The diagnostic criteria for tuberculous meningitis

The cause of death of patients is the late diagnosis of tuberculous lesions of the meninges. Diagnosis of tuberculous meningitis is based on a specific criteria, the presence of which allows to establish the diagnosis in the early stages. Early diagnosis is considered when the diagnosis was made no later than ten days after the start of the second period, the period of illness or irritation. TB meningitis occurs at a sufficiently high rate, so it has great importance to the timely diagnosis.

On the probability of the presence of tubercular meningitis nature can be judged based on the following criteria:

• dynamics of clinical symptoms
• the presence of prodromal period, the gradual development of the disease
• the presence of cerebral symptoms
• characteristic changes in the cerebrospinal fluid

Liquor in tuberculous meningitis varies, so this feature is seen as an important diagnostic criterion. During the diagnostic puncture draws attention to the fact that a jet of fluid flows, indicating that the increase in pressure in the spinal canal. In appearance, the liquid is clear. In the case of the blockade of the spinal cord at the level of the color may be yellow. It shall be required to study the cellular composition of cerebrospinal fluid, bacteriological examination.

Differential diagnosis of tuberculous meningitis is based on a study of the composition of cerebrospinal puncture. The characteristic symptoms are to increase protein and decrease sugar. Changes in blood sugar observed in almost 90% of cases of tuberculous meningitis, but in the early stages of the pathological process of the sugar content can remain within normal parameters. This feature should be considered when interpreting the results of lumbar puncture. Investigation of the composition of cerebrospinal fluid eliminates meningitis Meningitis - an inflammation of the meninges   bacterial or viral, as well as the defeat of the meninges in patients with HIV infection.

TB infection, which is the cause of meningitis may have a different location .  If you suspect meningitis, it is important to conduct a survey of the state of other organs and body systems .  It is necessary to eliminate tuberculosis lung, lymph nodes .  The greatest diagnostic value is X-ray examination of the lungs, which allows you to identify pathological changes in the lung tissue .  Delayed diagnosis hampers therapeutic measures due to the rapid spread of the pathological process, so the patient should be hospitalized to the hospital to conduct a comprehensive examination, if it is suspected tuberculous meningitis nature .  Under steady-state conditions, diagnosis can be made in full, with specific therapy will be appointed in due time, which will increase the patient's chances of recovery .

What determines the success of therapeutic measures

Influence the course of an infectious disease became possible only after the introduction of the practice of public health antibacterial agents. Advances in health care have a positive impact on the course of the disease, but in spite of this, continues to be a high percentage of cases of severe complications of tuberculous meningitis. Various treatment methods are improved, widely used anti-TB drugs that promotes patient recovery. The most severe consequences of tuberculous meningitis can be seen in pediatric practice and in frail people who have comorbidities.

Specific TB therapy is conducted on the basis of weight, age of the patient, which is of particular importance in the treatment of children. There are various methods of administration of antibiotics, so the choice of treatment regimen is based on the extent to which can be given medical assistance in a particular hospital. Of particular note is the treatment of tuberculous meningitis in children Meningitis in children - a dangerous disease   at an early age, as this age group recorded the highest number of deaths the disease. Allowed the following route of administration of antimicrobials:

• spinal canal
• intramuscularly
• tablet form

According to the findings of clinical trials, it was found that the most effective is the use of anti-TB drug "ftivazid" without additional administration of antibiotics Antibiotics - whether they will help you in the foreseeable future?   into the spinal canal. Such a tactic is justified in the treatment of meningitis Treatment of meningitis - the need to provide urgent assistance   in children at an early age. Have a positive effect on tuberculous meningitis antibacterial agents of the aminoglycoside. Conditions that determine their effectiveness, the ability to penetrate the blood-brain barrier. Most expressed the ability to have the drug "amikacin", so it is considered the drug of choice in the appointment of medical schemes.

With simultaneous use of some anti-TB drugs and anti-infectives there is a high risk of pronounced hepatotoxicity. This feature should be taken into account when prescribing "rifampicin" and "INH". It helps to reduce the toxic effect of B vitamins, so it is recommended to use during the course of treatment. It is now widely used for therapeutic purposes hormonal agents that have anti-inflammatory, desensitizing effect. The use of glucocorticoid drugs is justified in terms of the development of inflammatory changes in infectious disease.

