AT), which is difficult to diagnose. Aim. Identify clinical features and possibilities of timely AT diagnosis. Materials and methods. Medical reports of 116 AT patients. The results of clinical, microbiological, immunological, radiological, endoscopic and morphological studies were analyzed. The results. AT proceeded under the mask of ulcerative colitis and Crohn's disease (26.3%), alcoholic and biliary hepatitis (11.8%), lymphoproliferative and oncological diseases (61.8%), often generalized against the background of HIV-infection. The duration of the diagnostic search for disease verification exceeded 3 months due to incorrect (erroneous) interpretation of intoxication (26.3%) and radiological pattern in the lungs (23.7%), non - application and late application of laparoscopy (39.5%). Conclusion. When diagnosing AT, it is necessary to consider the peculiarities of its clinic and to conduct timely laparoscopy.
Platelets play a special role in the systemic inflammatory response syndrome, as they acquire the ability to become activated and aggregate. Literature has no direct evidence of a link between platelet aggregation activity and the severity of the systemic inflammatory response syndrome in patients with pulmonary tuberculosis. The aim of the paper is to study platelet aggregation in patients with pulmonary tuberculosis with severe systemic inflammatory response syndrome. Materials and Methods. Spontaneous and induced by ADP (0.1, 1.0 and 5.0 ml) platelet aggregation was determined by Born turbodynamic method. The study enrolled 27 patients with severe and 33 patients with indolent systemic inflammatory response syndrome Spontaneous and induced by ADP (0.1 and 1.0 ml) platelet aggregation was evaluated in absorbance units (a.u.); platelet aggregation induced by 5.0 ml of ADP was measured in percentage terms. Statistica 10 was used to process the results. Discrepancy tests were used to determine the significance of differences of mean values; McNemar’s test and Fisher’s exact test were used to estimate event rate, p<0.05. Results. In Group 1 spontaneous and induced by ADP (0.1, 1.0 and 5 ml) platelet aggregation was 0.85–2.65 (1.210.1) a.u., 0.81–3.67 (3.030.38) a.u., 1.06–6.25 (6.50.51) a.u., 5–66 % (39.53.6); in Group 2 – 0.84–1.36 (1.10.04) a.u., 0.77–2.49 (2.10.26) a.u., 0.64–5.49 (2.200.08) a.u., 8–66 (35.74.14) %, respectively. Frequency of spontaneous and induced by ADP (0.1, 1.0 and 5 ml) platelet hypoaggregation in Groups 1 and 2 was 33.3 % and 27.3 %; 14.8 % and 24.2 %; 0 % and 39.4 %; 14.8 % and 24.2 %, respectively; frequency of hyperaggregation was 14.8 % and 0 %; 11.1 % and 9.1 %; 29.6 % and 0 %; 0 % and 0 %, respectively. Conclusion. Platelet aggregation activity in patients with pulmonary tuberculosis is determined by the severity of the systemic inflammatory response syndrome. A pronounced systemic inflammatory response syndrome is associated with increased spontaneous and induced by ADP (1.0 ml) platelet aggregation in 14.8 % and 29.6 % of cases, respectively.
Taking into account the conflicting literature data on the frequency of the clinical form of pulmonary tuberculosis and its impact on the structural and functional state of the heart, an echocardiographic assessment of heart parameters was carried out in patients with pulmonary tuberculosis and its relationship with the vascular endothelial growth factor VEGF-A. The purpose — to evaluate the relationship between the structural and functional state of the myocardium and the concentration of VEGF in the blood serum in patients with pulmonary tuberculosis. Material and methods. The study included 77 patients with newly diagnosed pulmonary tuberculosis. During the study, the patients were randomized into 3 groups: group 1 — patients with an infiltrative form (n = 42), group 2 — patients with a disseminated form (n = 20), group 3 — patients with fibrous-cavernous form of pulmonary tuberculosis (n = 15). The control group consisted of 10 volunteers. B-mode echocardiography was performed and VEGF concentration was assessed by ELISA. Results. Higher values of RV length, LA area and RA area, and mean LA pressure were found in patients with fibrous-cavernous form, which is due to hypertrophy of the right heart, as indicated by higher values of wall thickness RV — 4.12 mm vs 3.70 in patients of the control group. A high concentration of VEGF-A in the blood serum is associated with higher parameters of erythrocyte sedimentation rate and platelet count, which may indicate a more pronounced systemic inflammatory response in the infiltrative form of pulmonary tuberculosis. Conclusion. Pulmonary tuberculosis is accompanied by structural and functional remodeling of the right and left parts of the heart, the severity of which is associated with the clinical form of the disease. The infiltrative form of pulmonary tuberculosis is associated with significantly higher values of the pro-inflammatory angiogenic cytokine VEGF-A compared to other clinical forms of tuberculosis and the control group.
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