Pub Date : 2023-12-25DOI: 10.58838/2075-1230-2023-101-6-90-95
A. E. Shklyaev, Y. Galikhanova, O. I. Starodubtseva
The article describes a clinical case of successful treatment of COVID-19 in a patient who previously underwent lung transplantation due to cystic fibrosis.
文章描述了一个成功治疗 COVID-19 的临床病例，患者曾因囊性纤维化接受过肺移植手术。
{"title":"A Clinical Case: Novel Coronavirus Infection COVID-19 in a Patient with Lung Transplantation","authors":"A. E. Shklyaev, Y. Galikhanova, O. I. Starodubtseva","doi":"10.58838/2075-1230-2023-101-6-90-95","DOIUrl":"https://doi.org/10.58838/2075-1230-2023-101-6-90-95","url":null,"abstract":"The article describes a clinical case of successful treatment of COVID-19 in a patient who previously underwent lung transplantation due to cystic fibrosis.","PeriodicalId":37828,"journal":{"name":"Tuberculosis and Lung Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139159562","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}
Pub Date : 2023-12-25DOI: 10.58838/2075-1230-2023-101-6-50-55
O. Piskunova, L. Panova, V. V. Bereznitskaya, E. S. Ovsyankina, E. Krushinskaya
The objective: to evaluate expanded monitoring of cardiovascular disorders in older children and adolescents with multiple drug resistant tuberculosis receiving bedaquiline (Bq) as a part of anti-tuberculosis therapy.Subjects and Methods: A cohort retrospective-prospective study (2015-2021) was conducted, which included 36 patients aged 13-17 years old who received Bq. The prospective part included 19 patients (Main Group), they underwent extended monitoring (EM) of cardiotoxic reactions; this extended monitoring program was developed in Central Tuberculosis Research Institute. The retrospective part included 17 patients (Control Group), in whom cardiotoxic reactions were assessed using standard monitoring recommended by the Russian Society of Phthisiologists at that time. The relationship between the studied risk factor (monitoring by standard ECG) and the outcome (Bq discontinuation) was assessed using the Pearson χ2 test.Results. Prolongation of the QTc interval > 0.440 ms was noted in 17.6% of cases in Control Group and it was regarded as a cardiotoxic effect of Bq, the drug was discontinued. In Main Group, prolongation was noted in 47.3% of cases which was considered a functional disorder of the cardiovascular system according to EM, the drug was not discontinued, χ2 = 3.896; p = 0.049. EM can be used in older children and adolescents with multiple drug resistant respiratory tuberculosis, which will make it possible to safely include Bq to chemotherapy regimens.
{"title":"Monitoring the Cardiotoxic Effects of Bedaquiline in Older Children and Adolescents with Multiple and Extensive Drug Resistance","authors":"O. Piskunova, L. Panova, V. V. Bereznitskaya, E. S. Ovsyankina, E. Krushinskaya","doi":"10.58838/2075-1230-2023-101-6-50-55","DOIUrl":"https://doi.org/10.58838/2075-1230-2023-101-6-50-55","url":null,"abstract":"The objective: to evaluate expanded monitoring of cardiovascular disorders in older children and adolescents with multiple drug resistant tuberculosis receiving bedaquiline (Bq) as a part of anti-tuberculosis therapy.Subjects and Methods: A cohort retrospective-prospective study (2015-2021) was conducted, which included 36 patients aged 13-17 years old who received Bq. The prospective part included 19 patients (Main Group), they underwent extended monitoring (EM) of cardiotoxic reactions; this extended monitoring program was developed in Central Tuberculosis Research Institute. The retrospective part included 17 patients (Control Group), in whom cardiotoxic reactions were assessed using standard monitoring recommended by the Russian Society of Phthisiologists at that time. The relationship between the studied risk factor (monitoring by standard ECG) and the outcome (Bq discontinuation) was assessed using the Pearson χ2 test.Results. Prolongation of the QTc interval > 0.440 ms was noted in 17.6% of cases in Control Group and it was regarded as a cardiotoxic effect of Bq, the drug was discontinued. In Main Group, prolongation was noted in 47.3% of cases which was considered a functional disorder of the cardiovascular system according to EM, the drug was not discontinued, χ2 = 3.896; p = 0.049. EM can be used in older children and adolescents with multiple drug resistant respiratory tuberculosis, which will make it possible to safely include Bq to chemotherapy regimens.","PeriodicalId":37828,"journal":{"name":"Tuberculosis and Lung Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139159664","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}
Pub Date : 2023-12-25DOI: 10.58838/2075-1230-2023-101-6-96-101
A. Zaytsev, E. Filon, V. I. Likhodiy, I. T. Kulagina, N. A. Ternovskaya
The article describes a clinical case pulmonary and lymph node sarcoidosis which development coincided with the implantation of mammary gland implants and their partial destruction. It discusses the differential diagnosis of sarcoidosis and sarcoid reaction to the contents of implants.
