[Trends in major tuberculosis epidemiological indices in Armenia over 10 years (1997-2006)].

The authors studied statistical data on the trend in quantitative and qualitative tuberculosis epidemiological indices in Armenia in the period of 1997 to 2006. They ascertained a 1.7-fold rise in the incidence and prevalence of tuberculosis per 100,000 (from 27.8 to 48.6 and from 103.8 to 176.1), by preserving the mortality rates at the same level (4.3). However, morbidity rates have become steady-state in the past 2 years. Along with this, that was a slight deterioration in the qualitative indices--new tuberculosis cases showed increases in the proportion of destructive forms from 62.9 to 67.7%, bacteria-discharging persons from 70 to 75.9%, extrapulmonary forms from 7.3 to 9.3%, childhood morbidity from 9.6 to 19.1% with reductions in their proportion among all detected patients from 12.2 to 9.9%; an increase in the proportion of deceased persons within the first year of the disease from 20.6 to 35.0% and in postmortem diagnosis rates from 0.7 to 0.8%. The cure rates comprised an increase in cavern closure rates from 55.4 to 66%, with the preservation of bacterial discharge cessation at the level of 73-74%, a reduction in mortality rates among both new cases from 3.5 to 2.5 and the contingent of tuberculosis patients from 4.8 to 3.5%, a 3.3-fold rise in early recurrences (from 0.9 to 1.3 per 100,000). The further task of the republic's antituberculosis service, planned by the authors, is to improve work in actively detecting tuberculosis in risk groups and treatment monitoring in patients with tuberculosis.

[Prediction of a risk for drug resistance in the pathogen of pulmonary tuberculosis].

The authors studied the spread of drug resistance in Mycobacterium tuberculosis was studied in Armenia and its association with risk factors in 1114 patients with positive bacterial culture and developed a mathematical method for early detection of a risk of its developed, which had been tested in 210 patients. Over 3 years (2002-2004), there was a rise in multiple drug resistance from 8.83 to 10.03% and polyresistance from 5.61 to 7.67%, a reduction in monoresistance from 8.68 to 6.96%; among new cases, there was an increase in multiple resistance from 3.23 to 6.59%, polyresistance from 4.42 to 7.01% and a decrease in monoresistance from 8.73 to 6.74%. For estimation of the value of clinical, laboratory, and social risk factors, the authors complied a rapid diagnostic table (RDT) that reflected 16 signs. Fischer's angular transformation method and stage-by-stage computer-aided analysis were analyzed, by detecting the diagnostic coefficients and informative value of signs, which was based on Wald's analysis called a heterogeneous sequential statistical recognition procedure. Testing this procedure indicated that their data was concordant with the results of bacterial cultures. The use of the proposed procedure make is possible in any conditions to predict the possible development of drug resistance and to take measures of its prevention.

[Clinical and epidemiological characteristics of tuberculosis in children and adolescents in Armenia].

In Armenia, the incidence of tuberculosis among children aged less than 18 years increased by 53.2% (from 7.9 to 12.1% per 100,000 inhabitants) in 1993 to 2003. On the contrary, the proportion of children and adolescents among all the patients decreased by almost twice (from 13.4 to 8.1%), which is largely due to the reduction in birth rates and to the inadequate detection of minor and local forms of primary tuberculosis. The clinical composition of tuberculosis in 1270 examined patients was the following: tuberculosis of respiratory organs (82.9%); its extrapulmonary forms (14.4%); tuberculous intoxication (2.7%); a concomitance of pulmonary and extrapulmonary tuberculosis (5%). The boy-girl ratio was 2:1. Tuberculosis of intrathoracic lymph nodes was predominant in children aged less than 14 years; infiltrative tuberculosis was prevalent in adolescents. Lung tissue destruction was observed in 15.7%; Mycobacterium tuberculosis was found in 10.2% of the patients. 49.9% of the patients were from the foci of tuberculosis; half of these cases were from the hidden foci of this infection.

