BA and SD - to the phthisiatrician!

[elevsi]

Good evening!

Yesterday has gone to an out-patient department, to write out the daughter in school (with a gastritis of the house have sat). Rolled up local asks, and whether gave a direction to the phthisiatrician. What for? So at you - BA, and younger it is necessary! At it or him - Diabetum.:confused: what communication or connection Has tried to find out, have not told or said. It is necessary! All inoculations, - on age. Mantoux reactions, - in norm or rate. At both children. What for it is necessary to do or make also the Tuberculine test?! In general, veleno to hand over AS WELL AS urine on VK and to splash on reception to the phthisiatrician. Contacts, by the way, no.

Prompt, for what it is necessary? (it would not be desirable to drag children to sit in turn in other out-patient department, in sew the phthisiatrician is not present)

Yes! And in passing still a question it is possible? Mantu and the tuberculine test do or make only in Russia and the former USSR or everywhere in the world? It already so, curiosity:o

[DrOleg]

Good evening!

Yes! And in passing still a question it is possible? Mantu and the tuberculine test do or make only in Russia and the former USSR or everywhere in the world? It already so, curiosity:o

Tuberkulinovye assays do or make all over the world.

But I did not hear, that in Russia did or made the Tuberculine test (at least massovo)

[Elliv]

elevsi, earlier was considered (and, probably, continues to be considered traditionally), that diabetics of percent or interests on 40 - for accuracy of digit, sorri, I do not warrant or vouch - vospriimchivee to infection with a tuberculosis, than nediabetiki. Really, in turned yellow knizhentsii under the name *quot; a?aiNO*quot;, let out or released somewhere in 40-50 years (and rolling at me in a case since times when I caught at any got sources on Diabetum and more has not left on English-speaking) in the resulted or brought examples of patients almost through one besides Diabetum suffered as well a tuberculosis (if exaggerate it is not strong). From modern examples (I conduct in city group of mutual aid of parents of children with Diabetum, therefore I know almost everyone who was ill with Diabetum in the childhood, beginning or starting somewhere about 1984-85) I can result or bring only one: the brother and the sister hurted or ill;sick by Diabetum since the childhood, have died of a tuberculosis (one in 19 years - disintegration of lungs, another at 25-26). But it was a classical case of extremely badly compensated and uncontrollable Diabetum. Certainly, it is impossible to exclude, that there are also others which prefer to not advertise this accompanying diagnosis. Nevertheless, it is interesting - what today's statistics of a case rate by a tuberculosis at well compensated (or, at least, daily controllable) Diabetum, with application of modern human insulins, intensive basally- schemes or plans, pomp, etc.?

[vadimbondar]

Often konsltiruju detok with a tuberculosis, from a tuberculosis intrathoracic limfatichesikh sites, up to serious cases (meningitises) - never Diabetum saw among them.... (children from 0 till 16 years). Personal experience certainly means a little, but nevertheless....

But sample at me with shift aside serious forms, as children from all SSSRa.

[Elliv]

Thanks. Somewhat a stone from soul. I, layer', for some reason too had an impression, that the given problem at modern methods of treatment of Diabetum becomes less actual. And though, as you write, Personal experience certainly means a little, nevertheless it is experience of the expert before which pass or take place tens and hundreds people. The only thing that - yours patients in fact, how much or as far as I have understood, children... On this sample it is difficult to judge, that occurs or happens to diabetics further during a life. But we shall hope, that *quot; ?NOO??*quot; ftiziatrichesky the forecast for them really already an anachronism... (t-O-)



To my son, by the way, put at 4 years or summer age the diagnosis *quot; OOio?Oa?*quot; (mantushka was up to 12 mm), some months he accepted Tubazidum - added by me just in case gepatoprotektorami and vitamins. Have then made a roentgen, the diagnosis *quot; o?Oa?*quot; have removed or have taken off. I am at times tormented - can in vain poisoned or persecuted the child so *quot; ?NOn?OU?*quot; an antibiotic... However, what now...



With mantu was so further. Someone to me has advised next mantu to make not wiping an arm or a hand alcohol (ostensibly *quot; U??an*quot; the papule can be consequence or investigation of allergic reaction to an admixture of a tuberculin with alcohol), and simply preliminary to wash a place of assay by water with soap. I do not know, whether there was a sense in such assumption, however the first result mantu, made in such a way there were 4 mm! http: // www.dia-club.ru/forum_ru/images/smiles/icon_rolleyes.gif



Still couple of years the papule remained quite modest sizes... But in 2005 has again returned to 12 mm.:confused: Again *quot; o?Oa?*quot;?

[vadimbondar]

I do not think, that your manipulations as that have affected or influenced on Mantushku. By the way and the roentgen does not remove or take out the diagnosis *quot; o?Oa?*quot;.

The matter is that Mantu it is an especial allergy - a hypersensitivity of the slowed down type and consequently is estimated or appreciated in 72 hours. In the first day the allergy us does not interest, as it *quot; iU?OOan*quot; an allergy.