{"title":"Pulmonary Sarcoidosis and Intrathoracic Lymph Node Sarcoidosis or Sarcoid Reaction?","authors":"A. Zaytsev, E. Filon, V. I. Likhodiy, I. T. Kulagina, N. A. Ternovskaya","doi":"10.58838/2075-1230-2023-101-6-96-101","DOIUrl":"https://doi.org/10.58838/2075-1230-2023-101-6-96-101","url":null,"abstract":"The article describes a clinical case pulmonary and lymph node sarcoidosis which development coincided with the implantation of mammary gland implants and their partial destruction. It discusses the differential diagnosis of sarcoidosis and sarcoid reaction to the contents of implants.","PeriodicalId":37828,"journal":{"name":"Tuberculosis and Lung Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139159739","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}
Pub Date : 2023-12-25DOI: 10.58838/2075-1230-2023-101-6-74-80
V. Solodovnikova, A. E. Skryagin, Y. I. Isaykina, D. A. Klimuk, G. L. Gurevich, E. M. Skryagina
The objective: to evaluate the effectiveness of treatment with autologous mesenchymal stromal cells (MSCs) in patients with drug resistant pulmonary tuberculosis (DR TB).Subjects and Methods. 120 patients with drug resistant tuberculosis aged 18 to 61 years old were enrolled in the study. They all were treated at the Republican Scientific and Practical Center of Pulmonology and Phthisiology from 2009 to 2018. Against the background of anti-tuberculosis treatment, patients (60 people) from Main Group (MG) underwent bone marrow sampling and then intravenous administration of autologous MSCs.Results. The average dose of administered cells was 1x106 per kg of the patient body weight. The average duration of MSC cultivation made 35 days. Treatment effectiveness in MG made 90% versus 71% in Control Group (CG). All patients who were successfully cured of tuberculosis (TB) using autologous MSCs had no tuberculosis relapses during 5 years of follow-up. In Control Group, 8 (19%) cases of relapse were reported. In Main Group versus Comparison Group, the rates indicating healing of cavities and absence of relapse are statistically significantly better.Conclusion. The use of autologous MSCs in patients with drug resistant tuberculosis has shown its high effectiveness.
