scholarly journals LONG-TERM OUTCOMES OF TREATMENT IN PATIENTS WITH DRUG-RESISTANT PULMONARY TUBERCULOSIS AND NON-EFFICIENCY OF PREVIOUS THERAPY

Author(s):  
A. I. Elgali ◽  
A. V. Aseev ◽  
Dmitriy S. Riasenskii ◽  
N. A. Grishkina

In 2018 key changes were made to the recommended treatment for multi-drug resistant tuberculosis, the priority of oral medications over injectables was indicated. For the first time in history, a new, completely oral 20-month treatment regimen was proposed. The regimen recommends bedaquiline and linezolid together with levofloxacin / moxifloxacin, cycloserine / clofazimine. This treatment regimen differs from the standard 4 MDR-TB chemotherapy regimens adopted in Russia. Until recently, bedaquiline and linezolid were relatively unobtainable in the conditions of tuberculosis dispensaries, patients who needed such treatment were referred to specialized Federal tuberculosis facilities. The aim of the study was to study the long-term results of treatment of patients with drug-resistant pulmonary tuberculosis in cases of the ineffectiveness of previous therapy in an antituberculosis dispensary and referral to a specialized Federal tuberculosis institution. In 2010-2014, 143 people of both sexes in the age group from 20 to 60 years old were treated in the Tver Regional Clinical Antituberculosis Dispensary. Individual conversations, organizing communication with other patients who received effective anti-tuberculosis treatment, watching the training video “Tuberculosis: Questions and Answers”, studying the materials of the brochure “School of the Patient. A brochure for patients suffering from tuberculosis” developed by the charitable organization “Partners in the name of health” was used in the process of increasing adherence to treatment. When carrying out measures to increase adherence to treatment among patients with pulmonary tuberculosis, a positive result was obtained in 143 people. These patients agreed to possible surgical intervention in the Federal Tuberculosis Institution. Immediately after the surgical stage of treatment, cavity closure and/or abacillation were achieved in 132 (92.3%) people. In the postoperative period anti-tuberculosis therapy was continued in accordance with the drug-resistant pathogen, the discipline of patients in receiving anti-tuberculosis drugs increased significantly.

2021 ◽  
Vol 19 (1) ◽  
pp. 36-39
Author(s):  
Yu. A. Sheifer ◽  
◽  
I. S. Gelberg ◽  

Background. In destructive forms of pulmonary tuberculosis, especially in the presence of drug resistance of mycobacteria, one of the ways to increase the effectiveness of therapy is the use of collapse therapeutic techniques in various modifications. Purpose of the study: to develop and substantiate an algorithm for complex treatment of destructive forms of pulmonary tuberculosis, using artificial pneumothorax (AP). Material and methods: A cohort of 84 people with destructive pulmonary tuberculosis was formed. It was divided into two groups: 42 patients in the main group (chemotherapy (ChT) + AP) and 42 in the comparison group (ChT). Results: an algorithm for the treatment of patients with destructive forms of pulmonary tuberculosis was formulated. Within a period of up to 6 months, abacillation was achieved in 61.9% of cases in the main group (MG), and in 18.9% (p <0.05) in the comparison group (CG). By the 10th month of treatment, the closure of decay cavities was achieved in 78.7% of cases in the MG and in 42.8% (p <0.05) in the CG. By 12 months the closure of decay cavities was observed in 92.1 and 52.4% of cases respectively (p <0.05). Conclusions: The use of the algorithm for the complex treatment of destructive forms of pulmonary tuberculosis makes it possible to achieve abacillation at an earlier time (up to 6 months - in 61.9%). It also allows to increase the frequency of cavity closure by 39.6% as well as achieve an increase in clinical cure (according to long-term results of treatment) by 23.8% and a decrease in the amplification of drug resistance and mortality by 14.3% and 11.9% correspondingly.


GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 35-41
Author(s):  
T Yu Pestrikova ◽  
I V Yurasov ◽  
E A Yurasova

Medical, social and economic relevance of inflammatory diseases of the woman's reproductive organs requires a very careful attitude to the diagnosis and treatment of this pathology. The number of patients with genital infections and inflammatory diseases of the pelvic organs can takes the first place in structure of gynecological morbidity, and is 60.4-65.0%, and this fact is not unique to Russia, but all over the world. Incidence rate of inflammatory diseases of the pelvic organs in the first decade of the twenty-first century is increased at 1.4 times in patients who are from 18 to 24 years old and at 1.8 times in patients aged 25-29 years. At the same time, the cost of diagnosis and treatment has increased, reaching 50-60% of the total cost of providing gynecological care for population. The inflammatory diseases of pelvic organs are a collective concept. It includes of various nosological forms. There are numerous contradictions in the views on diagnostic approaches and treatment tactics, the nature of screening and control over the long-term results of treatment, the etiological and pathogenetic significance of various microorganisms found in the genital tract in patients with inflammatory diseases of the pelvic organs. Currently, there are many opinions among specialists about diagnostic approaches and treatment tactics, the type of screening and monitoring the long-term results of treatment, the etiological and pathogenetic role of various microorganisms which can be found in the genital tract in patients with inflammatory diseases. This review presents the results of a modern approach to the diagnosis, management and rehabilitation of patients with inflammatory diseases of the pelvic organs.


Author(s):  
Anton Yarikov ◽  
Maxim Shpagin ◽  
Iliya Nazmeev ◽  
Sergey Gorelov ◽  
Olga Perlmutter

The immediate and long-term results of treatment of 30 patients with severe pain syndrome of the lumbar region, who underwent operations on denervation of DOS, were studied. The aim of the study was to evaluate the effectiveness of minimally invasive technologies for the treatment of pain in the lumbar region (denervation of DOS), to study the near and distant results of these treatment methods. Denervation DOS is an effective minimally invasive method for the treatment of facet syndrome caused by spondylarthrosis. It allows in the early and distant postoperative periods to significantly reduce the pain syndrome and improve the quality of life of patients.


1989 ◽  
Vol 103 (2) ◽  
pp. 149-157 ◽  
Author(s):  
T. Lau ◽  
M. Tos

AbstractTo obtain the best possible results of treatment of acquired cholesteatoma, we made a subdivision of cholesteatoma types into attic and pars tensa cholesteatomas, and subdivided the latter further into tensa retraction cholesteatoma and sinus cholesteatomas. Tensa retraction cholesteatoma is defined as arising from a retraction or perforation of the whole pars tensa, whereas sinus cholesteatoma is defined as arising from a retraction or perforation of the postero-superior part of the tensa. We present the long-term results obtained in tensa retraction cholesteatomas treated with one stage surgery from 1964 to 1980. Median observation time was 9 years, range 2 to 19 years. Sixty-one ears were treated without mastoidectomy, whereas 71 ears had canal wall-up mastoidectomy and 64 ears had canal wall-down mastoidectomy. The total recurrence rate was 13.3 per cent; 17 ears had residual cholesteatoma, and nine ears had recurrent cholesteatoma. The best results were obtained in ears with an intact ossicular chain where mastoidectomy was not performed. In 49 per cent of the cases, the cholesteatoma was confined to the tympanic cavity without reaching the aditus, antrum or mastoid process. About one-third to one-quarter of the ears had tympanoplasty only, with removal of the cholesteatoma through the ear canal.


1986 ◽  
Vol 67 (4) ◽  
pp. 300-300
Author(s):  
I. I. Strelnikov

We followed the fate of 166 patients with limb arterial embolism in the late stage of the disease after conservative and surgical treatment from 6 months to 10 years. Of 166 patients, 44 (26.5%) died after hospital discharge. Thirty of them were older than 61 years. The most frequent causes of death in the long-term period were acute cerebrovascular disease (11), myocardial infarction (7), progressive cardiovascular insufficiency due to cardiac defects (6), repeated peripheral artery embolism causing limb gangrene (7). In 7 patients the cause of death was not determined.


