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Biomedical subjects

O B Nechaeva

Publications and source records attributed to O B Nechaeva.

At least 19 recordsLinked to original sources
PubMed2006

[Causes of death from fibrocavernous pulmonary tuberculosis in the Sverdlovsk Region].

In the Sverdlovsk Region, the main reason of death from tuberculosis is a fibrocavernous pulmonary process (51.8%) that is most commonly detected in the postportem diagnosis of tuberculosis (61.9%). Before death, patients with fibrocavernous tuberculosis do not ask for medical aid frequently (73.4%). In the first-year follow-up, most deceased persons come to health care facilities 3 months or more after the occurrence of significant clinical symptoms (60.8%). The refusals of patients to receive in- and outpatient therapy, multiple discharges from hospital due to their incompliance, following by long-term therapy discontinuance, which led to secondary multidrug resistance, were responsible for progressive tuberculosis that was the main cause of death from a fibrocavernous process.

Adult↗
PubMed2005

[Tuberculosis in children from the Sverdlovsk Region].

The tuberculosis morbidity rate in BGC-unvaccinated infants is 18 times greater than that in BCG-vaccinated infants and 6 times higher than the rate of complications due to BCG vaccination. If a scar due to BCG vaccination is absent or 1-2 mm, the tuberculosis morbidity in children of 3 years of life is 7 times higher than when a 3-mm or more scar has formed after vaccination. The technological failures are main causes of complications due to BCG vaccination. The type of a vaccine (BCG-1 or BCG-M) does not play a substantial role in the development of complications.

Adolescent↗
PubMed2005

[Tuberculosis in the prisons of the Sverdlovsk Region].

In 1997 to 2002, the Sverdlovsk Region showed a reduction in the proportion of the accused and prisoners among adults and adolescents from 37.2 to 17.3% in the structure of tuberculosis morbidity and from 18.2 to 3.2% in that of its mortality. In 2003, prophylactic examinations revealed tuberculosis in 95% of the accused and prisoners. As compared with the general population, in adult and adolescent prisoners, morbidity due to tuberculosis was 8 times higher, its relapses were 9 times greater (early and late relapses being 28 and 3 times greater, respectively), its incidence was 9-fold and mortality, 1.3-fold.

Age Distribution↗
PubMed2005

[Causes of death from tuberculosis in municipal entities of the Sverdlovsk Region].

Before the disease was registered, the first detected patients who died from tuberculosis had not generally turned for medical aid or had turned 3 months or more after the occurrence of significant clinical signs. Before their death from tuberculosis, the contingents of tuberculosis-controlling services of municipal entities were discharged from hospital many times for violation of the inpatient routine; subsequently they did not come to a tuberculosis dispensary and refused to be treated in the outpatient setting. Primary drug resistance, allergic reactions, and intolerability of antituberculous drugs did not play a significant role in the occurrence of death. The patients are themselves guilty in the development of secondary resistance to some drugs.

Catchment Area, Health↗
PubMed2005

[Tuberculosis and HIV infection in the Sverdlovsk Region].

In 2003, there were 6.9-, 4.6-, and 5.5-fold increases in the prevalence, incidence of, and mortality due to tuberculosis, respectively among the HIV-infected as compared with the HIV-uninfected population (adults and children) of the Sverdlovsk Region. As HIV infection progresses from its preclinical stages to AIDS, the tuberculosis epidemic situation in the Sverdlovsk Region begins to drastically deteriorate with a predominant rise in tuberculosis mortality rates. The large number of tuberculosis-unvaccinated babies born to HIV-infected mothers cause an increase in primary infection with tuberculosis and in its incidence in young childhood.

Adolescent↗
PubMed2004

[Fibrocavernous pulmonary tuberculosis in the Sverdlovsk Region].