{"title":"Cellular Therapy with Autologous Mesenchymal Stromal Cells in Patients with Drug Resistant Pulmonary Tuberculosis","authors":"V. Solodovnikova, A. E. Skryagin, Y. I. Isaykina, D. A. Klimuk, G. L. Gurevich, E. M. Skryagina","doi":"10.58838/2075-1230-2023-101-6-74-80","DOIUrl":"https://doi.org/10.58838/2075-1230-2023-101-6-74-80","url":null,"abstract":"The objective: to evaluate the effectiveness of treatment with autologous mesenchymal stromal cells (MSCs) in patients with drug resistant pulmonary tuberculosis (DR TB).Subjects and Methods. 120 patients with drug resistant tuberculosis aged 18 to 61 years old were enrolled in the study. They all were treated at the Republican Scientific and Practical Center of Pulmonology and Phthisiology from 2009 to 2018. Against the background of anti-tuberculosis treatment, patients (60 people) from Main Group (MG) underwent bone marrow sampling and then intravenous administration of autologous MSCs.Results. The average dose of administered cells was 1x106 per kg of the patient body weight. The average duration of MSC cultivation made 35 days. Treatment effectiveness in MG made 90% versus 71% in Control Group (CG). All patients who were successfully cured of tuberculosis (TB) using autologous MSCs had no tuberculosis relapses during 5 years of follow-up. In Control Group, 8 (19%) cases of relapse were reported. In Main Group versus Comparison Group, the rates indicating healing of cavities and absence of relapse are statistically significantly better.Conclusion. The use of autologous MSCs in patients with drug resistant tuberculosis has shown its high effectiveness.","PeriodicalId":37828,"journal":{"name":"Tuberculosis and Lung Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139159392","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}
Pub Date : 2023-12-25DOI: 10.58838/2075-1230-2023-101-6-82-88
B. E. Borodulin, E. Borodulina, S. Pushkin, E. Vdoushkina, L. Povalyaeva
The article describes a clinical case of Wegener's granulomatosis, which manifested in the post-COVID period in a young man; also it discusses diagnostic difficulties.
{"title":"Wegener's Granulomatosis (Granulomatosis with Polyangiitis). Difficulties in Diagnosis in the Post-COVID Period","authors":"B. E. Borodulin, E. Borodulina, S. Pushkin, E. Vdoushkina, L. Povalyaeva","doi":"10.58838/2075-1230-2023-101-6-82-88","DOIUrl":"https://doi.org/10.58838/2075-1230-2023-101-6-82-88","url":null,"abstract":"The article describes a clinical case of Wegener's granulomatosis, which manifested in the post-COVID period in a young man; also it discusses diagnostic difficulties.","PeriodicalId":37828,"journal":{"name":"Tuberculosis and Lung Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139158523","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}
Pub Date : 2023-12-24DOI: 10.58838/2075-1230-2023-101-5-36-44
S. Kayukova, V. A. Ulyumdzhieva, L. S. Idrisova, N. Karpina
The objective: to study specific features of the respiratory tuberculosis course and effectiveness of its treatment during pregnancy and postpartum period, and to evaluate the impact of tuberculosis on perinatal outcomes.Subjects and Methods. In 2010 - 2022, a retrospective-prospective case-control study enrolling 164 patients of reproductive age was conducted in Central Tuberculosis Research Institute. Two groups were formed: Case Group included 82 pregnant women with respiratory tuberculosis; Control Group included 82 non-pregnant patients with respiratory tuberculosis.Results. In both groups, new cases of respiratory tuberculosis were notified more often versus relapses. Distinctive features of respiratory tuberculosis in pregnant women versus the non-pregnant were as follows: the predominance of the proportion of extensive drug resistant M. tuberculosis – 55.5% versus 31.7% (p<0.05), respectively; lower frequency of lung tissue destruction – 18.3% versus 32.9% (p≤0.05); higher incidence of cavities - 80% and 40.7% (p≤0.05) and complications of respiratory tuberculosis – 25.6% versus 12.2% (p≤0.03), respectively. The high effectiveness of respiratory tuberculosis treatment such as relief of clinical symptoms and sputum conversion was achieved at the end of the intensive therapy phase both in Case Group and Control Group. Longer time until sputum conversion and lower rate of cavity healing were reported in the patients from Case Group. In 75.6% of pregnant women from Case Group there was a delivery with favorable perinatal outcomes.
