The objective: to study postoperative complications in pulmonary tuberculosis HIV positive patients with the relevance to CD4+ count and viral load before surgery.

Subjects and methods. The results of planned lung resections of various extent for tuberculosis in 139 HIV positive patients were analyzed.

Results. There was no statistically significant correlation between baseline CD4+ count and viral load and the development of postoperative complications in the investigated cases.

The objective: to assess the strength of respiratory muscles (RM) in patients with chronic obstructive pulmonary disease (COPD) and determine the role of certain pathogenetic factors of COPD in the development of respiratory muscle dysfunction.

Subjects and methods. In in-patient settings, the strength characteristics of respiratory muscles were studied in 85 men aged 39-78 years suffering fromCOPD exacerbation. MicroRPM (CareFusion, UK) was used to determine the levels of maximum inspiratory and expiratory pressures in the oral cavity, maximum rate of their rise during inspiration and expiration as well as the level of intranasal pressure before and after the test with salbutamol.

Results. Significant variability in strength characteristics of respiratory muscles was observed depending on the stage of COPD, its phenotype, and the presence of hypoxemia or hypercapnia. In patients at early stage of COPD, only expiratory respiratory muscle dysfunction was documented; at moderate and severe stages, inspiratory and expiratory muscle dysfunction was observed, and at very severe stage – diaphragm dysfunction prevailed. The results of the salbutamol test demonstrated the maximum increase in the strength of respiratory in early and moderate COPD and the minimum increase in extremely severeCOPD indicating the role of the irreversible component of bronchial obstruction in the development of respiratory muscle dysfunction. The emphysematous phenotype of COPD was characterized by inspiratory respiratory muscle dysfunction, while the bronchitic phenotype was characterized by expiratory respiratory muscle dysfunction. In patients with hypoxemia and hypercapnia, the strength of inspiratory respiratory muscle was lower versus normoxemia.

The objective of the study: evaluation of mutagenic properties of thiosonide in tests of chromosomal aberrations in mammalian bone marrow cells and mutation accounting on Salmonella typhimurium strains.

Subjects and methods. Studies were carried out using F1 hybrids of CBA×C57BL/6 mice, they received thiozonide in the equivalent of a therapeutic dose and 160 times above it, once and in the course of 5 injections. The genetic toxicity of thiosonide was evaluated on Salmonella typhimurium strains in the tested doses of 1,000, 100, 10, 1 and 0.1 μg per plate.

Results. No mutagenic activity of thiosonide in the chromosomal aberration counting test in bone marrow cells of mice was demonstrated. The level of chromosome aberrations in the experiment did not exceed the corresponding control values. Thus, thiosonide at the therapeutic dose (25 mg/kg) and 160-fold increase above it (4,000 mg/kg) did not induce chromosomal aberrations in the bone marrow cells of mice either with single dosing or several intragastric administrations.

According to the Ames test results, the number of revertant colonies in the solvent control in the CM- and CM+ variants was within the range of spontaneous fluctuations for these strains; thiosonide in all tested doses did not show mutagenic effect on the TA 100, TA 98, and TA 97 strains both with the system metabolic activation and without it.

The objective of the study: to develop criteria to evaluate the duration of the intensive phase of chemotherapy for respiratory tuberculosis in children without bacterial excretion and at no risk of multiple and extensive drug resistance of tuberculous mycobacteria.

Subjects and methods. Totally, 93 patients with newly diagnosed respiratory tuberculosis without bacterial excretion and at no risk of multiple and extensive drug resistance of tuberculous mycobacteria. Their age varied from 2 to 12 years old. Regimen III was used: the intensive phase – 4 drugs (isoniazid, rifampicin, pyrazinamide, ethambutol – HRZE).

Results. The intensive phase lasted for 2 months in 39.8% of cases – the main criteria were achieved (relief of intoxication symptoms, normal blood rates, positive or stable CT changes) after 2 months and there was no indication to extend the duration of it. The intensive phase lasted for 3 months in 37.6% of cases – the main criteria were achieved after 2 months and there was at least one additional indication to extend it (17.2%); and the main criteria were achieved after 3 months and there was no indication to extend the duration of it (20.4%). The intensive phase lasted for more than 3 months (4 to 6 months) in 22.6% of cases – the main criteria were achieved after 3 months and there was at least one additional indication to extend it (12.9%), as well as in the case of failure to achieve the main criteria after 3 months regardless of the presence/absence of additional indications to extend its duration (9.7%).

Conclusion. Various combinations of the main criteria and additional indications made the basis for differential approach to determining the duration of the intensive phase of chemotherapy in children with respiratory tuberculosis 

The objective: to study specific features of the course and diagnosis of respiratory tuberculosis in persons aged 70 years and older.

Subjects and methods. Medical records of 93 patients aged 70 years and older who were hospitalized due to respiratory tuberculosis in 2000-2019 were retrospectively analyzed. Men made 60.2%, and women – 39.8%.

Results. Often tuberculosis was detected late when referring for medical care (68.8%). In 59.4% of patients, tuberculosis was detected later than in 2 months after the onset of the first symptoms. 89.2% had multiple co-morbidities. Destruction was detected in 52.7% of patients, bacterial excretion – in 69.9%, and remaining post-tuberculosis changes – in 34.4%. Sputum conversion was achieved in 81.5% of patients and cavities were healed in 53.1%.

The objective: to assess changes in the level of lactoferrin and ferritin in patients with pulmonary tuberculosis and COVID-19 during treatment, to determine their correlation with parameters of free radical oxidation and antioxidant protection.

Subjects and methods. Levels of lactoferrin and erythrocyte catalase ferritin, neutrophil myeloperoxidase were studied against the background of successful treatment in the group of pulmonary tuberculosis patients (n = 80) and the group of COVID-19 patients (n = 75). Their correlation with parameters of free radical oxidation and antioxidant protection was assessed.

Results. Before treatment, the median level of lactoferrin and ferritin increased in both groups, but in the COVID-19 Group, it was significantly more pronounced. At the end of the intensive phase in the Tuberculosis Group and when clinical improvement was achieved in the COVID-19 Group, the median ferritin level decreased. Increased myeloperoxidase activity and decreased level of erythrocyte catalase were also noted in both groups before treatment start; in the COVID-19 Group, the median level of myeloperoxidase was higher versus the Tuberculosis Group, which correlated with a higher median level of ferritin and lactoferrin in this group. After the end of the intensive phase of tuberculosis treatment and achievement of clinical improvement in COVID-19, there was a decrease in the median levels of myeloperoxidase, which coincided with a decrease in the levels of lactoferrin and ferritin. There was a direct strong correlation between myeloperoxidase-ferritin levels (r = 0.80; p < 0.01) and myeloperoxidase-lactoferrin levels (r = 0.73; p < 0.01). Against the background of treatment, intracellular catalase activity increased in both groups, almost reaching the normal value. Also, there is a strong inverse correlation between catalase and ferritin (r = -0.79; p < 0.01).

The article describes a clinical observation of an 18-year-old patient suffering from bronchial asthma complicated by mediastinal emphysema which developed during a coughing attack. It demonstrates the possibilities of computed tomography in the complex diagnosis of spontaneous mediastinal emphysema.

The article presents the review of 68 publications, recommendations, and guidelines on clinical trials of pretomanid for the treatment of patients with drug resistant tuberculosis. According to the publications, combinations of pretomanid with other anti-tuberculosis drugs are highly effective and promising in the treatment of such patients.