The Bulletin of Contemporary Clinical Medicine最新文献

{"title":"COMPREHENSIVE DIAGNOSIS OF PROSTATE CANCER","authors":"M. N. Nasrullayev, Marat M. Nasrullayev, M. Z. Khasanov, Murad M. Nasrullayev, Adelina А. Fassakhova","doi":"10.20969/vskm.2022.15(2).44-48","DOIUrl":"https://doi.org/10.20969/vskm.2022.15(2).44-48","url":null,"abstract":"Aim. The purpose of the study is to study the possibility of clinical, laboratory and instrumental diagnostics in the combination in the diagnosis of prostate cancer. Material and methods. 147 patients were examined, the middle age of which was 69.5 ± 6.7 years. All patients underwent examination: identification of the level of prostate-specific antigen (PSA) in blood serum, ultrasound transabdominal and transrectal examination in B mode, followed by the use of color Doppler mapping of blood flow, 3-dimensional Dopplerography, elastography and intravenous contrast enhancement. All patients underwent multifocal transrectal biopsy under ultrasound control followed by morphological examination of the obtained material. Results and discussion. The digital rectal examination found an increase of the prostate’s size at 115 patients, increase of the prostate’s density – at 69 patient, the high density’s existence of separate nodes - at 59 patients. The median level of prostate-specific antigen in the blood serum of the surveyed patients was 16,5±6,7 ng / ml. Under transrectal ultrasound at 88 patients the hypoechogenicity center, at 34 – isoechogenicity and at the 22 th center – the mixed echogenic was revealed. We identified 111 patients with abnormal vascularity in disintegration and deformation of vascular pattern. Hyperintensive contrast in 59.0% of cases, rapid accumulation of the contrast agent in 56.0% and rapid leaching of the drug in 59.0% of cases were characteristic of prostate cancer. Comparison of data obtained at transrectal ultrasound with indicators of the Gleeson’s scale was carried out. It was established that hypoechogenic focus is more common in the total score 5-7, and less than 5 points, isoechogenic tumor often with a score 5-7. The pathological vascularization was more often diagnosed in the group of patients with a score 5-7. Conclusion. The use of clinical laboratory and modern methods of ultrasound examination in a complex allows to increase the effectiveness of prostate cancer diagnosis, which undoubtedly contributes to the choice of rational treatment tactics.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131737408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PARENTS’ ASSESSMENT OF MEDICAL CARE FOR THEIR CHILDREN WITH BRONCHIAL ASTHMA AND COMORBID PATHOLOGY","authors":"I.A. Ulishchenko, A. Shulaev, O. Konovalov, V. I. Pak, S. A. Yakhyaeva","doi":"10.20969/vskm.2022.15(2).76-80","DOIUrl":"https://doi.org/10.20969/vskm.2022.15(2).76-80","url":null,"abstract":"Currently, there is a steady increase in the number of children suffering from two or more diseases simultaneously occurring. In this regard, the assessment by parents of the medical care received by children with concomitant diseases is highly relevant. Aim. The aim of the study is to study the satisfaction of parents with medical care provided to patients with bronchial asthma and children with comorbid pathology. Material and methods. On the basis of the regional children’s clinical hospital, a selective sociological study was carried out, in which 368 parents of children aged 7 to 14 years old, patients with bronchial asthma with concomitant pathology, took part. Study design: single-center, non-randomized, uncontrolled study. Results and discussion. In the opinion of only 36.4% of the parents surveyed, inpatient medical care provided to their children is always available. The availability of outpatient care was positively assessed by only 29.5% of the respondents. In this case, the main reasons for dissatisfaction were called insufficient provision of the specified specialists and a long wait for the day of admission. The majority (81.8%) of the respondents would like to receive consultations from specialists of other profiles, taking into account concomitant diseases, when the child is in the pulmonary department of the hospital. At the same time, according to almost every second parent, the level of consultation of various specialists is higher in hospitals than in children’s polyclinics. Among the respondents, 69.3% considered themselves sufficiently informed on the issues of bronchial asthma in children. However, the results of the survey showed that only 69% of parents always follow medical recommendations. Conclusion. The presence of concomitant pathology in childhood, including with such a fairly common chronic disease such as bronchial asthma, requires special medical and organizational approaches to treatment. At the same time, it is necessary to take into account the opinion of the legal representatives of children on the availability and quality of medical care provided.