Features of tuberculosis infection. Differences from Single Player DLC

Currently, Diaskintest (vaccination with a tuberculosis allergen) is widely used to diagnose tuberculosis infection. Until recently, this diagnostic method did not exist; only the Mantoux test was used. Today the issue of completely replacing the Mantoux test with Diaskintest is being discussed. Tuberculosis is one of the most important problems in medicine. This is explained by the following factors:

difficulty of treatment;
widespread spread of the disease;
resistance and constant variability of mycobacteria;
the possibility of transmitting an infectious agent through the air;
high mortality;
the possibility of a long asymptomatic course;
mass infection of the population.

What are the indications and contraindications for Diaskintest?

Features of tuberculosis infection

Tuberculosis is infection, the causative agent of which is mycobacteria, most often affecting the lungs, although they are not always the ones who suffer with this disease. May affect skin, bones, internal organs, eyes, genitourinary organs, The lymph nodes. Total infected people worldwide is about 2 billion. This is explained by the high susceptibility of the body and the widespread distribution of mycobacteria. In Russia there are the most high performance morbidity. Over 300 thousand people are registered in tuberculosis dispensaries. The peculiarity of the infection is that it is impossible to cleanse the body of mycobacteria. Even after long-term treatment microorganisms remain in the tissues.

Not everyone infected with tuberculosis suffers from tuberculosis. The risk group includes people with reduced immunity. Most often people between the ages of 20 and 40 get sick. Mycobacteria can be transmitted in the following ways: aerosol (airborne), vertical (from mother to child), contact and fecal-oral (food). Predisposing factors include:

presence of HIV infection;
presence of diabetes mellitus;
long-term smoking;
malnutrition;
frequent colds and hypothermia;
living with persons sick with tuberculosis;
living in damp, cold rooms.

Main clinical manifestations pulmonary tuberculosis are: increased body temperature, intense cough, expectoration of sputum with blood, excessive sweating at night, weakness, weight loss, loss of appetite, pain syndrome V chest, shortness of breath. With tuberculous lymphadenitis, the lymph nodes become enlarged.

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Characteristics of Diaskintest

What is Diaskintest? This is a rapid diagnostic method for tuberculosis. The method is based on the body’s reaction to the introduction of proteins from the tuberculosis pathogen. Diaskintest is a recombinant tuberculosis allergen. The drug contains two antigens. These antigens (proteins) are present in mycobacteria that cause tuberculosis, but at the same time they are absent in BCG strains. It is important that after administration of the drug the risk of developing tuberculosis is completely eliminated. Diaskintest is allergy test, like the Mantoux test. It cannot be used for specific prevention diseases.

Diaskintest has some advantages over the Mantoux test:

more accurate result;
ability to distinguish false positive result from true infection;
higher sensitivity;
Possibility of use for assessing the quality of treatment.

Often, after a negative diaskintest result is detected, the Mantoux vaccination gives a different result (false positive). Because of all this, samples are often made simultaneously at different hands.The drug should be injected into the area middle third forearms. The needle is inserted intradermally. The patient must sit. The leather is pre-treated with alcohol. The injection is done on inner surface forearms. The dose of the administered drug is 0.1 ml. After injection, a small papule forms under the skin. The results of the diaskintest are assessed after three days.

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Indications and contraindications

The vaccine is used for both children over one year of age and adults. Allergy testing is used for the following purposes:

diagnosis of tuberculosis infection;
disease activity assessments;
exclusion of other pathologies similar in course to tuberculosis;
differential diagnosis of reaction after infection and reaction after administration;
assessing the effectiveness of therapy.

There are some restrictions under which Diaskintest cannot be performed. Contraindications to the test include the presence acute pathology or exacerbation chronic disease, epilepsy, acute allergies, skin diseases. If restrictive measures (quarantine) have been introduced in children's institutions for other infections, diaskintest is carried out after the quarantine is eliminated. If a person is sick at the time of the examination, it is recommended to do the test no earlier than a month after recovery. It is also necessary to observe the interval between testing and vaccination. It must be at least one month. The test is carried out and assessed by a doctor. If a child is suspected of having tuberculosis, the pediatrician will issue a referral to a TB specialist. Adults first turn to a therapist about complaints.

