scholarly journals ALGORITHM OF COMPLEX TREATMENT OF DESTRUCTIVE FORMS OF PULMONARY TUBERCULOSIS AND ITS RATIONALE

2021 ◽  
Vol 19 (1) ◽  
pp. 36-39
Author(s):  
Yu. A. Sheifer ◽  
◽  
I. S. Gelberg ◽  
Keyword(s):  
Drug Resistance ◽  
Pulmonary Tuberculosis ◽  
Comparison Group ◽  
Main Group ◽  
Long Term Results ◽  
Complex Treatment ◽  
Results Of Treatment ◽  
Artificial Pneumothorax ◽  
Cavity Closure

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.

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

2019 ◽  
Vol 24 (2) ◽  
pp. 88-91
Author(s):  
A. I. Elgali ◽  
A. V. Aseev ◽  
Dmitriy S. Riasenskii ◽  
N. A. Grishkina
Keyword(s):  
Pulmonary Tuberculosis ◽  
Treatment Regimen ◽  
Long Term Results ◽  
Drug Resistant ◽  
Adherence To Treatment ◽  
Recommended Treatment ◽  
Results Of Treatment ◽  
Previous Therapy ◽  
Cavity Closure

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.

THE USE OF THORACOPLASTY IN THE TREATMENT OF DESTRUCTIVE PULMONARY TUBERCULOSIS

2021 ◽  
pp. 18-28
Author(s):  
Andrey V. Ivanov ◽  
Alexey A. Malov ◽  
Vadim A. Kichigin ◽  
Vasily A. Ivanov ◽  
Larisa V. Tarasova
Keyword(s):  
Drug Resistance ◽  
Body Weight ◽  
Surgical Treatment ◽  
Treatment Group ◽  
Pulmonary Tuberculosis ◽  
Comparison Group ◽  
Main Group ◽  
Negative Reaction ◽  
Normal Body ◽  
Normal Body Weight

Despite a decrease in the incidence of pulmonary tuberculosis in the Russian Federation in recent years, among the newly diagnosed patients there remains a significant proportion of patients with bacterial excretion and destructive pulmonary tuberculosis. In patients with destructive pulmonary tuberculosis, surgical treatment is often the only possible method for saving lives. We studied the results of extrapleural posterosuperior thoracoplasty in 42 patients with destructive pulmonary tuberculosis. The comparison group consisted of 30 patients who received medicamentous therapy. The mortality rate for 3 years of follow-up in the conservative treatment group was 36.7%, in the surgical treatment group it was 23.8%, p = 0.237. Among patients with more than 2 years of disease experience, mortality was 45% in the main group, 88% in the comparison group, p = 0.070. In the absence of drug resistance, mortality in the main group was 4%, that in the comparison group – 14.2%, p = 0.283. Mortality in individuals with normal body weight was lower in the group of patients who underwent thoracoplasty than in the comparison group: 17.6% vs. 33.3% (p = 0.202). Among those who did not achieve sputum negative reaction, mortality was lower, and passing to the 3rd group of dispensary care was more common in the surgical treatment group – 41.7% vs. 71.4% (p = 0.077) and 33.3% vs. 21.4% (p = 0.426). Among patients with drug resistance or low body weight or unachieved sputum negative reaction, mortality rates were comparable in both groups. Thus, thoracoplasty, in comparison with conservative therapy, makes it possible to improve treatment results in patients regardless of the length of the disease in groups with Mycobacterium tuberculosis sensitive process, with normal body weight, with preservation of elimination of bacilli. The effectiveness of thoracoplasty decreases in patients with an increase in the disease duration.

The use of Dimexide in the complex treatment of Peyronie's disease

1980 ◽  
Vol 61 (6) ◽  
pp. 53-54
Author(s):  
M. G. Muhamadeev ◽  
M. P. Trofimova
Keyword(s):  
Clinical Manifestations ◽  
Disease Recurrence ◽  
Peyronie’S Disease ◽  
Long Term Results ◽  
Complex Treatment ◽  
Results Of Treatment ◽  
Peyronie's Disease

We observed 9 patients with plastic induration of the penis (Peyronie's disease), 3 of them interrupted treatment. Long-term results of treatment were traced in 6 patients (age - from 48 to 60 years): in 5 patients, complaints and clinical manifestations of disease recurrence were not noted for 2-4 years.