Among new cases of fibrocavernous pulmonary tuberculosis and those who have died from it, the proportion of females and subjects with postmortem diagnosis increases and that of prisoners and the accused decreases. The institutions of confinement do not greatly affect the general regional morbidity and mortality due to fibrocavernous pulmonary tuberculosis. The new cases of fibrocavernous pulmonaary tuberculosis and those had died from it were mainly males aged 45 years or older who had a very low social status, lived in large towns and died outside a hospital, which substantiated forensic medical autopsy. Most of them had not consulted a doctor or long followed up for tuberculosis. This led to the fact that postmortem diagnosis was made in 62.6% of the cases.

Adolescent↗
PubMed2003

[Causes and factors of development of drug resistance in pulmonary tuberculosis].

To prevent secondary multidrug resistance and polyresistance of Mycobacterium tuberculosis (MBT), it is necessary to strictly observe the tested chemotherapy regimens during intensive care by using at least four essential antituberculous drugs (ATD) mainly in combination. The rehabilitative phase should be monitored at outpatient units of a day hospital. To prevent cross MBT infection with drug resistance to essential ATD and to efficiently use expensive reserve drugs, it is necessary to set up specialized inpatient units (wards) for treatment and rooms for outpatient receipt of patients who isolate drug-resistant MBT strains.

Ambulatory Care↗
PubMed2002

[Drug resistance of Mycobacterium tuberculosis in the Sverdlovsk Region].

In the Sverdlovsk Region, multidrug resistance was observed in greater than 8% of patients isolating bacteria mainly in the residents of cities, former prisoners, those having fibrocavernous tuberculosis complicated by chronic nonspecific lung disease (CNLD). Primary resistance was determined in 4.7%, secondary resistance developing in 57.4% of cases 3 years or longer after the initiation of treatment. The most common cause of multiresistant tuberculosis is irregular treatment, patients' discontinuation of some antituberculous agents, as well as scarce financing of a tuberculosis control service, which prevents the standard treatment regimens from using in tuberculosis. Death due to tuberculosis was largely occurred irregularly treated dwellers of cities, tuberculosis-induced disabled individuals, alcohol abusers, patients with CNLD, or having fibrocavernous tuberculosis resistant to 4-5 antituberculous agents.

Adolescent↗
PubMed2001

[Effectiveness of tuberculosis vaccines].

BCG revaccination in the Sverdlovsk Region is performed thrice: at the age of 5, 10 and 15 years. The percent of children covered by tuberculin diagnosis and BCG vaccination is growing. Complications of BCG vaccination remain at the same level. Tuberculosis morbidity in children rises due to minor forms of tuberculosis. However, it is 2 times less than mean tuberculosis incidence in Russia. Primary infection is registered 4.5 times less frequently.

Adolescent↗
PubMed2001

[Dispensary registration groups and follow-up periods of patients with silicotuberculosis].

Silicosis is the most common and most frequently tuberculosis-complicated pneumoconiosis with poor prognosis. So a procedure for following up patients with silicotuberculosis requires revision and elaboration. Long-term follow-ups have made it possible to define early signs of this disease and to propose a number of techniques for its early diagnosis, such as chest computed tomography and polarization serum crystal microscopy. Specific recommendations on follow-ups of patients with silicosis and silicotuberculosis by a phthisiologist are laid down.

Antitubercular Agents↗
PubMed2000

[Concept of rendering antituberculosis care to the population of Sverdlovsk Region under present socioeconomic conditions].

The regional concept of rendering antituberculosis care to the population includes: the creation of a legal basis by passing a law on tuberculosis, special planning of tuberculosis control measures by adopting a special programme, an interdepartmental approach to rendering antituberculosis care to the population by setting up interdepartmental commission on tuberculosis control, computer-aided tuberculosis monitoring, activities in the prevention and detection of tuberculosis mainly in high-risk groups, the activities of phthisiological facilities by the developed standards and regulations, and the centralization of the antituberculosis drug supply system.

Humans↗
PubMed2000

[Tuberculosis morbidity in the Sverdlovsk region].

