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Tuberculosis and Lung Diseases

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Vol 98, No 4 (2020)
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REVIEW

6-14 2432
Abstract

The article presents the review of 59 publications describing the aspects of etiology, pathogenesis, diagnostics, and treatment of COVID-19 caused by SARS-CoV-2 coronavirus.

The authors state that they have no conflict of interests.

ORIGINAL ARTICLES

15-23 775
Abstract

Malignant tumors of the trachea, bronchi, lungs represent a serious medical and social problem. Most cases of cancer of the trachea, bronchus, and lung are detected at stage IV, and therefore, to improve the survival of patients, a new treatment strategy is proposed based on modern data on mutagenesis and receptor status of tumor cells, which has a personalized approach for each specific case. To make managerial decisions about the introduction of innovative drugs, a forecast of expected results is required which should be improved indicators of the State Program On Healthcare Development. It has been found out that the transition to a new strategy for lung cancer chemotherapy will reduce mortality from malignant tumors by 1.2-0.7%, including lung cancer by 3.9%, as well as one-year case fatality by 3% for all malignant tumors, including 15% for lung cancer. At the same time, within 5 years after the introduction of the new strategy for lung cancer treatment, the indicator reflecting the proportion of patients with malignant tumors registered for 5 years or more is expected to decrease, which is related to specific parameters of the calculation method.

The authors state that they have no conflict of interests.

24-31 680
Abstract

The objective: to study the effect of sleep-related breathing disorders on the activation of blood coagulation reactions associated with systemic inflammation in patients with chronic obstructive pulmonary disease and concurrent obstructive sleep apnea.

Subjects and methods. An open prospective comparative study analyzed thrombogenic risk factors, markers of inflammation and insulin resistance in 65 patients with chronic obstructive pulmonary disease and concurrent obstructive sleep apnea, 26 of them received non-invasive ventilation as a part of their therapy (main group).

Results. The blood levels of homocysteine and prothrombin fragments 1+2 are closely associated with the duration of nocturnal hypoxemia, concentrations of C-reactive protein, C-peptide, and endothelial vascular growth factor and can be managed with CPAP therapy.

The authors state that they have no conflict of interests.

32-39 823
Abstract

The objective: to assess the nutritional status and actual nutrition of respiratory tuberculosis patients with various drug resistance patterns.

Subjects and methods. The actual nutrition of tuberculosis patients was assessed using a standard questionnaire containing questions about the amount of food and meals consumed at home in the last 30 days preceding the survey. Assessment of anthropometric indicators and the survey were carried out by medical workers when the patients were admitted to hospital. Patients were enrolled from April to August 2018 out of 300 respiratory tuberculosis patients who had a positive result of a sputum test for M. tuberculosis. The multidrug resistant tuberculosis group consisted of 222 patients, while the group of those drug susceptible or having mono- or polyresistance included 78 patients.

Results. It was found out that the home diet of patients with active respiratory tuberculosis was imbalanced in respect of basic nutrients and energy. The following was detected: lack of protein in the diet (including the one of animal origin) in 80.6 ± 2.3% with a depth of more than 55.7%; excess unbalanced fat consumption in 66.6 ± 2.7%; insufficient consumption of dietary fiber in 45.0 ± 2.8%. Multidrug resistant tuberculosis patients consumed more energy and macronutrients (proteins, fats, dietary fiber, animal protein, cholesterol, and fatty acids) both in absolute terms and relative to individual needs, but at the same time they had worse nutritional status indicators; 37,2% of them had malnutrition of the 1st to 3rd degree. At the same time, patients with multidrug resistant tuberculosis were significantly more often HIV-positive, they had disseminated and chronic tuberculosis, the treatment of which itself lead to a decrease in appetite, malnutrition, metabolic and digestion disorders.

40-47 930
Abstract

The objective: to study the reasons for the refusal of legally authorized representatives of children to conduct mass immunodiagnosis of tuberculosis using a representative sample of population and to outline possible ways to change this negative situation.

Subjects and methods: A cross-sectional multi-center study was conducted. In 8 regions of the Russian Federation, the survey was conducted in 1,059 legally authorized representatives of children refusing to undergo mass immunodiagnostics of tuberculosis. The following main reasons for refusal were found out: fear of side effects and complications (32.6%), distrust in the quality of the test (29.7%), lack of understanding of the need to examine a child for tuberculosis. 72.2% of respondents demonstrated poor awareness of the problem of tuberculosis – they denied this problem or associated it with a different social environment, which was fertile ground for negative information received through various channels. To solve this problem, it is necessary to intensify health education in various groups of the population, including work with religious communities. Additional resources can be used such as targeted social advertisements, which will allow covering with health education propaganda of 33.1% of people who do not want to receive information about tuberculosis, expanding the regulation for the use of alternative methods of screening for tuberculosis.

The authors state that they have no conflict of interests.

48-52 2068
Abstract

In addition to standard skin tests (Mantoux test with 2 TU PPD-L and diaskintest) for the diagnosis of tuberculosis infection, in vitro tests are used. One of these tests is T-SPOT.TB being more widely used in recent years.

The objective: to evaluate the effectiveness of T-SPOT.TB test for early detection of tuberculosis infection in children and adolescents in Samara Region.

Subjects and methods. From 2016 to 2019, results of T-SPOT.TB tests performed in 596 children aged 2 to 17 years inclusive were analyzed; those children had no immunodiagnosis of tuberculosis infection using skin tests since their parents refused to have it.

Results. It was found out that the major reason for refusing skin tests was the “fear” of visiting a TB dispensary if the result had been positive — 38.43% (n = 229). The latent tuberculosis infection according to the results of T-SPOT.TB among children with concomitant pathology made 2.6%, among healthy children – 0.7%.

Conclusion. T-SPOT.TB test may be used as an alternative method for diagnosis of tuberculosis infection, should the parent refuse to have skin tests. In children with concomitant pathology, T-SPOT.TB test can serve as a leading method for immunodiagnosis of tuberculosis.

The authors state that they have no conflict of interests.

КЛИНИЧЕСКОЕ НАБЛЮДЕНИЕ

53-57 932
Abstract

The article presents a clinical case of myocardial infarction in the early postoperative period after lung resection due to tuberculosis in a 51-year-old patient; clinical manifestations, diagnosis, management tactics and successful treatment are described. In 24 hours after the diagnosis was made, the patient underwent emergency stenting of the right coronary artery in the cardiologic dispensary.

The authors state that they have no conflict of interests.

REVIEWS

58-64 1576
Abstract
The review presents methods for management of free radical reactions in pulmonary tuberculosis patients which are of great importance for relief of clinical symptoms, pathomorphological changes, and the outcome of the disease. It describes the effect of various antioxidant drugs on the course of tissue inflammatory reaction and the development of destructive changes in the lungs.


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ISSN 2075-1230 (Print)
ISSN 2542-1506 (Online)