[Analysis of tuberculosis mortality in Armenia]. / Analiz smertnosti tuberkulezom v Armenii.

The outpatient and patient histories were analyzed in 198 dead patients with tuberculosis. Particular concern is caused by an increase in mortality due to tuberculosis within a month after its detection. Clinically, there are predominant patients with progressive destructive forms of the disease. A total of 86.4% of the patients died directly from tuberculosis and its complications, the remaining (16.6%) patients died from other non-tuberculous diseases. The main cause of death from tuberculosis was its progression (50.1%), cardiopulmonary failure (34.3%), pulmonary hemorrhage (9%). A combination of several causes of death was noted in 33.1% of the patients who died from generalized tuberculosis.

[Changes in enzyme systems and lipogenesis metabolites in experimental tuberculosis]. / Izmenenie nekotorykh fermentnykh sistem i metabolitov lipogeneza pri éksperimental'nom tuberkuleze.

Lung tissue phospholipid metabolism has been studied under the conditions of experimental tuberculosis. These investigations were combined with the simultaneous studying of the qualitative and quantitative composition of individual phospholipids, of the changes in the content of glycerophosphate and dioxiacetonphosphate, as well as, of the abnormalities in the activity of glycerokinase and glycerophosphatedehydrogenase, which play an important role in the catalysis of the initial processes of phosphatidogenesis. Our data obtained have shown that formation of tuberculosis process is accompanied by the pronounced increase of glycerokinase and glycerophosphatedehydrogenase activities, which leads to the significant accumulation of the dioxiacetonphosphate and the free glycerol concentrations. It was established by us, that under the conditions of the pathology studied, the significant decrease of the quantity of phosphatidylcholines, phosphatidylethanolamines and phosphatidylserines took place, while the level of sphingomyelins was increased. The results of our investigations shed the light on the up-to-date understanding of the role of different fractions of phospholipids, as well as, of corresponding enzymatic systems in the pathogenesis of lung tuberculosis and in the formation of focus of necrosis in lung tissue.

[Control over treatment efficacy in pulmonary tuberculosis patients by determining the amount of nucleic acids in the blood]. / Kontrol' za éffektivnost'iu lecheniia bol'nykh tuberkulezom legkikh s pomoshch'iu opredeleniia kolichestva nukleinovykh kislot krovi.

The authors formulated for the first time a conception of the possibility of controlling the course of pulmonary tuberculosis treatment efficacy by means of determination of the amount of nucleic acids in the blood. A dependence has been established of changes of the amount of nucleic acids of the blood on the degree of clinical improvement of patients with pulmonary tuberculosis.

[Dynamics of the activity of antioxidant enzymes in the blood of patients with pulmonary tuberculosis]. / Dinamika aktivnosti antioksidantnykh fermentov v krovi bol'nykh tuberkulezom legkikh.

The given article deals with the results of analysing antioxidative enzymes, such as superoxide dismutase (SOD), glutathione peroxidase (GP) and glutathione reductase (GR) in the blood of pulmonary tuberculosis patients. It is demonstrated that with focal tuberculosis, lipid peroxidation rises, compensatory increase in SOD, GP and GR levels takes place. In infiltrative and disseminated tuberculosis, multidirectional changes of SOD, GP and GR levels are observed depending on a certain stage of the disease accompanied by an increased lipid peroxidation.

[The efficacy of antioxidant therapy in patients with tuberculosis of the lungs and the correction of lipid peroxidation processes]. / Effektivnost' antioksidantnoi terapii bol'nykh tuberkuleznom legkikh i korrektsiia protsessov perekisnogo okisleniia lipidov.

The article deals with the efficacy of the antioxidative therapy in tuberculosis. Besides chemotherapeutic drugs, the administration of alpha-tocopherol, vitamin C and sodium nucleinate brings about higher rates of smear-negative cases and shorter period of cavity closure. In case of tuberculosis, lipid peroxidation (LPO) stimulation accompanied by a sharp drop of superoxide dismutase (SOD) enzyme activity is observed. This process is considered to be a manifestation of the decompensation taking place in the antiradical cell defense systems. In the course of treatment, the LPO level seems to decrease, while SOD activity and SOD/LPO ratio tend to rise. The comparison of the results obtained in every group indicated that a combined administration of alpha-tocopherol, vitamin C and sodium nucleinate proved to be the most effective.

