REVIEWS
ORIGINAL ARTICLES
It was identified, that the proportion of lung tuberculoma is insignificant among TB cases with bacterial excretion and destruction of lung tissue, therefore their epidemical risk is low.
The analysis of relapses after surgical and non-surgical treatment of patients with lung tuberculoma was performed at 4-7 years after the completion of treatment which demonstrated that the frequency of relapses after both modes of treatment has no valid difference. However, the course of relapses in operated patients is more severe than in non-operated patients and the cost of treatment for surgical modes is significantly higher. It is necessary to revise the indications for surgical treatment of this form of tuberculosis.
Multivariate analysis was made to analyze a contingent of patients with tuberculosis concurrent with HIV infection in the Russian Federation over 7 years, by applying recording form No. 263-y/TB “Tuberculosis/HIV Patient Card”. The tuberculosis/HIV patients were shown to be the most difficult contingent among both the patients with tuberculosis and those with HIV infection.
Based on the characteristics of the contingent of co-infected patients, the authors propose additional recommendations to activate and improve approaches to preventing tuberculosis in HIV-infected patients. Among other activities, work is done in penitentiary and narcological facilities where there are commonly HIV-infected patients who are at high risk for tuberculosis and those who are unregistered in the AID center.
CLINICAL OBSERVATIONS
Spontaneous pneumothorax was treated by placing two endobronchial valves during rigid bronchoscopy under anesthesia in a patient with severe end-stage chronic obstructive pulmonary disease (an emphysematous phenotype) and overall paraseptal emphysema in the presence of grade III respiratory failure, with complicated spontaneous pneumothorax recurring manifold even after surgical treatment for spontaneous pneumothorax. This gave rise to the expansion of the lung that had collapsed within 18 months, to healing of bronchopleural fistula, and to return to normal life.
The duration of a follow-up was 1 year with the valves being present in the bronchi and another year after their removal; there was no recurrence of spontaneous pneumothorax. Examination of respiratory function established significant positive changes (forced expiratory volume, vital capacity, and forced vital capacity after one year, then after removal of endobronchial valves). There were more significant positive changes in blood gas composition: normalization of blood oxygen saturation was achieved.
ISSN 2542-1506 (Online)