{"title":"Specific Features of the Course and Treatment of Respiratory Tuberculosis in Women during Pregnancy and Postpartum Period. Perinatal Outcomes","authors":"S. Kayukova, V. A. Ulyumdzhieva, L. S. Idrisova, N. Karpina","doi":"10.58838/2075-1230-2023-101-5-36-44","DOIUrl":"https://doi.org/10.58838/2075-1230-2023-101-5-36-44","url":null,"abstract":"The objective: to study specific features of the respiratory tuberculosis course and effectiveness of its treatment during pregnancy and postpartum period, and to evaluate the impact of tuberculosis on perinatal outcomes.Subjects and Methods. In 2010 - 2022, a retrospective-prospective case-control study enrolling 164 patients of reproductive age was conducted in Central Tuberculosis Research Institute. Two groups were formed: Case Group included 82 pregnant women with respiratory tuberculosis; Control Group included 82 non-pregnant patients with respiratory tuberculosis.Results. In both groups, new cases of respiratory tuberculosis were notified more often versus relapses. Distinctive features of respiratory tuberculosis in pregnant women versus the non-pregnant were as follows: the predominance of the proportion of extensive drug resistant M. tuberculosis – 55.5% versus 31.7% (p<0.05), respectively; lower frequency of lung tissue destruction – 18.3% versus 32.9% (p≤0.05); higher incidence of cavities - 80% and 40.7% (p≤0.05) and complications of respiratory tuberculosis – 25.6% versus 12.2% (p≤0.03), respectively. The high effectiveness of respiratory tuberculosis treatment such as relief of clinical symptoms and sputum conversion was achieved at the end of the intensive therapy phase both in Case Group and Control Group. Longer time until sputum conversion and lower rate of cavity healing were reported in the patients from Case Group. In 75.6% of pregnant women from Case Group there was a delivery with favorable perinatal outcomes.","PeriodicalId":37828,"journal":{"name":"Tuberculosis and Lung Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139160010","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}
Pub Date : 2023-12-24DOI: 10.58838/2075-1230-2023-101-5-78-88
Z. Zagdyn, N. V. Kobesov, L. I. Rusakova, T. P. Vasilyeva, O. Y. Aleksandrova, A. S. Galoyan
Based on an analysis of archive materials, scientific publications and official statistics obtained from 56 sources, the global tuberculosis burden was assessed. In 1918 in Russia, tuberculosis mortality made 360 cases per 100,000 population, exceeding that in other industrial countries: in England this rate was 113.0; in the USA – 148.0; in Switzerland – 201.0; in Italy – 209.0; in France – 226.0; in Germany – 230.0; and in Japan (1920) – 234 cases respectively. Having undergone colossal socio-economic catastrophes like no other country, Russia achieved significant success in the fight against tuberculosis: in 1913, tuberculosis incidence was 733.0 per 100,000 population, tuberculosis mortality was 276.8; while in 2021 these made 31.1 and 4.3 respectively. In 2021, WHO excluded Russia from the list of countries with a high burden of tuberculosis. However, in Russia as well as in the other BRICS countries, the burden of MDR TB and TB/HIV co-infection still remains high, which requires allocation of resources to reduce their spread.
