MORPHOFUNCTIONAL FEATURES OF ERYTHROCYTES IN YOUNG WOMEN DEPENDING ON THE LEVEL OF MOTOR ACTIVITY AND HEREDITARY FACTOR

Aim. The paper deals with the adrenergic reactivity of erythrocytes and its connection with quantitative and qualitative characteristics of cells in young women with different levels of motor activity depending on the rs4646994(I/D) polymorphic variant of the angiotensin-converting enzyme (ACE) gene. Materials and methods. Young female students took part in the study: the 1st group (n = 33) included young women with a relatively inactive lifestyle, the 2nd group (n = 18) included those regularly involved in sports activity (volleyball and lapta). Red blood cells were counted with the ADVIA 60 hematology analyzer (BAYER, Germany). The adrenergic reactivity of erythrocytes (ARE) was assessed by changes in erythrocyte sedimentation rate (ESR) under the effect of adrenaline in vitro in final concentrations of 10–5; 10–6; 10–7; 10–8 (stress concentration – SCA) and 10–9; 10–11; 10–13 (physiological concentration – PCA) g/ml. The type of the adrenergic reactivity of erythrocytes was established depending on the direction of ESR changes in the presence of adrenaline – aggregative (Ag) with an ESR increase, anti-aggregative (AnAg) with a ESR decrease, and affectless (Af). The average and maximum values of changes were also taken into account. PCR analysis was performed on the rs4646994 polymorphic variant of the ACE gene. Results. A direct correlation was found between the I/D polymorphism of the ACE gene with average values of ARE when exposed to PCA (R = 0.52, P = 0.04), with the maximum ESR change under the effect of SCA (R = 0.52, P = 0.04), as well as with the direction of ESR changes induced by adrenaline (R = 0.55, P = 0.03). Thus, among individuals with the I/D genotype erythrocyte aggregation prevails, while female athletes with the D/D genotype are not characterized by the same type of ARE. Conclusion. Young female athletes, carriers of the D/D genotype of the АСЕ gene, are the most resistant to the effect of both PCA and SCA.

A retrospective analysis of treatment outcomes of drug-susceptible TB in Kazakhstan, 2013-2016

Kazakhstan has a high burden of multidrug-resistant tuberculosis (TB). The patient-centered National Program for the treatment and prevention of TB has been implemented in Kazakhstan. The program is aimed at meeting the needs of patients and expansion of the outpatient treatment of TB in the country.The aim of the study was to compare the efficacy of the outpatient and inpatient treatment of drug-susceptible TB.This study was a retrospective cohort study.A total of 36.926 TB cases were included. The majority of patients were treated as inpatients. The socioeconomic factors, sex, age, HIV status, and other diagnostic factors (e.g., sputum smear results, extrapulmonary disease) may serve as risk factors to estimate the likely TB treatment outcome. The outpatient treatment of drug-susceptible TB seems to be a comparable option to the inpatient treatment in terms of efficacy.The socioeconomic factors are the main modifiable risk factors for treatment failure. The outpatient treatment of drug-susceptible TB is safe and effective.

Treatment of tuberculosis in South Kazakhstan: clinical and economical aspects

BACKGROUND AND OBJECTIVE

Since 1990, the tuberculosis incidence rate in Eastern Europe and post-Soviet republics has been increasing in many countries including Kazakhstan. This problem is particularly important in Kazakhstan regions with limited financial resources, among them - in South Kazakhstan province. The aim of this study was to investigate the main clinical and antibiotic-related economic aspects of tuberculosis treatment in South Kazakhstan province.

MATERIAL AND METHODS

In total, 502 patients participated in the study. They were hospitalized to the tuberculosis dispensary of Sayram district (South Kazakhstan province) in 2007-2013. Statistical analysis included logistic regression for better treatment outcomes and analysis of antibiotic treatment costs.

RESULTS

Two-thirds of patients had infiltrative tuberculosis (67%). Positive treatment outcomes were determined in 85% of cases. The patients were mostly treated with cycloserine, protionamide, capreomycin, and ofloxacin. The majority of antibiotic costs were related to the treatment with capreomycin. In case of the positive results of the test for Mycobacterium tuberculosis, antibiotic expenses were almost 3 times greater than in case of negative test results (P<0.001).

CONCLUSIONS

The majority of patients had extensively drug-resistant tuberculosis. The negative results of the test for Mycobacterium tuberculosis at discharge were not related to pretreatment factors. Antibiotic-related costs were significantly higher in case of the positive results of the test of Mycobacterium tuberculosis, but were not associated with gender, residence place, hospitalization recurrence, or main blood test results before treatment.