UDC 617.55-002.5-07:616.155-097.36-07

Despite the high level of development of modern diagnostics, there is still a problem of diagnosing extrapulmonary and latent forms of tuberculosis. The purpose of the study was to determine the features of the immune status during the Koch immunoprovocation test. Studies were conducted in the venous blood of 50 patients with abdominal tuberculosis before and 72 hours after the Koch skin test. Indicators of cellular immunity were determined by the indirect immunofluorescence method and the content of cytokines by the immunoenzymatic method. The existence of statistically significant differences in the immunogram and in the cytokine profile of the examined patients before and after the Koch test was proved. The Koch immunoprovocation test
exacerbates the pathogenetic manifestations of the chronic inflammatory process, which is manifested by a change in the cytokine spectrum of the blood and makes it possible to clarify the diagnosis of abdominal tuberculosis. Determination of the level of TNFα in the blood serum of patients after the Koch test can be a marker of the latent form of the course of abdominal tuberculosis. Key words: immune system, cytokines, extrapulmonary tuberculosis, Koch test. 

Background. It is known about wide variety of individual reactions to stress explained by genetics factors. On the other hand, it is also known about aerobic fitness variability between individuals. From the above it follows the hypothesis that inter-individual differences in normal conditions determine the characteristics of the body's response to acute stress. The purpose of this study is to test the hypothesis. Material and methods. The experiment is at 58 rats (28 males) Wistar line. Animals were tested for resistance to hypoxic hypoxia and aerobic muscular performance by swimming test. On the basis of the received data two qualitatively equivalent groups in a ratio 10/48 were formed. After a week of recovery over the next 10 days, one animal remained intact and 5 other rats were exposed to water-immersion and restraint stress. The next day after stress, the ECG recorded and some endocrine, metabolic and immune parameters determined as well as erosive-ulcerative lesions of the gastric mucosa evaluated. Results. Four clusters by hypoxic and swimming tests were created retrospectively: normal resistance to hypoxia and muscular endurance (n=11); moderately reduced resistance to hypoxia and normal swimming test (n=25); drastic increased swimming test and normal hypoxic test (n=3); significantly increased resistance to hypoxia and normal swimming test (n=9). Each cluster is characterized by specific (correctness of classification 100%) post-stress changes in 6 neuro-endocrine, 12 immune, 10 metabolic and 2 ECGs parameters, as well as the index of damage to the gastric mucosa. The swimming test determines the post-stress state of the registered parameters by 63,8%, the hypoxic test - by 57,5%, and taken together - by 79,1%. Conclusion. The post-stress neuro-endocrine, immune and metabolic parameters as well as injuries of myocardium and gastric mucosa in rats are determined significantly by innate muscular endurance and resistance to hypoxia.

The first scientific publication on general adaption syndrome, or as we know today biologic stress has been published in Nature in 1936 by the 29-year old Hans Selye.¹ Szabo et al² in the anniversary review "Stress" is 80 Years Old” conclude that despite the extensive and multidisciplinary research on stress during the last 80 years, a lot of basic and clinical research is needed to better understand the manifestations, central and peripheral molecular regulators of stress response, especially the modes of prevention/management of distress or its transformation into eustress and the treatment of stress-related diseases.

In the vast majority of publications on stress, the HPA-, HPG- and autonomous systems are the objects of research, while the place in the general adaptation syndrome of such important hormones as calcitonin and PTH has been studied only in a few publications. Another methodological shortcoming of most studies is that the subjects of analysis are limited to a single neuro-endocrine system.

Therefore, we set ourselves the goal: to analyze relationships between some adaptation hormones, HRV, calcitonin, and PTH as well as electrocardiogram and gastric mucosal damage in naїve and post stressed rats.

 Introduction. Surgical interventions are accompanied by acute stress reactions, which are staged and cause functional changes, primarily in the nervous, cardiovascular, endocrine systems. The study of biochemical stress markers in blood provides valuable information about the state of patient’s state under conditions of surgical aggression. Aim: To investigate the biochemical manifestations of stress reactions in blood of dental patients with different
individual psychological characteristics during planned surgical treatments in the maxillofacial department. Materials and methods. The level of neuroticism was determined in 64 patients at the Department of Maxillofacial Surgery of Lviv Regional Clinical Hospital, by testing according to the well-known Eysenck method. The level of reactive anxiety and depressive manifestations in patients was determined using the Hospital Anxiety and Depression Scale (HADS). Before the surgery (before premedication) and fve hours after its completion, the content of cortisol, prolactin and interleukin-1β was examined in the peripheral venous blood of the patients. Results and discussion. Before premedication, the highest levels of cortisol and prolactin in the peripheral venous blood of patients with high neuroticism and anxiety, which could not be eliminated by antistress therapy in the stage of preoperative preparation, were found. In the pre-surgery period, all patients, regardless of their level of neuroticism, had a low level of interleukin 1-β in blood - 8.5 ± 3.6 pg/ml (p = 0.2547). Despite the satisfactory anaesthetic support of the surgical interventions, all patients had increased cortisol in blood, due to the development of an acute inflammatory reaction induced by surgical trauma. In the postsurgical period, there was also a statistically signifcant increase of interleukin 1-β in the blood in all patients - up to 19.7 ± 4.6 pg/ml. There is a close relationship (χ2 = 17.89, p < 0.01) between the anxious state of the patients and the increase in the concentration of prolactin in their blood. Conclusions. Under conditions of surgical stress in dental patients before analgesia, similar changes occur at biochemical level - the blood cortisol and prolactin levels increase, the intensity of this process being more pronounced in emotionally labile patients (with a high level of  neuroticism). There is a close relationship between the psycho-emotional state of patients (their level of anxiety)
and the dynamics of prolactin concentration in blood, while the concentration of cortisol in blood is affected by phlogogenic factors caused by surgical trauma.