{"title":"Global tuberculosis burden in Russia and the world as a public health problem (historical and analytical review)","authors":"Z. Zagdyn, N. V. Kobesov, L. I. Rusakova, T. P. Vasilyeva, O. Y. Aleksandrova, A. S. Galoyan","doi":"10.58838/2075-1230-2023-101-5-78-88","DOIUrl":"https://doi.org/10.58838/2075-1230-2023-101-5-78-88","url":null,"abstract":"Based on an analysis of archive materials, scientific publications and official statistics obtained from 56 sources, the global tuberculosis burden was assessed. In 1918 in Russia, tuberculosis mortality made 360 cases per 100,000 population, exceeding that in other industrial countries: in England this rate was 113.0; in the USA – 148.0; in Switzerland – 201.0; in Italy – 209.0; in France – 226.0; in Germany – 230.0; and in Japan (1920) – 234 cases respectively. Having undergone colossal socio-economic catastrophes like no other country, Russia achieved significant success in the fight against tuberculosis: in 1913, tuberculosis incidence was 733.0 per 100,000 population, tuberculosis mortality was 276.8; while in 2021 these made 31.1 and 4.3 respectively. In 2021, WHO excluded Russia from the list of countries with a high burden of tuberculosis. However, in Russia as well as in the other BRICS countries, the burden of MDR TB and TB/HIV co-infection still remains high, which requires allocation of resources to reduce their spread.","PeriodicalId":37828,"journal":{"name":"Tuberculosis and Lung Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139160384","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}
Pub Date : 2023-12-24DOI: 10.58838/2075-1230-2023-101-5-14-19
V. V. Sinkov, G. I. Alekseeva, S. Zhdanova, M. Vinokurova, E. S. Prokopiev, O. Ogarkov
The objective: to assess the stability of circulation of S genotype and S-like strains of M. tuberculosis (MTB) in the Republic of Sakha (Yakutia) over a 12-year period and perform their phylogenetic identification relative to the L4.4 Euro-American subline.Subjects and Methods. Between 2009 and 2022, 513 MTB strains isolated from pulmonary tuberculosis patients were studied using molecular genetic methods. 92 isolates belonging to S genotype or having an S-like genetic profile were found. Whole-genome sequencing of five strains of S genotype that circulated in the territory of the Republic of Sakha (Yakutia) in 2020-2022 was carried out. A global phylogenetic analysis was performed and evolutionary relationship of the obtained genomes was determined, a RT-PCR test was developed for the rapid detection of S genotype strains.Results. In the territory of the Republic of Sakha (Yakutia), there is a stable circulation of S and S-like MTB genotypes belonging to the L4.4 Euro-American subline, the L4.4.1.1 subtype. The evolutionary model has confirmed the previously stated hypothesis that the spread of the S genotype among the indigenous population of Yakutia is associated with mass exposure to the Russian settlers which started from the beginning of the 17th century.Conclusion. Spread of MTB strains of the L4.4 Euro-American subline, L4.4.1.1 subtype, among the indigenous populations of New Zealand, Canada and Yakutia in the 17th-19th centuries is very similar.
目的：评估萨哈共和国（雅库特）结核杆菌（MTB）S基因型和S类菌株在12年间的流通稳定性，并对其与L4.4欧美亚系进行系统发育鉴定。2009 年至 2022 年期间，采用分子遗传学方法对从肺结核患者体内分离出的 513 株 MTB 进行了研究。发现 92 株属于 S 基因型或具有类似 S 基因型的分离株。对 2020-2022 年在萨哈共和国（雅库特）境内流行的五株 S 基因型菌株进行了全基因组测序。结果显示，在萨哈共和国（雅库特）领土上，S基因型菌株的基因组序列为5株，并对其进行了全基因组测序，确定了所获基因组的进化关系。在萨哈共和国（雅库特）境内，属于 L4.4 欧美亚系、L4.4.1.1 亚型的 S 型和类 S 型 MTB 基因型稳定存在。进化模型证实了之前提出的假设，即 S 基因型在雅库特土著居民中的传播与 17 世纪初开始的俄罗斯移民的大规模接触有关。L4.4欧美亚系、L4.4.1.1亚型的 MTB 菌株在 17-19 世纪新西兰、加拿大和雅库特原住民中的传播非常相似。