An important place must be given to the sanitary measures which provide a thorough patient care, the organization of his daily routine and diet. Meals patient with meningitis has to be nutritious, fortified, which will also promote healing. The criterion for recovery is the result of clinical and laboratory examination, confirming the absence of the pathological process.

Marina Solovyov

Symptoms and treatment of Alzheimer's disease

Many have heard about the Alzheimer's disease (she suffered, for example, the US president Reagan), but not everyone understands what it is. With Alzheimer's disease are trying to fight a variety of ways, but to cure it is still not possible to anybody. It is heavy and largely incomprehensible disease is transmitted most often inherited.

What is Alzheimer's

Alzheimer's disease - a disease that begins in middle and old age and is characterized by gradually increasing deterioration of memory and other intellectual functions. The cause of Alzheimer's disease is the fact that in the brain develop disorders leading to increasing neuronal cell death and destruction of mental functions. Alzheimer's disease is early (up to 65 years) and late (after 65 years).

For the first time the disease was described by German psychiatrist A.Altsgeymerom in 1907. Causes of Alzheimer's disease is not completely established, there is evidence that it is a hereditary disease, but at the same time, there are cases that can not be attributed to heredity.

How does the disease

Alzheimer's disease develops slowly and quietly, and is characterized by the appearance of a gradual increase in memory disorders Memory Disorders - aggravation as dangerous as the weakening . At first appear impaired memory and attention in the form of forgetfulness and absentmindedness, worse than digest the new information, disturbed orientation in time and of the true sequence of certain events. Usually the patients themselves notice this phenomenon.

Sometimes the disease begins with a change in the nature: there is rudeness, selfishness, disregard for the interests of the family, indifference to everything. At the same character traits that were previously inherent to this person (eg, sensitivity, caring for children and grandchildren) are gradually erased.

One of the first signs of Alzheimer's disease is delirium, which can be expressed, for example, in the belief that no one likes being ignored, persecuted, etc. Such nonsense can cause a persistent lowering of mood or depression Depression - a little more than a bad mood .

With further development of the disease in humans may appear hallucinations, as he can see, hear or feel something really net.Nakonets, impaired orientation in time (do not remember what day, year), space (do not understand where there are) , the environment (can get lost in a familiar place). Patients do not recognize not only friends, but also the closest people.

At the same time there are violations of the right perception (agnosia), total or partial loss of speech or a lack of understanding (aphasia), impaired ability to perform usual activities, including the collapse of previously acquired skills (apraxia). Instead of the usual flow of meaningful speech appears poorly understood set of words, violated the skills of reading and writing.

Recent changes - a violation of orientation in the self, when the patient is difficult to understand who he is, how old he is, and so on. Patients forget how to dress, personal hygiene, use of household appliances. They gradually lose their ability to take care of themselves and live without assistance. The final stage - a deep general dementia. From motor acts are primitive reflexes - sucking, chewing, swallowing. Most of the time patients are in bed in a fetal position, uttering meaningless cries.

Diagnostics

Basically, the diagnosis is based on examination of the psychiatrist. Changes characteristic of Alzheimer's disease are detected on computed tomography (CT) and magnetic resonance imaging (MRI), elektoentsefalografii, as well as a number of biochemical studies.

Treatment

Patients usually come to a psychiatrist at the height of the disease, as the initial stage of almost all considered as natural aging. At the moment, unfortunately, absolute freedom from Alzheimer's impossible. The existing treatments are only able for a time to slow down the process of its development. Such a treatment is most effective in the early stages. Prescribe drugs that will delay the development of the disease, to partially restore violations of the higher nervous activity, improve the processes of thinking, and in the later stages - to facilitate the care of such patients.

Thus, for the treatment of Alzheimer's disease used acetylcholinesterase inhibitors such as galanthamine, which increases the amount of acetylcholine (substances transmitting excitation from one cell to another, and processes involved in memory), thereby improving brain processes. This means that the dementia can be treated at any stage of: first, in order to slow the progression of symptoms and to maintain adequate quality of life, and in advanced disease - to reduce its progression.

It is necessary to attach the patients with Alzheimer's disease to some useful process, more active lifestyle, which can be an incentive for more intensive work of the brain and, therefore, will help to slow the progression of the disease.

Remember to hold the maximum development of Alzheimer's disease as early as possible you need to seek medical help.

Galina Romanenko