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Biomedical subjects

O G Chelnokova

Publications and source records attributed to O G Chelnokova.

8 recordsLinked to original sources
PubMed2006

[Diagnostic features for the early variant of caseous pneumonia].

Examination of clinical, X-ray, and laboratory data of 312 patients with caseous pneumonia identified an early variant of this disease in 35%. The early variant was the initial stage of caseous pneumonia, characterized by the comparable restricted extent of alterative lesion and by the absence of signs of severe multiple organ dysfunction. The application of a package of intensive methods of etiotropic and pathogenetic therapy, including regional lymphotropic therapy and extracorporeal immune pharmacotherapy led to bacterial isolation cessation in 81% of patients. Clinical recovery was achieved in 63% of the patients with the detected early variant of caseous pneumonia. There were no fatal cases in patients with the early variant of caseous pneumonia. The study demonstrated the value of the clinical X-ray variants of caseous pneumonia for its early diagnosis and initiation of therapy.

Diagnosis, Differential↗
PubMed2004

[Pathogenetic therapy for caseous pneumonia].

The efficiency of treatment was studied in 79 patients with caseous pneumonia, including 37 patients (a study group) in whom pathogenetic therapy was performed in accordance with the proposed scheme and 42 patients (a control group) used routine treatment regimens. A study of clinical and X-ray picture of caseous pneumonia identified its three variants requiring a differential approach to its treatment, such as an early stage of caseous pneumonia; an infiltrative and necrotic stage; and a caseous and destructive stage. Analysis of the course of the disease showed it necessary to make a timely correction of complex etiotropic and pathogenetic therapy, to determine the optimal time of surgical treatment. The use of a programme for stepwise pathogenetic therapy for caseous pneumonia by taking into account the identified variants decreased the number of fatal outcomes by 2.8 times in the study group of patients as compared with this parameter in the control group.

Anti-Bacterial Agents↗
PubMed2004

[Problems of the epidemiology, diagnosis, and treatment of caseous pneumonia].

The pace on increases in new cases of caseous pneumonia in 1992-2001 is 50% ahead of that in the total number of new cases of pulmonary tuberculosis. Examination of the specific features and the course of caseous pneumonia in 128 new cases identified the criteria for diagnosing this form of tuberculosis. The leading criteria are the X-ray signs of caseous and necrotic lung tissue damage and the clinical and laboratory signs of significant endotoxicosis and immunodeficiency. The use of extracorporeal immune pharmacotherapy with diucifon in 53 patients and the retrosternal administration of isoniazid with hydrocortisone in 43 patients showed the efficiency of these methods in the treatment of patients with caseous pneumonia.

Adjuvants, Immunologic↗
PubMed2003

[Errors in diagnosing pulmonary tuberculosis in general hospitals and results of treating the disease].

AIM: To specify diagnostic approaches to rapidly progressive destructive pulmonary tuberculosis (RPDPT) in general hospitals and effects of the time of the diagnosis on treatment results. MATERIALS AND METHODS: History, diagnostic techniques and treatment of 162 patients with RPDPT (98 cases with cheesy pneumonia, 37 cases with rapidly progressive infiltrative tuberculosis, 27 cases with rapidly progressive disseminated tuberculosis) were studied. RESULTS: The diagnosis of tuberculosis was verified for 7 days in 56% patients, in 33% of them the diagnosis took more than 14 days. Tuberculosis was hidden under the mask of inflammatory pulmonary diseases in 60% patients, concomitant pathology--in 19%. Masks were also due to severe intoxication, multiorgan insufficiency, complications, tuberculosis of other organs. RPDPT was diagnosed primarily by x-ray examination, bacteriological test for M. tuberculosis was used in 14%. Lethal outcomes in the group of patients diagnosed for 14 days and longer occurred 2.6 times more frequently than in those diagnosed within 7 days. CONCLUSION: The analysis of the diagnostic errors resulted in design of the scheme of the diagnosis of RPDPT including cheesy pneumonia intended for use in general practice with account for possible "masks" of the disease. Basic criteria of the diagnosis are stepwise development of the disease and infiltrative-alterative changes on x-ray picture. Phthisiological alertness of general practitioners in relation to RPDPT must direct the physicians to active detection of M. tuberculosis in the sputum and close cooperation with phthisiologist in complicated diagnostic cases.

Diagnostic Errors↗
PubMed2003

[Extracorporeal immunopharmacological therapy in the treatment of patients with acutely progressing froms of pulmonary tuberculosis].

Extracorporeal immune-pharmacological therapy, involving Diuciphonium, was added to the complex treatment of 46 patients primarily diagnosed as having acutely progressing destructive pulmonary tuberculosis. Investigations showed that this method sped up the regression of clinical and X-ray signs, during 1 to 2 months, and recovered the immune reactivity in 89% of patients. The clinical changes were dynamically compared with those of 50 other patients in another group (including 39 patients with caseous pneumonia), who were treated by small-volume plasmapheresis. Advantages of applying the extracorporeal immune-pharmacological therapy were demonstrated; they comprise: a shorter time needed to arrest the endotoxicosis, a fuller and faster recovery of the main populations and sub-populations of lymphocytes and a less number of fatal outcomes.

Acute Disease↗
PubMed2003

[Some specific features of drug resistance of Mycobacteria tuberculosis in patients with acutely progressive destructive forms of pulmonary tuberculosis].

A clear correlation has been found between the drug resistance of Mycobacterium tuberculosis (MBT) and the degree of immunodeficiency in 127 patients with acute destructive tuberculosis. The findings indicate that it is possible to use significant immunodeficiency as an early marker of the multidrug resistance of MBT and as a predictor of cheesy pneumonia. The fact that there was X-ray involution in one lung and concomitantly progression in the other suggests the presence of MBT strains showing different drug resistance. The efficiency of treatment for acute tuberculosis has been ascertained to be determined by MBT drug resistance.

Drug Resistance, Multiple, Bacterial↗
PubMed2003

[Use of isofon in combined treatment of patients with acutely progressive forms of tuberculosis].

Isofon given in a dose of 800 mg daily for 1.5-2 months contributed to clinical and X-ray involution of a process in 16 of the 19 patients with acutely progressive destructive forms of tuberculosis. The drug proved to be effective in patients who isolated drug-resistant Mycobacteria tuberculosis, including those to a combination of isoniazide and rifampicin. When used in patients with significant immunodeficiency, isofon provided an immunomodulating effect. It caused relatively a great deal of adverse reactions as fever in 11 patients, weakness, dizziness in 5, and cardiac arrhythmia in 1. The findings show it necessary to perform further clinical trials of the drug.

Acute Disease↗