[Prevalence of primary drug resistance in M. tuberculosis in four administrative areas of the North-Western Federal District of the Russian Federation].

The paper describes the results of radiometric BACTEC assay of drug susceptibility of Mycobacterium tuberculosis strains, isolated from 81 new cases of tuberculosis, to first- and second-line antituberculosis drugs in four administrative areas of the North-Western Federal District of the Russian Federation. The results of determination of drug susceptibility to the antituberculosis drugs by the absolute concentration method and the BACTEC method are also compared. Primary drug resistance has been revealed in 58.0%; multidrug resistance in 34.6%. Comparison of the results of determination of drug susceptibility by the methods revealed no significant discrepancy between both methods; however, the procedure for drug susceptibility to some drugs requires improvement.

[Analysis of fatal cases of tuberculosis in the Arkhangelsk region in 2004].

Analysis of tuberculosis mortality in the civil sector of the Arkhangelsk Region in 2004 revealed that 55.4% of all death cases had been notified in patients with tuberculosis caused by multidrug-resistant Mycobacterium tuberculosis (MBT). In the above group of patients, 101 (85.6%) patients had not received chemotherapy with drug MBT resistance being kept in mind: tuberculosis autopsy was established in 15 patients with multidrug-resistance MBT at autopsy; in 5 patients MBT resistance to 7 and 8 antituberculosis agents had ruled out the use of etiotropic therapy; 81 patients had not received adequate treatment due to the shortage and spectrum of second-line antituberculosis drugs. The second cause of death from tuberculosis was the acutely progressive, disseminated forms of the disease, even, during treatment, leading to a fatal outcome, which were detectable in patients with a new case of tuberculosis (33.8% of all deaths) and its recurrence (5.6%).

[Impact of drug resistance of the causative agent on the outcomes of treatment for pulmonary tuberculosis in the Arkhangelsk Region].

The present study was undertaken to assess the results of treatment in patients with pulmonary tuberculosis in the Arkhangelsk Region in 1999 and to analyze the results of treatment in relation to the infection with Mycobacterium tuberculosis with different profiles of sensitivity to antituberculous drugs. The outcomes of treatment were assessed in relation to the infection with Mycobacterium tuberculosis with different profiles of sensitivity to antituberculous drugs in 76 patients to whom the BACTEC test was applied. Beneficial effects of therapy were recorded in 150 (63.9%) of the 235 new cases. In 29 (12.3%) patients, it ended in death, ineffective treatment was recorded in 20 (8.5%) first detected patients; 29 (12.3%) new cases discontinued treatment; the result of therapy was unknown in 7 (3.0%). There was a low efficiency of chemotherapy (26.2%), its inefficiency in 24 (39.4%) patients; treatment was discontinued in 18 (29.5%) cases and its outcome was unknown in 1 (1.6%) patient. Resistance to one antituberculous agent timely used in the effective chemotherapy regimen did not affect the outcome of treatment. The spread of drug resistance in pulmonary tuberculosis in the Arkhagelsk Region directly affects the outcome of the disease.

[Spread of multidrug resistance of Mycobacterium and its impact on the efficiency of treatment in patients with tuberculosis in the penitentiaries of the Arkhangelsk Region].

The paper deals with drug resistance of Mycobacterium tuberculosis in the prisons of the Arkhangelsk Region. The present study was undertaken to examine the spread of multidrug resistance of Mycobacterium tuberculosis and its impact on the outcomes of treatment of new cases of tuberculosis in the penitentiaries of the Arkhangelsk Region.

[Drug resistance of Mycobacterium tuberculosis of the genotype Beijing in imprisonment places in the Arkhangelsk Region]. / Lekarstvennaia ustoichivost' mikobakterii tuberkuleza genotipa Beijing v mestakh lisheniia svobody Arkhangel'skoi oblasti.

The paper describes the molecular genetic characteristics of M. tuberculosis (MT) strains isolated from 114 patients with pulmonary tuberculosis in the penitentiary system of the Arkhangelsk Region. The sensibility to the first-line antituberculous drugs was determined by the radiometric technique BACTEC; rpoB gene mutations were identified by Inno-Lipa, genotyping was made by the RFLPA assay and spoligotyping. The spread of MT of the genotype Beijing in the penitentiary system was found to be 76.3%. The high rate (79.8%) of the clustering pattern is indicative of active transmission of tuberculosis. The transmission of the Beijing genotype MBT strains was higher (96.6%) than that of other genetypes (25.9%). A multifactorial analysis has shown that streptomycin resistance is independently associated with the infection with the strain of MBT of the genotype Beijing (p = 0.02); the circulation and active transmission of Beijing among the population present a human health threat and an endemic risk from the spread of drug-resistant pulmonary tuberculosis.