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127765778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RESULTS OF THE USE OF COMBINED PROBIOTIC THERAPY FOR THE CORRECTION OF INTESTINAL MICROBIOCENOSIS DISORDERS IN PATIENTS WITH MULTIDRUG-RESISTANT TUBERCULOSIS OF THE PATHOGEN","authors":"A. A. Kholodov, E. Bryukhacheva, L. Otdushkina, Y. Zakharova, Marina V. Primkulova, T. V. Pyanzova","doi":"10.20969/vskm.2022.15(2).81-88","DOIUrl":"https://doi.org/10.20969/vskm.2022.15(2).81-88","url":null,"abstract":"Introduction. About 90% of TB patients have side effects of anti-TB therapy in the form of gastrointestinal disorders. Currently, the role of disorders of the intestinal microbiocenosis in the formation of dyspepsia has been proven. In turn, dyspeptic syndrome leads to a decrease in patient adherence to treatment, which affects the effectiveness of tuberculosis treatment. The most dangerous in this regard are second-line anti-tuberculosis drugs used in the treatment of drug-resistant tuberculosis. Long-term use of these drugs requires the development and implementation of algorithms for the correction of microecological disorders of the intestine. The aim of the study was to evaluate the microbiological results of using a combined probiotic in persons with tuberculosis and multidrug-resistant pathogen in the course of anti-tuberculosis therapy. Material and methods. A prospective linear study included 30 patients with respiratory tuberculosis and multidrug-resistant pathogen. The study consisted in a two-stage study of the microbiocenosis of the intestinal biotope of these patients by a quantitative bacteriological method before and after combined probiotic therapy with a further comparison of the number of microorganisms. Statistical data processing was performed using the IBM SPSS program. Qualitative signs are represented by absolute and relative frequencies, expressed as a percentage, with 95% confidence intervals calculated for them by the Wilson method (rel.% [95% CI]). Quantitative data are presented in the work in the format of the median and interquartile range (Me (25th; 75th). For variables related to the ordinal scale and nonparametric quantitative variables, the Mann-Whitney U test was used to compare the two groups of observations. the compared groups were considered statistically significant with a statistical significance of less than 0.05. Results and discussion. The use of combined probiotic therapy in patients with multidrug-resistant tuberculosis did not compensate for the deficiency of obligate microorganisms - Bifidobacterium spp., Lactobacillus spp. However, in the process of probiotic therapy noted a decrease in the concentration of Enterococcus spp., E. Coli lac-, E. Coli hly +, Streptococcus spp., as well as a decrease in the titers and species structure of fungi of the genus Candida. A clinical example showing the microbiological and clinical efficacy of probiotic therapy in a patient with co-infection TB / HIV. Despite the changes received, the average population indicators for the region have not been achieved. Conclusion. It was found that the use of combined probiotic therapy in patients with multidrug-resistant tuberculosis led to a decrease in the pool of opportunistic microorganisms in the intestinal lumen and had a positive clinical effect in a patient with TB / HIV co-infection.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115536390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FEATURES OF THE TOPOGRAPHIC-ANATOMIC STRUCTURE OF THE PERHOLOUS-LOWER MANDAL SPACE AFFECTING THE EFFICIENCY OF NERVEBLOCKADES AND OTHER SURGICAL INTERVENTIONS","authors":"A. Kushta, Sergii M. Shuvalov","doi":"10.20969/vskm.2022.15(2).117-123","DOIUrl":"https://doi.org/10.20969/vskm.2022.15(2).117-123","url":null,"abstract":"Introduction. The region of the pterygo-mandibular space is an anatomical formation that is quite often sub- jected to surgical interventions (blockade of the mandibular nerve and its branches, operations for purulent processes, injuries). Among the complications of these surgical interventions, there are contractures of the lower jaw, neuritis of the lower alveolar and lingual nerves, and failure of anesthesia during blockades of these nerves. The purpose of the study was to analyze literature data and anatomical preparations of the pterygo-mandibular space, to take into account different options for the location of nerves and blood vessels during blockades and operations. Material and methods. The analysis of the literature and our own anatomical studies of 8 preparations of the deep parts of the human head was carried out. Results and discussion. The pterygo-mandibular space has a rather complex topographic and anatomical structure. Its anatomical structures are mobile along with the lower jaw and, accordingly, are adapted to these conditions in the form of a tortuous course of nerves and blood vessels, which prevents their stretching, tension, and injury. These features must be taken into account when performing surgical interventions, blockades of sensory and motor nerves in this area. Spatial perception of the location of the anatomical structures of the pterygo-mandibular space is facilitated by describing them relative to the lateral and medial muscles. Conclusions: The topographic and anatomical structure of the pterygo-mandibular space is variable and complex, which must be taken into account when performing nerve blocks, diagnostics, operations for purulent processes and traumatic injuries. The pterygo-mandibular space, connected directly with the peripharyngeal, should also be considered as part of the oral pharynx communicating with the base of the skull and neck.