For today it is accepted in a nursery ftiziopediatrii, that there is no norm or rate for a Mantoux reaction. Use delutions. Take a usual tuberculin and plant it or him in tens times. So usual assay which put at school is 2 THOSE (tuberkulinovyh units). It is standard assay on which estimate or appreciate a degree infitsirovannosti very approximately. Further try to put delutions the Fourth delution there corresponds or meets one THOSE, the second delution - 0.1, the third 0.01 and so on.



It is considered, that the problem it when the child reacts (though as) less than to the fourth delution (1 THOSE), exception - infected more than year. Normal infitsirovanyj the child should react, only on 4 delution - 1 THOSE. If he reacts to smaller concentration it is a problem. If the child reacts a papule (any size) to 5-6-7-delutions it is very active infection and it is necessary to treat.



Tubazidum, it not an antibiotic, and tuberkulostatik. If it is necessary so it is necessary and it is not necessary to regret. But in Moscow it is better to use simultaneously two preparations!!!

[Elliv]

Metamorphosises with mantu, taken place on a background of ours *quot; ?a??O?n?*quot; (with alcohol/without of alcohol), were absolutely *quot; OONO?U??*quot; - i.e. a papule looked, certainly, as well as it is necessary in 72 hours, the size of a papule was estimated or appreciated in all cases by the doctor. So till now I do not know to that to attribute then jump with 12 on 4 mm.:confused:



Usual assay which put at school is 2 THOSE (tuberkulinovyh units). It is standard assay on which estimate or appreciate a degree infitsirovannosti very approximately. Further try to put delutions the Fourth delution there corresponds or meets one THOSE, the second delution - 0.1, the third 0.01 and so on.



It is considered, that the problem it when the child reacts (though as) less than to the fourth delution (1 THOSE), exception - infected more than year. Normal infitsirovanyj the child should react, only on 4 delution - 1 THOSE. If he reacts to smaller concentration it is a problem. If the child reacts a papule (any size) to 5-6-7-delutions it is very active infection and it is necessary to treat.



At us so not zamorachivajutsja, do or make one assay in a year, most likely in *quot; standard Oa?oNnN???*quot;. Even with a papule anybody of any additional assays did not offer of 14 mm to us. But we, sobstvennno, and not in Moscow. So... In one Ukranian language urjupinske...:)



Nevertheless it is interesting, really in our advanced century of anything more exact it is not thought up instead of the same Mantoux reaction (even for problem cases of type prospective *quot; o?Oa?a*quot;, *quot; ??o??Ooa???O?*quot;, etc.)? From time to time write about any specific test for the originator, but in its or his practice, similar, anywhere do not do or make.



By the way, and than differs *quot; o?Oa?*quot; from *quot; ??o??Ooa???O?*quot; (or it is synonyms)? For today a papule again 12 mm. Prompt plz, whether it is necessary again to start for something to do or make? (the course of Tubazidum about which I wrote, has been done in 4 years, now to the boy 15).

[vadimbondar]

Well we can guess only as mantushirovanie was spent and as was estimated or appreciated.



Yes there are still tests for a tuberculosis which are based or founded;established on qualitative definition of humoral immunity. In particular on definition of antibodies to kordfaktoru. This method somehow has not received diffusion to Russia since at a tuberculosis humoral immunity zajdestvovan it is weak and basically there is a job cellular. Toest there is no correlation between quantity or amount of antibodies and activity of an infection. Phthisiatricians of those countries where it is a lot of a tuberculosis (Russia and others) otvergli this technique, as not INFORMATIVE, there where it is not enough tuberculosis, but it is a lot of self-conceit (the USA and other) try to learn or teach our phthisiatricians. In particular program DOTS is imposed. Well it I have distracted - it is possible on sorosovskom a site tuberculosis.ru to look or see.



Vobshchem the most informative technique priznany-dermal tuberkulinovye tests. Blagodorja the tuberculin can receive and focal reactions to reveal or tap for example a tuberculosis of eyes.



If a Mantoux reaction positive it already speaks about infitsirovannosti. Toest the fact of positive assay - an attribute infitsirovannosti without accounts of the sizes of a papule. The another matter, that infitsirovannost can be strain BTSZH, and in that case intensity of immunity year from a year falls and infitsirovannost can be the pathogenic strain.

Bend name that interval of time between two Mantoux reactions when the person became infitsirovannym.dikim the strain.

There are many attributes as estimate or appreciate the moment of a becoming infected. It is better to not describe them that were not perceived unequivocally.



Well and at last, to estimate or appreciate activity use delutions. So it is considered normal, if the patient reacts a papule of any size to 4 delution (1 THOSE), if there is a papule on 5 (0.1 THOSE) or 6 (0.01 THOSE), it it is an active infection and nazanchaetsja (Except for the some people *quot; ?*quot;) chemoprophylaxis.



Chemoprophylaxis is how much necessary to you is possible to judge, only on correct sdelanym to assays.



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