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How are the results of diaskintest assessed?

After performing the Diaskintest (DST), the results are deciphered. The results are assessed by a doctor or an experienced nurse. To do this, use a simple ruler to determine the size of the redness and infiltrate (papules) directly at the injection site. Measured cross dimension. If there is no infiltration, then hyperemia is taken into account. Otherwise, it is not taken into account. The result of the diaskintest can be positive, negative and doubtful. Positive result Diaskintest (DST) is observed in the presence of papules of any size.

A positive reaction can be weak, moderate, pronounced and hyperergic. A weak reaction occurs when the infiltrate does not exceed 5 mm in diameter. If its dimensions are from 5 to 9 mm, the reaction is moderate. If the size of the infiltrate is from 10 to 14 mm, a pronounced allergic reaction occurs. A hyperergic reaction of the body is less common. The main criteria: the presence of a papule more than 15 mm, the formation of a vesicle at the injection site, signs of lymphangitis or lymphadenitis. Negative result indicates the absence of disease. This is the norm.

If the reaction is questionable or positive, additional examination is required.

As for the Mantoux test, the interpretation of the results is somewhat different. It is important that the Mantoux test may be false positive when the production of antibodies in the body is associated not with infection, but with the introduction BCG vaccines. Distinguish true infection from post-vaccination reaction very hard. The following data may indicate infection with mycobacteria:

a significant increase in the size of the papule compared to other years;
presence of a positive reaction for 3-5 years in a row;
the presence of a positive reaction against the background of previous negative results;
the size of the infiltrate is more than 12 mm after 3-5 years after immunization with the BCG vaccine;
the presence of risk factors for the development of tuberculosis (living with patients, smoking, immunodeficiency).

In our age modern technologies And unique techniques The number of tuberculosis patients is growing inexorably. Wide use To identify this problem in the last decade, the drug Diaskintest (DST test, Di-test, Diaskin-test, etc.) has been used.

A positive result of this test gives the right to claim that the body has already encountered tuberculosis bacteria, but it is not a fact that the disease will develop. With good immunity, the body is able to cope with the disease and also acquire the necessary antibodies for immunity against such “attacks.”

Di-test, characteristics, specifics.

Diaskintest (DST) – modern method detection of tuberculosis disease, the principle of action is similar to the Mantoux reaction known to everyone since childhood.

This is not even a vaccination, but a test sample, a request from the body for the presence of pathogenic bacteria, pathogens unpleasant disease.

DST does not protect the body from the disease, but only detects its presence.

A protein drug (antigen) is injected under a person's skin to test the body's immune response. A positive diagnostic result suggests that given organism I have already encountered such bacteria as pathogens. It turns out that the infection has already penetrated some time ago, and the patient does not even suspect it.

Diagnostics using the drug Diaskintest has more high accuracy results when compared with the Mantoux test. This occurs due to the special composition of proteins that are sensitive to the pathogen and have anti-allergenic properties. Thus, the likelihood of a false-positive DST reaction is noticeably reduced.

Contraindications for use.

Like any medical manipulation, Diaskintest has some contraindications. The most important rule: the patient must be absolutely healthy. This is a very important circumstance for carrying out vaccination or administering a drug to the body for the presence of infection.

As you understand, there are plenty of infections in a sick human body, and how can he give the correct reaction to the requested sore if he cannot cope with another problem. A positive reaction will not be reliable, and what’s even worse, will lead to unnecessary treatment with serious medications that do not improve health at all.

If there is quarantine in a preschool or other institution, or if there is any suspicion of a disease, such a procedure is not carried out. When assessing the body’s reaction to Diaskintest, there should be no doubt about the patient’s health.