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127160133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COMPLIANCE AND SUBJECTIVE SYMPTOMS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN PATIENTS WITH ALCOHOL DISEASE","authors":"M. Ivanova, A. A. Punin, S. Vaulin","doi":"10.20969/vskm.2022.15(2).22-27","DOIUrl":"https://doi.org/10.20969/vskm.2022.15(2).22-27","url":null,"abstract":"Introduction. Chronic obstructive pulmonary disease (COPD) and alcohol disease submit a serious health- care problem due to their wide distribution and medical and social burden. Aim. The aim of the study was to reveal the impact of alcoholism on the level of COPD subjective symptoms in patients with different compliance. Material and methods. 147 men with COPD in the age of 40 – 88 years were examined. Spirometry criteria, mMRC, CAT, domestic questionnaire of adherence to therapy, 6-minutes walking tests were performed. The stage of alcohol disease was es- tablished. Results and discussion. We observed the trend to subjective COPD symptoms underestimation in patients with the II, III stages of alcohol disease. Alcohol disease performed no impact on subjective symptoms in patients with stages III, IV of COPD. The compliance level and subjective symptoms severity showed no interrelation in patients suffering from alcoholism. This emphasized the absent association between the high level of compliance and critical self-state perception in patients with concomitant diseases. Conclusion. The poor informativity of mMRC dyspnea scale and CAT-test was demonstrated in patients with mild and moderate COPD and severe alcoholism. The high level of compliance showed no impact on this tendency.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124349129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MORPHOFUNCTIONAL ASPECTS OF AGING THAT DETERMINE THE COURSE OF RESPIRATORY DISEASES IN OLD AND SENILE AGE","authors":"G. R. Kamasheva, A. Sineglazova, E. V. Arkhipov","doi":"10.20969/vskm.2022.15(2).95-102","DOIUrl":"https://doi.org/10.20969/vskm.2022.15(2).95-102","url":null,"abstract":"Aim. Based on an analysis of the medical literature, describe the key features of age-related organic and functional changes that potentially affect the course and therapy of respiratory diseases in elderly and senile people. Material and methods. A review of publications in the scientific and methodological literature on the problems of physiological and pathological aging, the epidemiology of somatic pathology and the peculiarities of its clinical manifestations and outcomes in the age aspect, including the relationship with the course of non-infectious and infectious respiratory diseases in elderly and senile people, is carried out. Results and discussion. The article provides relevant data on morbidity and mortality from respiratory pathology in old and senile age. A description is given of the mechanisms of aging of organs and systems, changes in the regulation of their functions, including changes in immunoreactivity from the standpoint of influence on the occurrence and course of respiratory diseases. Conclusion. When managing elderly and senile patients, it is necessary to take into account the age-related characteristics of the aging organism, the existing comorbid pathology and its therapy, take a differentiated approach to the assessment of the clinic, taking into account the direct signs of age-associated symptoms and manifestations of the «pharmacological cascade».","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124230307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PRINCIPLES OF GLUCOCORTICOSTEROID ADMINISTRATION IN PATIENTS WITH COVID-19","authors":"I. Tanin, L. Ivanova, I. V. Korol, Yuliya S. Kovalenko, L. V. Ruzhitskaya, Anzhelika S. Kondratenko, Kapitolina A. Bandura","doi":"10.20969/vskm.2022.15(2).103-109","DOIUrl":"https://doi.org/10.20969/vskm.2022.15(2).103-109","url":null,"abstract":"Introduction. This article discusses the treatment of coronavirus infection (COVID-19) with glucocorticoste- roid drugs (GCS), side effects of drugs and their prevention, transfer from intravenous to intramuscular and then to oral administration, and the development of withdrawal syndrome. The article describes the conditions under which antibiotic therapy is prescribed, as well as the conditions under which the combined use of corticosteroids and antibiotics is neces- sary. Aim. The aim to analyze the basic principles of corticosteroids prescribing in the treatment of COVID-19: indications for corticosteroids administration, administration regimens and required dosages, side effects of corticosteroids admin- istration. Material and methods. The