{"title":"The Place of S Genotype of Mycobacterium Tuberculosis Which is Endemic to the Republic of Sakha (Yakutia), in the Global Phylogeny according to Results of Whole-Genome Sequencing","authors":"V. V. Sinkov, G. I. Alekseeva, S. Zhdanova, M. Vinokurova, E. S. Prokopiev, O. Ogarkov","doi":"10.58838/2075-1230-2023-101-5-14-19","DOIUrl":"https://doi.org/10.58838/2075-1230-2023-101-5-14-19","url":null,"abstract":"The objective: to assess the stability of circulation of S genotype and S-like strains of M. tuberculosis (MTB) in the Republic of Sakha (Yakutia) over a 12-year period and perform their phylogenetic identification relative to the L4.4 Euro-American subline.Subjects and Methods. Between 2009 and 2022, 513 MTB strains isolated from pulmonary tuberculosis patients were studied using molecular genetic methods. 92 isolates belonging to S genotype or having an S-like genetic profile were found. Whole-genome sequencing of five strains of S genotype that circulated in the territory of the Republic of Sakha (Yakutia) in 2020-2022 was carried out. A global phylogenetic analysis was performed and evolutionary relationship of the obtained genomes was determined, a RT-PCR test was developed for the rapid detection of S genotype strains.Results. In the territory of the Republic of Sakha (Yakutia), there is a stable circulation of S and S-like MTB genotypes belonging to the L4.4 Euro-American subline, the L4.4.1.1 subtype. The evolutionary model has confirmed the previously stated hypothesis that the spread of the S genotype among the indigenous population of Yakutia is associated with mass exposure to the Russian settlers which started from the beginning of the 17th century.Conclusion. Spread of MTB strains of the L4.4 Euro-American subline, L4.4.1.1 subtype, among the indigenous populations of New Zealand, Canada and Yakutia in the 17th-19th centuries is very similar.","PeriodicalId":37828,"journal":{"name":"Tuberculosis and Lung Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139160647","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}
Pub Date : 2023-12-24DOI: 10.58838/2075-1230-2023-101-5-6-13
R. Sharifov, D. A. Nabirova, Z. Tilloeva, R. Hort, S. Zikriyarova, N. D. Dzhafarov, S. D. Yusufi
The objective: to study delays in provision of medical care to pulmonary tuberculosis patients above 15 years old with laboratory confirmation of the diagnosis before and during the COVID-19 pandemic in Dushanbe, Tajikistan.Subjects and Methods. A retrospective cohort study was conducted among new pulmonary tuberculosis patients above 15 years old with laboratory confirmation of the diagnosis registered by TB Control Centers in Dushanbe in 2019–2021. Information was collected from medical records, medical databases, and patient questionnaires. Two types of delays were detected during the provision of medical care: delays related to the patient (defined as >14 days between onset of tuberculosis symptoms and the first visit to a health unit); delays related to health system (defined as >3 days from the first visit to TB unit to the initiation of tuberculosis treatment).Results. Of the 472 patients enrolled in the study, 276 were registered during the COVID-19 pandemic (2020–2021) and 196 patients were registered before the pandemic (2019). Frequency of delays was similar (83% vs 82%, p=0.8) during and before the COVID-19 pandemic. The frequency of delay related to health system was statistically significantly lower during the pandemic versus the period before the pandemic (34% vs 44%, p=0.023). The median duration of delays associated to the patient before the pandemic (60 days, IQR: 15–541) and during the pandemic (60 days, IQR: 15–360, р=0.6) was also similar as well as delays related to health system (before the pandemic – 7 days, IQR: 4–336) and during the pandemic (7 days, IQR: 4–225, р=0.6).Conclusion. Contrary to the expected result, no significant difference in delays related to the patient before and during the pandemic was found, and the frequency of delay related to health system during the pandemic significantly reduced compared to the period before the pandemic.
