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Tuberculosis and Lung Diseases

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No 5 (2014)
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3-9 679
Abstract
01 декабря 1943 г. Приказом Совета народных комиссаров СССР в г. Новосибирске был организован научно-исследовательский институт туберкулеза, который до сих пор остается единственным федеральным центром борьбы с туберкулезом на территории Сибири и Дальнего Востока.

LECTURES

10-15 1348
Abstract
Всемирная организация здравоохранения (ВОЗ) обозначила туберкулез как глобальную проблему современности, имея в виду преимущественно туберкулез органов дыхания. Экстрато- ракальному туберкулезу должного внимания мировыми организациями не уделяется. Однако, по данным аутопсий, туберкулезное поражение предстательной железы встречается у 70% больных с распространенными формами туберкулеза легких, как правило, прижизненно не диагностированное [2].

ORIGINAL ARTICLES

16-21 711
Abstract

The paper characterizes the laboratory service that carries out microbiological tests to diagnose tuberculosis in 12 and 9 subjects of the Siberian and Far Eastern Federal Districts, respectively.

The efficiency of tuberculosis detection was evaluated by light microscopy of Ziehl-Neelsen- stained smears during primary health care for the population. There were changes in the efficiency of detection using different microbiological diagnostic methods in the bacteriological laboratories of tuberculosis facilities in 2008 to 2012.

Emphasis is laid on the topical moments in laboratory service work, which require further improvement and optimization. 

22-25 601
Abstract
The potential bactericidal activity against tuberculosis and the activity against urinary opportunistic Enterobacteriaceae were determined in healthy individuals, by using the Bactec MGIT 960 automatic system for cultivation and determination of drug resistance in mycobacteria and inoculating to dense nutrient media. The urine of healthy individuals was found to have no bactericidal activity against M. tuberculosis in vitro.
26-35 602
Abstract
A retrospective cohort study was performed to reveal risk factors for fluoroquinolone resistance in M. tuberculosis during treatment of 463 patients with multidrug-resistant (MDR) tuberculosis (TB) in the Novosibirsk Region. The factors associated with an increased risk were the extent of a TB process within > 2 lung segments (OR 1.39; 95% CI, 0.87-2.21), abundant bacterial excretion (OR 2.32; 95% CI, 1.54-3.5), primary aminoglycoside/capreomycin resistance in M. tuberculosis (OR 3.35; 95% CI, 1.80-6.24), concomitant alcohol/drug dependence (OR 1.46; 95 CI, 0.76-2.80), renal dysfunction (OR 4.60; 95% CI, 1.28-16.51), deviations from the standard polychemotherapy of MDR TB (OR 3.17; 95% CI, 1.58-6.34), fluoroquinolones used in doses lower than the recommended one (OR 5.23; 95% CI, 2.27-12.10), discontinuation of a polychemotherapy cycle (OR 5.70; 95% CI, 2.97-10.93), rural residence (OR 2.0; 95% CI: 1.14-3.51), and being in prison (OR 2.0; 95% CI, 1.14-3.51). Resection surgery (OR 0.48; 95% CI, 0.2-1.13), in-hospital intensive-phase polychemotherapy (OR 0.43; 95 CI, 0.27-0.63), and parenteral administration of anti-TB drugs (OR 0.40; 95% CI, 0.18-0.86) were associated with risk reduction.
36-41 547
Abstract

The children and adolescents of the Siberian Federal District continue to have high tuberculosis morbidity rates that are 1.5-1.7 times greater than the average Russian rate. The severe clinical pattern of tuberculosis is noted among new tuberculosis cases. Preventive measures are insufficiently effective.

To improve the quality of antituberculosis care to the children and adolescents of the Siberian Federal District, it is necessary to coordinate the work of a specialized and general health service on the specific prevention and early detection of tuberculosis among the children and adolescents; to solve the problem associated with discontacts in the everyday foci of tuberculosis infection; to improve the material and technical basis of children’s sanatoria; to observe infection control measures in children’s hospitals and units (to allow for the reconstruction of existing buildings and the construction of new ones); and to brisk up the work on sanitary education of the population. 