scholarly journals Endobronchial valve in complex treatment of patients with drug resistant fibrous cavernous pulmonary tuberculosis

2020 ◽  
Vol 98 (1) ◽  
pp. 35-40
Author(s):  
O. Yu. Askalonova ◽  
E. A. Tseymakh ◽  
A. V. Levin ◽  
P. E. Zimonin
Keyword(s):  
Pulmonary Tuberculosis ◽  
Comparison Group ◽  
Main Group ◽  
Drug Resistant ◽  
Complex Treatment ◽  
X Ray ◽  
Endobronchial Valve ◽  
Sputum Conversion ◽  
Valve Implantation ◽  
Valve Block

The objective of the study: to assess the efficacy of complex treatment with endobronchial valve implantation in the patients suffering from drug resistant fibrous cavernous pulmonary tuberculosis.Subjects and methods. Treatment outcomes in 97 patients with limited fibrous cavernous pulmonary tuberculosis were analyzed. Main Group included 42 patients who had bronchial valve block implanted. Comparison Group included 55 patients. Artificial pneumoperitoneum was used in both groups.Results. In Main Group, sputum conversion was achieved in 12 months in 40 (95.2%) patients, and in 32 patients (58.2%) in Comparison Group (p < 0.01). In 12 months after treatment start, positive X-ray changes were observed in 42 (100%) patients of Main Group and 40 (72.7%) patients of Comparison Group. Healing of cavities in 12 months was observed only in the patients from Main Group (26 (61.9%) patients). Upon completion of the study, surgery was still indicated to 4 (9.5%) of patients from Main Group and to 35 (63.6%) patients from Comparison Group.

scholarly journals THE MODERN VIEW ON THE COMPLEX TREATMENT OF PATIENTS WITH UTERINE FIBROIDS

2010 ◽  
Vol 1 (3) ◽  
pp. 15-20
Author(s):  
S A Levakov ◽  
A G Kedrova ◽  
K V Kojurina ◽  
N S Vanke
Keyword(s):  
Uterine Artery ◽  
Combined Therapy ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Long Term Results ◽  
Complex Treatment ◽  
Female Pelvis ◽  
Results Of Treatment ◽  
Risk Of Relapse

Uterine fibroids are the most common solid tumours in the female pelvis. The purpose was to examine the long term results of treatment uterine myoma through combined therapy in 54 patients. To assess the reproductive health of patients with uterine fibroids after treatment included to use ana logues of gonadotropinreleasing hormone (GnRH) with or without embolization of uterine artery(UAE) and myomectomies. . The introduction of gonadotrophinreleasing hormone agonists (GnRHa) has been found to be useful in the management of patients of reproductive age with uterine fibroids for minimization of risk of relapse.

scholarly journals Immediate and Long-Term Results of Original Methods of Longitudinal Pancreatojejunostomy With The Expansion of the Area of Pancreatojejunal Anastomosis

2020 ◽  
Vol 9 (1) ◽  
pp. 35-45
Author(s):  
A. R. Propp ◽  
E. N. Degovtsov ◽  
S. A. Nikulina
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Main Pancreatic Duct ◽  
Comparison Group ◽  
Pancreatic Head ◽  
Main Group ◽  
Long Term Results ◽  
Hospital Treatment ◽  
Enzyme Preparations