{"title":"Delays in Diagnosis and Treatment of Pulmonary Tuberculosis Patients during the COVID-19 Pandemic in Dushanbe, Tajikistan, 2022","authors":"R. Sharifov, D. A. Nabirova, Z. Tilloeva, R. Hort, S. Zikriyarova, N. D. Dzhafarov, S. D. Yusufi","doi":"10.58838/2075-1230-2023-101-5-6-13","DOIUrl":"https://doi.org/10.58838/2075-1230-2023-101-5-6-13","url":null,"abstract":"The objective: to study delays in provision of medical care to pulmonary tuberculosis patients above 15 years old with laboratory confirmation of the diagnosis before and during the COVID-19 pandemic in Dushanbe, Tajikistan.Subjects and Methods. A retrospective cohort study was conducted among new pulmonary tuberculosis patients above 15 years old with laboratory confirmation of the diagnosis registered by TB Control Centers in Dushanbe in 2019–2021. Information was collected from medical records, medical databases, and patient questionnaires. Two types of delays were detected during the provision of medical care: delays related to the patient (defined as >14 days between onset of tuberculosis symptoms and the first visit to a health unit); delays related to health system (defined as >3 days from the first visit to TB unit to the initiation of tuberculosis treatment).Results. Of the 472 patients enrolled in the study, 276 were registered during the COVID-19 pandemic (2020–2021) and 196 patients were registered before the pandemic (2019). Frequency of delays was similar (83% vs 82%, p=0.8) during and before the COVID-19 pandemic. The frequency of delay related to health system was statistically significantly lower during the pandemic versus the period before the pandemic (34% vs 44%, p=0.023). The median duration of delays associated to the patient before the pandemic (60 days, IQR: 15–541) and during the pandemic (60 days, IQR: 15–360, р=0.6) was also similar as well as delays related to health system (before the pandemic – 7 days, IQR: 4–336) and during the pandemic (7 days, IQR: 4–225, р=0.6).Conclusion. Contrary to the expected result, no significant difference in delays related to the patient before and during the pandemic was found, and the frequency of delay related to health system during the pandemic significantly reduced compared to the period before the pandemic.","PeriodicalId":37828,"journal":{"name":"Tuberculosis and Lung Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139160918","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}
Pub Date : 2023-12-24DOI: 10.58838/2075-1230-2023-101-5-31-35
O. Komissarova, R. Abdullaev, S. Aleshina
The objective: to develop approaches to selection of optimal chemotherapy regimens in tuberculosis patients with concurrent diabetes mellitus (DM), by studying complications of diabetes mellitus and adverse drug reactions to anti-tuberculosis drugs.Subjects and Methods. 235 adult pulmonary tuberculosis patients with concurrent diabetes were enrolled in the study. Of them, 123 were men (52.3%) and 112 were women (47.7%), and the age of the patients varied from 19 to 78 years old.Results. Complications of diabetes mellitus (DM) were reported in 190/235 (80.8%) patients. Encephalopathy occurred most often – in 147/190 (77.3%) patients, diabetic macroangiopathy developed less often - in 41 (21.6%), followed by diabetic retinopathy – in 20 (10.5%), diabetic nephropathy - in 11 (5.8%), ketoacidosis – in 4 (2.1%), and diabetic foot – in 4 (2.1%). Diabetic macroangiopathy was significantly more often observed in men (66.7%) versus women (31.7%); p<0.01, and diabetic nephropathy was more common in women (81.8%) than men (18.2%); p<0.01. As the age of patients and duration of diabetes increased, the incidence of complications of diabetes also increased. Adverse drug reactions (ADRs) to anti-tuberculosis drugs (TB drugs) occurred in 168/235 (71.4%) patients. ADRs to two or more TB drugs were registered in 140/168 (83.3%) patients. The most frequent irreversible ADRs were caused by the following drugs (of the number of patients taking them): aminoglycosides (58.8%), capreomycin (54.5%), PAS (50.0%), ethambutol (100.0%), cycloserine (40.0%), levofloxacin (33.3%), pyrazinamide (23.3%), terizidone (28.6%), prothionamide (26.3%), linezolid (21.4% ), and moxifloxacin (20.0%).Conclusion. When treating pulmonary tuberculosis in patients with diabetes mellitus, chemotherapy regimens containing aminoglycosides, capreomycin, prothionamide, and pyrazinamide should be avoided. If there is even an initial stage of retinopathy, ethambutol should be avoided. Patients with encephalopathy should be switched from cycloserine to terizidone.
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