article uses data from the Interim Guidelines for the Prevention, Diagnosis and Treatment of New Coronavirus Infection (COVID-19), the Federal Clinical Guidelines for the Specialty “Rheumatology”, as well as using the literature on basic and clinical endocrinology, cardiology and pharmacology. The work was written using a systems approach, methods of analysis, induction and observation. Results and discussion. Systemic cortico- steroids are used in cases of severe and critical course of the disease COVID-19 (confirmation may be an increase in ferritin, procalcitonin, C-reactive protein (CRP), decreased cognitive functions, development of sopor). Their appointment is also justified when the initial course of the disease was not diagnosed as severe, but suddenly the patient’s condition deteriorated. The use of antibiotic therapy is advisable when a bacterial infection is attached - (procalcitonin (PCT)> 0.5 ng / ml, purulent sputum, leukocytosis> 12 × 109 / L (in the absence of previous use of glucocorticoids), an increase in band neutrophils of more than 10%). In the presence of chronic infectious diseases in patients with COVID-19 (for ex- ample, chronic obstructive pulmonary disease-COPD, chronic pyelonephritis, etc.), antibiotics are prescribed to prevent exacerbations of these diseases. Conclusion. In the course of the study, the authors of the article formulated the follow- ing principles of glucocorticoid therapy: drugs should be prescribed according to strict indications; maximum doses are applied in a short course; when the patient’s condition is stabilized, it is necessary to reduce the dose in a timely manner and gradually to complete withdrawal to prevent the development of “withdrawal” syndrome, adrenal insufficiency of cen- tral genesis, sympathoadrenal crises; during and after treatment, prevention of complications of glucocorticoid therapy (hyperglycemia, hypocalcemia, osteopenia, inflammatory diseases of the urinary system) is recommended; collegial management of patients by infectious diseases and endocrinologists is mandatory.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"57 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113970635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"INHIBITION OF SODIUM GLUCOSE TRANSPORT PROTEIN 2: CLINICAL AND PHARMACOLOGICAL EFFECTS IN CHRONIC HEART FAILURE","authors":"G. Galyautdinov, Alexander G. Zhidyaevskij, Maria K. Nesterina, Karina R. Minnegalimova","doi":"10.20969/vskm.2022.15(2).89-94","DOIUrl":"https://doi.org/10.20969/vskm.2022.15(2).89-94","url":null,"abstract":"Introduction. This article provides information of sodium-glucose co-transporter-2. Aim. The aim of the study was to review the current information on the positive effect of drugs from the sodium-glucose co-transporter-2 on the cardiovascular system of patients with chronic heart failure. Material and methods. A review of current published studies of sodium-glucose co-transporter-2 is provided. Results and discussion. In 2015, for the first time, there was a mention of the positive effect of sodium-glucose co-transporter-2 on the cardiovascular system of patients with type 2 diabetes mellitus. There was a decrease in the risk of death from cardiovascular diseases, non-fatal myocardial infarction, acute cerebrovascular accident, as well as a decrease in the frequency of hospitalizations for exacerbation of chronic heart failure. In 2020, information was obtained on the isolated effect of this group on chronic heart failure, regardless of the presence of type 2 diabetes. When studying the drugs, it was found that their cardioprotective effect is due to a decrease in blood pressure by increasing osmotic diuresis, partial suppression of the activity of the renin- angiotensin-aldosterone system due to an increase in sodium concentration in the area of the dense spot of the distal convoluted tubule, increased oxygen delivery to the heart muscle by stimulating erythropoiesis. Conclusion. It is reasonable to use drugs that belong to the group of inhibitors of sodium-glucose co-transporter-2 in clinical practice for the treatment of patients with chronic heart failure, regardless of whether they have type 2 diabetes mellitus.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127438816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SPECIAL ASPECTS OF GIANT RENAL ANGIOMYOLIPOMA DIAGNOSIS AND TREATMENT (CLINICAL CASE)","authors":"S. Styazhkina, L. F. Khuzina, B. A. Mullakhmetov, N. A. Kiryanov, D. Kuklin, Oleg A. Erokhin","doi":"10.20969/vskm.2022.15(2).110-116","DOIUrl":"https://doi.org/10.20969/vskm.2022.15(2).110-116","url":null,"abstract":"Introduction. One of the rare complex diseases in clinical practice is Bourneville-Pringle disease (tuberous sclerosis). It is a genetically determined polysystemic disease with an autosomal dominant type of inheritance, one of the manifestations of which are renal angiomyolipomas. Angiomyolipoma is a benign kidney tumor. It consists of epithelioid, smooth muscle cells and adipose tissue and has abundant abnormal vascularization. Aim. We analyze a complex clinical case in a patient