RELEVANCE. The dependency results of draining operations on the efficcacy of drainig of ductal system of the pancreas and adequate outflow of the pancreatic juce through anastomosis are undoubtful, therefore the development of new techniques of longitudinal pancreatojejunostomy (LPJ) extending area of anastomosis is an actual challenge.AIM OF STUDY. To compare the immediate and long-term results of longitudinal pancreatojejunostomy with the expansion of the area of anastomosis in patients with chronic pancreatitis.MATERIAL AND METHODS. We analysed immediate and long-term results of LPJ in 58 patients with chronic pancreatitis with impaired patency of the major pancreatic duct (MPD) without the head enlargement.RESULTS. All patients were divided into two groups: comparison group ( n=26, operated up to 2008 ) and main group (n=32, operated stumps during the MPD diastasis and posterior pancreatic surface (n=3) into anastomosis, with resection of the anterior pancreatic surface in the form of triangular fragments (n=11), with circulation of the small intestine loop during the recovery phase (n=19). The original LPJ in the study group of patients did not lengthened the surgery (160 [135, 185]) and intraoperative blood loss (265 [175, 340]). In the main group of patients there was no postoperative complications and fatal outcomes, but the average duration postoperative hospital treatment (18 [16; 20.5]) exceeded some data of foreign and domestic authors. Pain within 5 years after surgery in patients of the main group exceeded 26.6% and the appearance of diarrheal syndrome with dependance from reception of enzyme preparations was twice lower than in patients og the comparison group. According to questionnaire EORTC QLQ-C30, 5 years after surgery statistically significant differences between groups in terms of scales CF, NV, DY (p=0.03, 0.02, 0.006 respectively), indicating the advantage of intervention performed in the mail group.CONCLUSIONS. 1. An indication for longitudinal pancreatojejunostomy in chronic pancreatitis is impaired patency of the main pancreatic duct in the absence of an increase and inflammatory mass in the pancreatic head.2. The width of the main pancreatic duct is less than 5 mm and the presence of diastasis between its proximal and distal stumps with the posterior surface of the pancreas preserved, is not a reason for refusing longitudinal pancreatic jujunostomy in favor of the resection method.3. The expansion of pancreatojejunal anastomosis when performing longitudinal pancreatojejunostomy can improve the immediate and longterm results of surgical treatment for chronic pancreatitis.

P14.53 Immunotherapy in the complex treatment of HGG

2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii47-ii48
Author(s):  
A Rynda ◽  
V Olyushin ◽  
D Rostovtsev
Keyword(s):  
Malignant Gliomas ◽  
Long Term Results ◽  
Complex Treatment ◽  
Average Life ◽  
Average Life Expectancy ◽  
Standard Methods ◽  
Results Of Treatment ◽  
Antitumor Immunotherapy

Abstract BACKGROUND To improve the long-term results of complex treatment of patients with malignant gliomas MATERIAL AND METHODS The long-term results of treatment of 220 patients with malignant gliomas of supratentorial localization (anaplastic astrocytomas, glioblastomas, giant cell glioblastomas, gliosarcomas) were evaluated. Of these patients, in addition to standard treatment methods (surgery, radiation therapy and chemotherapy), 110 patients underwent specific antitumor immunotherapy. In 110 patients, only standard methods were used in the complex treatment structure. Follow-up results were considered follow-up data, and a relapse-free period was also evaluated. RESULTS The implementation of specific antitumor immunotherapy in patients with malignant gliomas was safe and did not lead to an increase in the number of complications compared with the control group. It was revealed that the use of immunotherapy based on autologous dendritic cells, in addition to standard methods of treating patients, increases the average life expectancy (in patients with anaplastic astrocytomas up to 40.5 months (p = 0.001), in patients with glioblastomas up to 21.8 months (p = 0.002)) and the value of the relapse-free period (in patients with anaplastic astrocytomas up to 17.4 months (p = 0.002), in patients with glioblastomas up to 14.3 months (p = 0.003)), provided that three or more courses are carried out. Conducting 1 or 2 courses of immunotherapy does not significantly affect the average life expectancy and median survival of patients. CONCLUSION The development and use in clinical practice of specific antitumor immunotherapy based on autologous dendritic cells seems to be a very promising direction for further research, the development of which will improve the long-term results of treatment of patients.

scholarly journals The surgical correction of refractory venous trophic ulcers

2021 ◽  
pp. 38-46
Author(s):  
S. E. Katorkin ◽  
M. J. Kushnarchuk ◽  
M. A. Melnikov ◽  
A. A. Zhukov ◽  
P. F. Kravtsov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Comparison Group ◽  
Complete Healing ◽  
Long Term Results ◽  
Group Iii ◽  
Results Of Treatment ◽  
Group I ◽  
Group Ii ◽  
Shave Therapy

Objectives. To study the effectiveness of layered dermatolipectomy and endoscopic fasciotomy in the surgical treatment of refractory venous trophic ulcers.Materials and methods. Patients (n = 105) of the C6 clinical class underwent crossectomy and short stripping. In group I (n = 35), free autodermoplasty of trophic ulcers with a perforated flap was performed. In group II (n = 36), shave therapy and autodermoplasty were performed. In group IIІ (n = 34), fasciotomy, shave therapy and autodermoplasty were performed. Long-term results of treatment were studied in the period from 1 to 12 months.Results. Complete healing of venous trophic ulcers was observed in group I at 49,4 ± 7,2, in II – at 31,4 ± 4,7, in III – at 32,1 ± 3,6 days сутки (t1-2 = 2,09; p1-2 = 0,049; t1-3 = 2,24; p1-3 = 0,024; t2-3 = 0,03; p2-3 = 0,763). Full engraftment of an autograft graft was recorded in 7 (19,4 %) patients of group I, in 27 (77,1 %) cases in group II and in 27 (79,4 %) patients of comparison group III (χ21-2 = 23,674; p1-2 = 0,001; χ21-3 = 25,173; p1-3 = χ22-3 = 0,052; p2-3 = 0,826).Conclusion. Layered dermatolipectomy with autodermoplasty and endoscopic decompression fasciotomy is an effective method for the treatment of persistent refractory venous trophic ulcers.