Childhood and adolescence tuberculosis morbidity rates are higher in girls than in boys. Adult males fall ill 5.3 times more frequently than adult females. Males fall ill with destructive (6.1 times), bacillary (4.1 times), pulmonary tuberculosis (5.3 times) more frequent than females. Females experience extrapulmonary tuberculosis 1.6 times as high as males. Convicts and those under investigation are ascertained to have earlier forms of respiratory tuberculosis than in the general population. At the same time, the facilities of the RF Ministry of Justice do not record extrapulmonary tuberculosis. Goal-oriented work with these facilities has caused a reduction in tuberculosis morbidity in the whole Sverdlovsk region.

Age Factors↗
PubMed1998

[Tuberculosis in psychoneurological boarding houses of Sverdlovsk region].

Since 1993, the pace of increased tuberculosis mortality and morbidity rates in patients with mental disorders has essentially out-stripped that for the general population in the Sverdlovsk Region. At the same time, the highest tuberculosis mortality and morbidity rates were seen in contingents of psychoneurological boarding houses (PBH) where not only sporadic (single), but group cases of tuberculosis, as well as its outbreaks (epidemics), including massive ones has been annually notified in recent years. In 1993-1996, the mean morbidity rate among those present in PBH was 10.5 times as high as that among the general adult population in the region.

Adult↗
PubMed1998

[Impact of tuberculosis in penal labor facilities on the epidemiological situation in the Sverdlovsk region].

The unfavourable tuberculosis situation in the corrective labour facilities affects the main rates of tuberculosis in the region. Presently, the total registered cases of tuberculosis among prisoners are 36.7 times as high as those in the age-matched general population of the Sverdlovsk Region. The rates of relapses, incidence, death due to tuberculosis show 72.0-, 36.1-, and 10.4-fold increases, respectively. Almost every 10 persons from the labour corrective facilities suffer from active tuberculosis. In the past decade, the growth rates of main tuberculosis parameters in the corrective labour facilities were much higher (total tuberculosis morbidity by 2.1 times, relapses by 2.1 times, general morbidity by 1.7 times, and total tuberculosis mortality by 2.8 times) than those in the region's general population. Extrapulmonary tuberculosis was not virtually detected in the labour corrective facilities) due to the lack of special diagnostic methods.

Adolescent↗
PubMed1997

[Analysis of tuberculosis mortality dynamics in Sverdlovsk region in 1995-96].

Among the deceased in the Sverdlovsk Region in 1995 - 1996 there was a larger proportion of males and individuals aged over 40 years, unemployed, homeless persons, patients with infiltrative pulmonary tuberculosis, concomitant diseases and a smaller proportion of those with prolonged pulmonary tuberculosis, its fibrocavernous type, persons who died from secondary nonspecific changes and complications of the tuberculosis process. Today the most common causes of premature death due to tuberculosis are in patients' refusal of treatment, systemic incompliance, a severe concomitant disease, contraindications for surgical treatment, drug resistance to tuberculostatic agents, drug shortage, late referral for medical aid and long-term evasion of prophylactic surveys for tuberculosis.

Adolescent↗
PubMed1997

[Impact of risk groups on morbidity of tuberculosis and its preventive measures].

The patients with the tuberculosis first established are increasing from different risk groups. New social populations which are at risk for tuberculosis have appeared. The duration of follow-ups of the persons contacting with tuberculosis patients should be revised through its increase. The division of foci into bacillary and abacillary is arbitrary.

Adolescent↗
PubMed1997

[Tuberculosis mortality in Sverdlovsk region under the present conditions].

The tuberculosis mortality rate is the most informative epidemiological indicator. Tuberculosis mortality in the Sverdlovsk Region in 1989-1996 directly, closely, and significantly correlated with tuberculosis morbidity and general mortality. The structure of manpower losses caused by premature tuberculosis mortality due to antituberculosis work defects included one third of losses associated with the defects of antituberculosis work, about one fourth of those with the general therapeutical network, one tenth of those with sanitary epidemiological surveillance centers and another approximately one third with failure of detection and treatment of patients with tuberculosis.

Humans↗