with a giant angiomyolipoma of a single kidney. Material and methods. Patient S., 58 years old, was urgently admitted to the urology department. The patient complained of pain in the left lumbar region, in the left half of the abdomen, blood impurities in the urine. General clinical, laboratory and instrumental research tools were conducted. Results and discussion. According to the spiral CT of the kidneys with contrasting, in the left kidney a giant mass with a violation of its architectonics, with signs of hemorrhage and a formed hematoma in the upper third of the mass and hemorrhagic impregnation of its lower half was found. Surgical treatment was prescribed, during which embolization of the segmental arteries of the left kidney, selective angiography of the left renal artery, total nephrectomy on the left with a successful outcome were performed. Conclusion. On the basis of the given clinical case, it should be concluded that despite the benign nature of the renal angiomyolipoma, the tumor has reached gigantic sizes due to the late treatment of the patient caused by concomitant oligophrenia. In this regard, the late diagnosis has led to life-threatening complications that required immediate decision-making. The given clinical observation shows the success of the chosen surgical tactics in the form of a radical operation that allowed saving the life of the patient with a rare disease. The patient was discharged from the hospital for outpatient follow-up by an urologist and a nephrologist. Regular hemodialysis, monitoring with the help of laboratory and instrumental research tools are prescribed. The patient was put on the waiting list for renal trans- plantation in specialized centers in Russia.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132928608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"INCREASING THE EFFICIENCY OF PATIENTS WITH PULMONARY TUBERCULOSIS TREATMENT WITH THE USE OF NEW THERAPY REGIMENS","authors":"P. Yablonsky, A. Starshinova, Mikhail M. Nazarenko, E. Belyaeva, A. L. Chuzhov, D. Alekseev, M. Pavlova","doi":"10.20969/vskm.2022.15(2).67-75","DOIUrl":"https://doi.org/10.20969/vskm.2022.15(2).67-75","url":null,"abstract":"Introduction: Improving the effectiveness of treatment of the most difficult category of patients with extensively drug-resistant tuberculosis is still relevant in the present circumstances. Efficacy of therapy is not higher than 35,7%. New therapy regimes with the use of bedaquiline and pyridinium perchlorate were recommended for extended drug resistance treatment. Aim. Aim of the study is to compare efficacy of new regimes of treatment with the use of bedaquiline and pyridinium perchlorate in patients with extended drug resistance of mycobacterium. Material and methods. Retrospective study with analysis of therapy in 150 patients with extended drug resistance tuberculosis, who were treated in the period from 2016 till 2019, divided into three groups: (I-st group, n=80) – standard therapy; (II-nd group, n=47) – regime with pyridinium perchlorate; and III-rd group (n=23) – regime with bedaquiline. Analysis was performed for clinical, laboratory, and radiology assessments. Evaluation of treatment efficacy was done based on criteria defined in the international guidance. Results and discussions. To the end of hospitalization stage of therapy, in the group with bedaquivilin cessation of bacterial excretion in extended drug resistance tuberculosis patients was observed significantly more frequent than in the group of standard therapy without Bq (60,8% (III) vs 30,0% (I), p˂0,01). In the II group of cessation was also significantly more frequent than in the group of standard therapy without pyridinium perchlorate (57,8% (III) vs 30,0% (I), p˂0,01). Efficacy to the end of treatment assessed by positive roentgenologic dynamic was 78,2% и 57,8% (p˂0,0001) for 6-8 months of treatment by bedaquiline and pyridinium perchlorate correspondently, that was significantly more frequent than in the I-st group (25%). Based on performed analysis inclusion of this antituberculosis drugs in therapy of extended drug resistance tuberculosis patients is associated with increase of its efficacy ((р=0,0046, ОР=0,7325, 95%Сl 0,3 – 1,65%, PPV=0,6140, NPV=0,1618). Comparison of general parameters of efficacy demonstrates significantly high percent of treatment efficacy in extended drug resistance tuberculosis patients while addition into therapy new antituberculosis drugs. Significant difference between groups for surveillance, while addition of new antituberculosis drugs, was not observed. Conclusion. Results of the study demonstrate opportunities to increase treatment efficacy with addition of new antituberculosis drugs. Nevertheless, efficacy of treatment limited by 6-8 months, that allows to recommend extension of treatment duration by new antituberculosis drugs, and as well to implement other methods to increase its efficacy.","PeriodicalId":110361,"journal":{"name":"The Bulletin of Contemporary Clinical Medicine","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128178742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}