scholarly journals The use of extemporal dosage form with pyroctone olamine in the complex treatment of patients with seborrheic dermatitis

2021 ◽  
Vol 26 (1) ◽  
pp. 191-196
Author(s):  
I.V. Odintsova ◽  
A.D. Diudiun
Keyword(s):  
Therapeutic Efficacy ◽  
Dosage Form ◽  
Comparison Group ◽  
Seborrheic Dermatitis ◽  
Local Treatment ◽  
Clinical Manifestations ◽  
Main Group ◽  
Long Term Results ◽  
Comprehensive Treatment ◽  
Complex Treatment

The purpose of the work is to evaluate the efficacy and tolerance of extemporal dosage form with pyroctone olamine in the local treatment of patients with seborrheic dermatitis. Under our supervision there were 78 patients with seborrheic dermatitis aged 18 to 57 years. The average age of the patients was 29.5±2.1 years. Comprehensive treatment of patients with seborrheic dermatitis in both groups depended on the severity of clinical manifestations, the duration of the disease, and information on the effectiveness of previous therapy. For external treatment of the main group of patients with seborrheic dermatitis, an extemporaneously prepared gel with pyrocton olamine was used. Local treatment of patients in the comparison group consisted of the appointment of 1% cream of clotrimazole. An analysis of the results shows good therapeutic, microbiological effectiveness and good tolerance of extemporaneously prepared gel with pyrocton olamine in the complex treatment of patients with seborrheic dermatitis. The period for resolving the clinical manifestations of seborrheic dermatitis among patients in the main group was 2.5±0.1 days shorter compared with patients in the comparison group. The intensity of clinical manifestations in patients with seborrheic dermatitis of the main group decreased twice on the second day of complex treatment. In control patients with comparative seborrheic dermatitis, similar therapeutic efficacy was achieved on the fourth to fifth day. Long-term results of the study showed that the recurrence of the disease among patients of the main group was 5 (6.4%), and in patients of in the comparison group was 14 (17.9%). Clinical studies have shown good therapeutic efficacy and tolerance of the extemporal gel with pyroctone olamine in the complex treatment of patients with seborrheic dermatitis, which gives reason to recommend this dosage form for wider use in the practice of dermatovenerologists.

scholarly journals ASSESSMENT OF EFFICACY OF THE METHOD OF PROGRAMMED IRRIGATION ASPIRATION SANATION IN COMPLEX TREATMENT OF PATIENTS WITH CHRONIC POSTTRAUMATIC OSTEOMYELITIS OF THE LONG BONES

2016 ◽  
Vol 175 (3) ◽  
pp. 40-43
Author(s):  
A. A. Glukhov ◽  
V. A. Sergeev
Keyword(s):  
Comparison Group ◽  
Main Group ◽  
The Other ◽  
Long Term Results ◽  
Long Bones ◽  
Treatment Results ◽  
Posttraumatic Osteomyelitis ◽  
Sf 36

The analysis of treatment results of 128 patients aged from 21 to 62 years old with chronic posttraumatic osteomyelitis of the long bones was made at the period from 2006 to 2013. The main group included 67 patients and the method of programmed irrigation aspiration sanation was applied for them. The comparison group consisted of 61 patients and drainage was performed for these patients using the conventional ways. The authors noted good immediate results in the main group in 56 (83,58%) out of 67 patients and in the comparison group - in 43 (70,49%) out of 61 patients. The long-term results were analyzed in 116 (90,6%) out of 128 patients in terms from two to five years after treatment. The rate of recurrences such as formation of purulent fistula were twice less in patients of the main group, than in the comparison group. According to the results of questionnaire SF-36, there was noticed, that patients of the main group got better mean indices of quality of life on all 8 scales compared with the other group.

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