Contraindications for use according to the instructions for use of the drug are: epilepsy, severe allergic reactions, any diseases in acute phase. As we see, health comes first.

Preparing and conducting the Di-test.

Diaskintest is usually planned to be done before other vaccinations. If you have recently been vaccinated, you must wait at least a month to test for tuberculosis. And after DST, almost any vaccination can be given, with the exception of BCG. This is unless the DST test shows a positive reaction, otherwise any vaccination will have to be postponed for at least six months.

Before the procedure, you should once again make sure that the patient is healthy and has no allergy symptoms. If the patient has an allergic reaction, it is allowed to take an antiallergic drug 5 days before taking the sample and another 2 days after. This way the body will be “covered” from adverse reaction to the allergen, making the diagnostic result more reliable.

Injections of the drug are administered subcutaneously using a disposable syringe with an ultra-thin needle. A papule forms at the injection site, initially with a white lemon crust, up to 1 cm in diameter. Subsequently, this injection site will change and become the main field for diagnosing the reaction from the introduction of the drug into the body.

Children under 7 years of age are given Mantoux in the old-fashioned way, but starting from the age of one year, it is allowed to diagnose children using DST. And if the test is positive, this is mandatory.

Diaskintest is performed annually for healthy children (8-18 years old). Testing is possible twice a year if there are diseases: stomach ulcers, diabetes, HIV infection, lung and kidney diseases.

After testing and before evaluating the results, the patient should adhere to the following rules:

not recommended water procedures And ;
should be avoided mechanical damage papules should not be scratched, covered with a band-aid and, in general, it is advisable not to touch;
do not apply ointments or cosmetical tools at the injection site;
need to give up heavy physical activity on the body (workouts, physical labor);
try to avoid thermal exposure to the place where the papule formed ( sunburn or frostbite).

When checking the reaction in children, in mandatory Parents should be informed about this on the day of the injection. Often these announcements are made in advance, at a meeting or in a parent chat.

Evaluation of DST results

The result obtained is assessed 3 days after the injection. Conducting an assessment of the result of a test for tuberculosis should be done medical worker. The measurement is carried out with a transparent flexible ruler with millimeter divisions, taking into account the size of the papule, the presence and area of hyperemia, and other reactions.

The result of the check is:

negative reaction: the papule is not visible, there is no obvious redness, the injection mark is up to 2 mm.
questionable reaction: there is hyperemia, but the papule is small (more than 4 mm) or absent;
positive reaction: there is a compaction after injection measuring more than 5 mm in diameter.

A small hematoma at the injection site is not bad sign, is formed only upon defeat blood vessel. Sometimes this can interfere with the interpretation of the result. If the hematoma does not allow the area of redness to be assessed, then the result of the reaction is assessed as “doubtful” and the patient is sent for re-examination after a couple of months.

A negative reaction means that there is no infection in the human body. This normal reaction, there is no need to do other tests and examinations. For children, this result gives them the right to attend children's group, And next vaccination can be placed on schedule (only BCG every other month).

A questionable reaction is controversial and requires additional examination. When assessing the result, many factors must be taken into account: whether the patient was completely healthy before the test, whether he was susceptible to allergic reactions, how well he complied with the doctor’s requirements after the test, and everything that may be important in the aggregate.

A positive reaction means the body is infected. If visible signs there is no disease, it's latent form, most likely just an infection. Good immunity will prevent the infection from developing into a disease. The man, who for a long time is a carrier of the infection, does not know about it.

If a positive reaction is detected, a serious examination is necessary. The patient is shown X-ray diagnostics and repeated laboratory test(by taking a Mantoux test). Once the diagnosis is confirmed, the patient must be registered at the tuberculosis dispensary.

Diaskintest is very rarely false positive, i.e. the result is positive, but there is no infection in the human body.

Side effects

Diaskintest is known as a new generation drug, therefore, side effects from its use is less than that of analogues.

