[Surgical treatment of patients with chest malignancies in anti-tuberculosis hospital]. / Khirurgicheskoe lechenie bol'nykh zlokachestvennymi novoobrazovaniyami organov grudnoi kletki v protivotuberkuleznom statsionare.

OBJECTIVE: To evaluate the effectiveness of surgical treatment of patients with malignancies of lungs, pleura and chest wall in early and long-term follow-up period in anti-tuberculosis hospital. MATERIAL AND METHODS: There were 2139 patients between 2016 and 2020. Chest tumors were diagnosed in 290 (13.6%) patients and 210 (94.2%) ones underwent surgery. RESULTS: Surgical interventions are rare in patients with lung cancer and active tuberculosis (0.7%, n=15). Lobectomies prevailed (73.3%). All sublobar resections were performed in elderly patients with severe comorbidities and low functional reserves. Postoperative complications occurred in 9% of cases. Overall 3-year survival rate was 84.8%, overall 5-year survival rate - 70.8%. Overall survival of patients with lung cancer and tuberculosis does not depend on activity of specific process. CONCLUSION: The TRA test used in differential diagnostics of tuberculosis and lung cancer has a mediating value. Lung cancer surgery in patients with active tuberculosis has no negative effect on effectiveness of tuberculosis treatment. Surgical treatment of malignancies in anti-tuberculosis hospital can be performed in accordance with standards of specialized medical care in oncology.

Magnetic resonance imaging of the heart in the diagnosis of sarcoidosis.

Heart sarcoidosis diagnosis presents great difficulties due to the absence of specific clinical manifestations. Most often, the diagnosis is established during autopsy. Magnetic resonance imaging (MRI) of the heart with contrast enhancement is one of the most informative methods of intravital diagnosis of cardiac sarcoidosis. In this article, two clinical cases, shows the role of MRI of the heart with contrast enhancement in the diagnosis of cardiac sarcoidosis.

[The application of the pulsed low-frequency electrostatic field for the combined treatment of the children presenting with bronchial asthma].

The objective of the present study was to develop a scientifically sound rationale for the application of the pulsed low-frequency electrostatic fields (PLIESF) for the combined treatment of the children presenting with bronchial asthma and the comparative assessment of the effectiveness of the use of this method either as monotherapy or together with therapeutic physical exercises based on the immediate and long-term results of the treatment. The dynamic clinical observations and special investigations were carried out on 101 children at the age varying from 5 to 15 years who suffered from bronchial asthma. PLIESF were shown to produce the beneficial effect on dynamics of clinical symptoms in the children manifested as the disappearance or reduced frequency of episodes of laborious respiration and the improvement of sputum discharge, auscultation picture, bronchial patency, and respiratory excursions of the chest. The application of PLIESF significantly increased the level of the general physical performance in the children with bronchial asthma, improved the functional conditions of the cardiovascular system, normalized both the cardiac rhythm and the heart rate. It was shown based on the analysis of the short-term and long-term outcomes of the treatment that the combined therapy with the use of the two physical factors, i.e. the pulsed low-frequency electrostatic fields and therapeutic physical exercises, ensures the significantly higher effectiveness of the treatment than the separate application of either of them.

[Physical training for the treatment of children presenting with bronchial asthma].

This paper reports the results of the treatment of 101 children presenting with bronchial asthma. The study has demonstrated the pronounced positive effect of the combined application of a pulsed low-frequency electrostatic field and therapeutic physical training on the dynamics of clinical symptoms of the disease. By the end of the treatment period, all the patients reported the disappearance of paroxysmal night-time coughing, productive cough, expectoration, and attacks of respiratory distress. Auscultation failed to reveal dry, whistling, and bubbling rales. Dynamics of the changes of the impaired airway patency was estimated from the results of computed pneumotachometry and monitoring peak expiratory flow by the peak flowmetric technique. The combined application of a pulsed low-frequency electrostatic field and therapeutic physical training significantly improved characteristics of the external expiratory function (PEF, FEV1, MEFR25, MEFR50--p < 0.02, MEFR75--p < 0.001). In the end of therapy, 96.7% of the children had normal parameters of computed flowmetry in the absence of a generalized impairment of bronchial patency while obstruction at the level of peripheral bronchi persisted only in 3.3% of the patients. The increase of PEF based on the results of peak flowmetry averaged 44.21% (p < 0.001). A rationale has been developed for the application of the proposed therapeutic strategy to the treatment of children with bronchial asthma.

[The application of the physical factors for the rehabilitation of the children presenting with bronchial asthma].

The use of anti-asthmatic preparations alone can not be considered sufficient for the rehabilitation of the children suffering from bronchial asthma. Traditional medicamental therapy does not allow mortality from asthma to be appreciably reduced. At the same time, it is known to produce serious adverse effects. The physical factors proved to be fairly well compatible with the basal treatment; specifically, their application makes it possible to decrease the amount of pharmaceutical products and the duration of therapy.

[Cardiac damage in sarcoidosis: clinical features and impact of steroid therapy].

Twenty-seven sarcoidosis patients with signs of cardiac damage were examined to study the clinical features of cardiac sarcoidosis and the impact of systemic glucocorticosteroid (GCS) therapy on its course. ECG and echoECG changes were observed in 21 (78%) and 17 (63%) patients, respectively; abnormal perfusion was seen in 25 (93%) patients at single-photon emission myocardial computed tomography using 99mTc-MIBI. Three clusters (clinical types) of patients were identified, which differed in the pattern and degree of cardiac disorders. The use of systemic GCSs in 13 of 20 patients resulted in myocardial perfusion recovery and clinical improvement, the degree and duration of which depended on what cluster it belonged to. Seven GCS-untreated patients had progressive perfusion disorders with subsequent or synchronous clinical deterioration (p < 0.05). The degree and duration of the positive effect of a GCS differed depending on the clinical type of cardiac damage.