Author(s):  
P. G. Gadzhieva ◽  
D. B. Giller ◽  
A. A. Glotov ◽  
O. Sh. Kesaev ◽  
V. V. Koroev ◽  
...  

Objective. To increase efficiency of cavitary pulmonary tuberculosis treatment by developing modern indications and technology of extrapleural pneumolysis with filling material.Material and methods. We reviewed 25 patients with cavitary pulmonary tuberculosis and bacterial excretion who had undergone extrapleural pneumolysis with different types of filling material in 2004–2015. In 16 cases, we performed surgery in patients with one lung.Results. 56% of operated patients demonstrated extensively drug-resistant TB, 40% had multidrug-resistant TB. Cavities were closed and bacterial excretion ceased in 92% of patients at discharge. Long-term results with observation period from 1 to 12 years were analyzed in 24 patients, 17 (71%) of them had complete clinical efficacy.Conclusion. Extrapleural pneumolysis is a mini-invasive surgical treatment that can prove positive effect in patients with non-fibrotic changes in a cavity wall and pathological process in upper parts of the lungs. 


2019 ◽  
Vol 5 (12) ◽  
pp. 156-162
Author(s):  
M. Sabyraliev

Surgical treatment of patients with spinal injuries, accompanied by traumatic stenosis of the spinal canal, is an urgent and discussed problem of modern vertebrology. Surgical treatment of 111 patients with various injuries of the thoracolumbar spine was performed. In 40 patients, post-traumatic stenosis was eliminated using ligamentotaxis using transpedicular osteosynthesis. The immediate results of treatment were followed up in all patients: good results were obtained in 33 (82.5%) cases; satisfactory — in 6 (15.0%), unsatisfactory — in 1 (2.5%). Long-term results with a follow-up of more than 1 year were followed up in 27 (67.5%) patients; good results were obtained in 20 (74.0%), satisfactory in 7 (25.0%).


2020 ◽  
Vol 73 (2) ◽  
pp. 329-331
Author(s):  
Serhiy I. Savolyuk ◽  
Valentyn A. Khodos ◽  
Roman A. Herashchenko ◽  
Vladyslav S. Horbovets

The aim: To analyze and evaluate the efficacy of CDLLV treatment, using high-frequency endovascular welding (EVW), endovenous laser coagulation (EVLC) and catheter microfoam echosclerotherapy. Materials and methods: We have treated 329 patients with CDLLV C2-C6 functional classes according to the Clinical Etiological Anatomical Pathophysiology. Of these, 102 patients had vertical reflux eliminated by EVW, in 112 – by EVLC, and in 115 – by catheter microfoam echosclerotherapy. Results: In the EVW group 3 patients (2.94%) had a partial recanalization of coagulated veins 3 months after the procedure. In EVLC group 2 patients (1.79%) also had partial recanalization group after 6 months. In the group of catheter microfoam echosclerotherapy partial recanalization occurred in 3 patients during 3 months of observation, in the period of 6 months – in 2, in the period of 12 months – in 9, in total – in 14 patients (12.17%). The EVW and EVLC methods showed high efficacy of vertical reflux elimination on the great and small subcutaneous veins (GSV/SSV) in CDLLV and have no fundamental differences in the immediate and long-term results of treatment. Microfoam catheter echosclerotherapy leads to a greater number of recanalisations, compared with EVW and EVLC. Conclusions: High-frequency endovenous welding results in complete fibrotic GSV/SSV transformation in 97.06% of patients. Endovascular laser coagulation results in complete fibrotic GSV/SSV transformation in 98.21% of patients. Elimination of vertical reflux by microfoam echosclerotherapy results in complete fibrotic GSV/SSV transformation in 87.83% of patients.


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