42-46 836
Abstract
Mini-access osteoplastic thoracoplasty was performed in 130 patients with disseminated fibrocavernous pulmonary tuberculosis. The use of this technique could achieve sufficiently satisfactory and no higher results than that of conventional methods, namely to stop bacterial excretion and to close decay cavities with a 10.7% reduction in the risk of postoperative complications, and considerably decrease intraoperative blood loss.
47-49 792
Abstract
The results of treatment using an endobronchial valve were analyzed in 49 patients with destructive infiltrative pulmonary tuberculosis. Endobronchial valve application caused complications in 14.3% of cases in the course of the underlying disease and the treatment policy was changed. Following endobronchial valve insertion, 40.8% of the patients were found to have clinical manifestations of the endobronchial valve being in the bronchus; all the symptoms were abolished with medications for 3 weeks. Endobronchial valve insertion induced granulation tissue growth in the area of bronchoblockation, followed by the development of varying cicatricial stenoses of the blocked bronchi. At the same time, the tuberculosis treatment could provide a clinical effect in 85.7% of the patients with infiltrative tuberculosis in the decay phase, with a history of treatment failures for 5 months or more.
50-55 688
Abstract
The authors analyze the epidemic situation associated with tuberculosis concurrent with HIV infection in the subjects of the Siberian Federal District (SFD) in 2010-2012. There was a further overall (1.4-fold) increase in the detection of coinfection in the district; at the same time the rate of its increase decreased as compared to the previous years. In spite of the lower incidence of tuberculosis in SFD in the years under study, the proportion of patients of HIV-associated tuberculosis increased in the structure of new cases. No stabilization of the epidemics of HIV infection makes unfavorable the prognosis of further spread of tuberculosis concurrent with HIV infection. The timely detection of patients with HIV infection, as well as antiretroviral therapy and adequate tuberculosis chemoprophylactic coverage of patients with already detected HIV infection will be able to reduce the tense epidemic situation.
56-59 810
Abstract
The paper shows problems in the differential diagnosis of malignancies of the lung and pleura in 55 patients. It characterizes the duration of a diagnostic period in patients with lung cancer identified at all diagnostic stages in tuberculosis hospitals. The clinical manifestations of lung malignancies are shown. The predictors of delay in the verification of diagnosis are found.
60-65 1149
Abstract
The level of patient satisfaction with the result of the medical services received is one of the important aspects of assessment of the quality of medical care. The rendered medical care that meets the expectations and requirements of patients determines the level of their satisfaction. Insufficiently high patient satisfaction with the quality of medical services is today a problem not only for the Institute, but also for whole Russia’s public health care. The elements of market mechanisms as a quality management system are being introduced to solve intricate problems to achieve the effective work of the public health care system under limited resources. Annual assessment of the level of satisfaction of the Institute’s patients, users of medical services, and calculation of the satisfaction index make it possible to estimate changes in the activity of the Novosibirsk Research Institute of Tuberculosis and its strengths and weaknesses and to elaborate a strategy for continuous medical care quality improvement.
66-68 642
Abstract
The paper gives the results of examination using QuantiFERON-TB and diaskintest in 180 employees of the Novosibirsk Research Institute of Tuberculosis. Latent tuberculosis infection was detected in almost one-third of the employees. The closest proximity to the patient (phthisiatricians and middle-level medical personnel) and a long (more than 10-year) service are important infection factors for the employees. Diaskintest and QuantiFERON-TB show a moderate agreement, more on a negative result. The obtained data on the conversion and reversion of QuantiFERON-TB during retesting are ambiguous and agree with those of available foreign publications.

DISCUSSION

69-73 1140
Abstract
Латентную туберкулезную инфекцию (ЛТИ) изучают около 60 лет. Рост интереса к ней (количество и качество публикаций в базе Medline) при- шелся на 2000 г., после ухудшения эпидемической ситуации в 1990-е годы, а с 2009 г. вышло почти столько же статей, сколько за предыдущие 55 лет. Это объясняется пониманием того, что ЛТИ – резервуар будущего туберкулеза (ТБ), а без контроля над ним все усилия по борьбе с ТБ будут сведены к минимуму.

CLINICAL OBSERVATIONS

74-81 833
Abstract
The paper describes complexities and errors in the management of a patient with pulmonary tuberculosis with broad drug resistance in М. tuberculosis and concurrent type 1 diabetes mellitus. It shows the need for long-term multimodality treatment involving adequate chemotherapy and additional methods in this category of patients.

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