The following reactions are detected:

appearance cosmetic defect in the form of a bruise at the injection site;
increase in temperature for the first day after injection;
allergic reactions in the form of shortness of breath, itching, redness of the eyes;
high blood pressure and malaise, especially in older people.

Side effects during testing can be avoided if you follow all doctor's recommendations before and after the injection. For allergy sufferers, start taking it early antihistamines, do not strain physically and mentally, protect the “button” from any impact.

Mantoux or Diaskin test

The drug Diaskin-test has been established on the pharmacological market in Russia since 2009, but it is still, in the old fashioned way, compared to the Mantoux test. Undoubtedly they have common features: principle of operation, the sampling procedure itself. However, there are significant fundamental differences between them. The Mantoux test contains tuberculin, a protein found in Mycobacterium tuberculosis. Diaskintest contains a synthetic protein that contains only the causative agent of tuberculosis.

The Mantoux reaction determines that there was tuberculin in one form or another in the body. Moreover, not the presence in this moment, but simply like “ residual phenomenon" It is entirely possible that a person previously had tuberculosis and is now being tested for prevention, or that a child has been given BCG. Or maybe the body is generally infected with bacteria of a non-tuberculous nature that do not cause harm, and Mantoux passes them off as pathogens.

Diaskintest is a highly sensitive drug that can “filter” and detect only the bacteria that cause tuberculosis. This fundamental difference allows us to talk about more high efficiency Diaskintest in the diagnosis of the disease. The Mantoux test gives a result with a reliability of 70%, and Diaskintest - 95%.

Diaskintest is modern, reliable and safe drug new generation. Without a doubt, the best among available analogues. You should not be afraid of such a procedure as testing for tuberculosis using Diaskintest. You just need to follow some recommendations and be attentive to yourself and others.

We will now consider these two categories of characters step by step.

Standard characters

Wilson (from English) W ilson) - first available character in Game. A fearless aristocratic scientist who was captured, presumably by a demon, and transported to a mysterious wild world in which he must survive and, most importantly, not starve. Wilson grows a beard, which protects it from the cold and gives hair when shaved. The voice is similar to muted trumpet.
Willow (from English) W illow) - first unlockable character And first girl in Game. Does not take fire damage And increases sanity when he is near him. From the very beginning of the game carries a lighter. Her voice is like flute.
Wolfgang (from English. W olfgang) - second unlockable character. Although Wolfgang has a mustache, he can't grow a beard. When satiety reaches more than 225 units, it becomes larger and stronger. However, he is shy, so darkness and monsters reduce his sanity faster. His voice sounds like tuba.
Wendy (from English) W endy) - third unlockable character. Wendy has a special flower with which she can summon his ghostly sister Abigail. The ghost will help Wendy in battle, especially since the latter is quite weak. Wendy's voice is similar to alto flute.
W X-78 - fourth unlockable character in Game. WX-78 can eat stale and spoiled foods no damage to health or penalty to satiety (but he cannot eat rot). Maybe there are gears to improve performance. Takes damage in the rain, but at the same time it glows. If he is struck by lightning (including from the Telelocation Staff), he will instantly regain health and speed up, but will lose some of his sanity. His voice is like synthesizer.
Wickerbottom (from English. W ickerbottom - fifth unlockable character. She initially knows the recipes of the scientific machine, and with its help can make items available to the alchemy machine. Can create books. Suffers from insomnia; receives greater than other characters stat penalty from eating stale food. Her voice sounds like oboe.
Woody (from English) W oodie - sixth unlockable character. Cuts down trees faster than others and has an infinitely durable ax Lucy. On a full moon or during felling large quantities trees turns into a giant beaver, which is almost immortal and can break anything, but does not pick up objects. Woody's voice sounds like cello, and Lucy's voice is like clarinet.
Wes (from English. W es) - mime, therefore expresses all phrases with gestures.
Do you think Don't Starve is too easy? Then play as Wes! He is very fragile ! It has in reserve air balloons.