[Dynamics of changes in lipid peroxidation and activity of superoxide dismutase in erythrocytes of patients with tuberculosis]. / Dinamika izmenenii perekisnogo okisleniia lipidov i aktivnosti superoksiddismutazy v éritrotsitakh u bol'nykh tuberkulezom.

Evaluation of the lipid peroxidation rate and the superoxide dismutase activity in patients with tuberculosis showed that lipid peroxidation was distinctly increased in focal and infiltrative forms of the disease, while the enzymatic activity was altered dissimilarly. Activation of superoxide dismutase observed in focal tuberculosis appears to have a compensatory importance.

[Lipid peroxidation and the antioxidant system in patients with bronchial asthma and asthmatic bronchitis subjected to graded physical load]. / Perekisnoe okislenie lipidov i antiokislitel'naia sistema u bol'nykh bronkhial'noi astmoi i astmaticheskim bronkhitom v usloviiakh dozirovannoi fizicheskoi nagruzki.

A study was made of lipid peroxidation and the antioxidant system in patients with bronchial asthma (BA) and chronic asthmatic bronchitis (CAB) before and after muscular exercise. Physical exercise in BA patients was accompanied by an increase in the amount of hydroperoxides and a raised activity of superoxide dismutase (SOD) and a drop of peroxidase and catalase activity. Peroxidase and SOD activity did not increase in CAB patients in whom muscular exercise caused no bronchospastic syndrome in the presence of an increase in the amount of hydroperoxides.

[Metabolic aspects of the differential diagnosis of chronic asthmatic bronchitis and bronchial asthma]. / O nekotorykh metabolicheskikh aspektakh differentsial'nogo diagnoza khronicheskogo astmaticheskogo bronkhita i bronkhial'noi astmy.

The authors have presented an analysis of the results of a study of patients with chronic asthmatic bronchitis and bronchial asthma to detect possible qualitative differences in changes of indices that characterize the intensity of free radical oxidation and antioxidant activity. With this aim in view the level of lipid peroxidation (LPO), alpha-tocopherol content and SOD activity were determined. In patients with bronchial asthma a raised LPO level was noted in parallel with a decrease in alpha-tocopherol content and SOD activity up to the values below the normal ones. A degree of deviation of the indices from those in health depended on the gravity of a course of bronchial asthma. In patients with asthmatic bronchitis in exacerbation and remission with a raised LPO level alpha-tocopherol content and SOD activity remained within normal. These differences can be used for differential diagnosis.

[Determination of the correlations between oxidant and antioxidant systems in bronchial asthma]. / Opredelenie sootnoshenii mezhdu oksidantnoi i antioksidantnoi sistemoi v kharakteristike techeniia bronkhial'noi astmy.

The authors devised a method for calculating the correlations of alpha-tocopherol and superoxide dismutase (SOD) activity to lipid peroxidation (LPO), presented in the form of the following coefficients: K1 = alpha-tocopherol/LPO, K2 = = SOD/LPO X 100. In patients with a bronchial asthma attack, there was an appreciable decrease in the K1 and K2 with a tendency toward recovery in the inactive disease phase. The coefficients ascended to relatively high values if the patients responded well to the treatment. As the disease duration increased (up to 5 years), there was a progressive lowering of the coefficients, with the LPO values being the highest and with those of alpha-tocopherol and SOD being low. The estimates under study were discovered to depend on the external respiration as shown by spirography and pneumotachometry. It has been demonstrated that the coefficients suggested by the authors characterize not only the level of the LPO-AOA system compensation but also of the pathological process on the whole. The data obtained point to the importance of determining the coefficients for the assessment of the patient's status gravity, the degree of the improvement following treatment, the disease gravity, and prognosis.