[Drug resistance in Mycobacteria tuberculosis in the Barents region of Russia and Norway]. / Lekarstvennaia ustoichivost' mikobakterii tuberkuleza v Barents-regione Rossii i Norvegii.

The paper considers drug resistance in Mycobacterium tuberculosis (MBT) in the Barents region of Russia and Norway. Along with a rise in tuberculosis morbidity, there has been recently an increase in the number of patients isolating MBT that are resistant to antituberculous agents. The most dangerous trend is an increase in MDR of MBT strains. In the north-west of Russia there are high MBT drug resistance rated as compared to Norway. There are differences in the determination of drug resistance by the absolute concentration method and by the BACTEC method.

[Molecular epidemiology of Mycobacterium tuberculosis in the Barents Sea region of Russia and Norway]. / Molekuliarnaia épidemiologiia mikobakterii tuberkuleza v Barentsevom regione Rossii i Norvegii.

The paper shows how to detect an epidemiological chain of spread of tuberculosis in the Barents Sea Region. RFLP typing of Mycobacterium tuberculosis strains may serve as an important tool in detecting an infection source and drawing up epidemiological chains of tuberculosis spread. Cross infection may occur in tuberculosis cure hospitals, which shows it necessary to delimit fluxes of tuberculosis patients into health care facilities.

[Difficulties in diagnosing pulmonary visceral forms of rheumatoid arthritis in tuberculous hospital]. / Trudnosti diagnostiki legochno-vistseral'nykh form revmatoidnogo artrita v klinike tuberkuleza.

The articulovisceral form of rheumatoid arthritis is severe, which creates difficulties in its diagnosis as it is characterized by polymorphism and atypical features. This type concurrent with pulmonary manifestations should be differentiated from inflammatory lung diseases, including tuberculosis.

[Use of maxaquin in the treatment of progressive pulmonary tuberculosis occurring with standard chemotherapy regimens]. / Primenenie maksakvina v lechenii progressiruiushchego tuberkuleza legkikh, voznikshego na fone standartnykh rezhimov khimioterapii.

To study the efficacy of the fluoroquinolone maxaquin (lomefloxacin), the latter was used in 27 patients with destructive bacillary pulmonary tuberculosis which progressed with routine drug regimens. After monthly therapy, positive clinical changes were achieved in 85.6% of patients, abacillation was obtained in 33.2%, a X-ray decrease in infiltrative and focal changes was recorded in 81.5% and decay cavitary closure occurred in 22.2% of patients at month 3 of maxaquin therapy. The positive clinical, laboratory, and X-ray changes occurring after the use of maxaquin necessitates the supplementation of this agent to the drug regimen for patients with progressive pulmonary tuberculosis. Mycobacterial resistance to the major drugs is an indication for the use of maxaquin.

[The use of apressin in patients with pulmonary tuberculosis and functional disorders of the external respiration and hemodynamics]. / Ispol'zovanie apressina u bol'nykh tuberkulezom legkikh s narusheniem funktsii vneshnego dykhaniia i gemodinamiki.

Effects of apressin, a peripheral vasodilator, on external respiration function and central hemodynamics was studied in 51 patients with pulmonary tuberculosis. The study showed that a single administration of 20 mg apressin in pulmonary tuberculosis patients failed to bring about any changes in both external respiration function and blood gases, only causing a minor shift in the buffer bases. Systolic pressure in the pulmonary artery remained unchanged after a single 20 mg dose of apressin was given. A statistically significant decrease in total pulmonary vascular resistance and an increase of the central hemodynamic values in pulmonary tuberculosis patients with hypokinetic type of circulation are recorded.

[Effect of nitroglycerin preparations on indicators of central hemodynamics in patients with pulmonary tuberculosis complicated by chronic cor pulmonale]. / Vliianie preparatov nitroglitserina na pokazateli tsentral'noi gemodinamiki u bol'nykh tuberkulezom legkikh, oslozhnennym khronicheskim legochnym serdtsem.

The effect of nitroglycerin drugs on central hemodynamic indices in 198 patients with pulmonary tuberculosis and chronic nonspecific pulmonary diseases was investigated. These studies revealed that in pulmonary tuberculosis, nitroglycerin caused blood pooling in peripheral vessels, a decrease in the central hemodynamic indices and an increase in the right heart. A single dose of nitrogen, 2.6 mg, given to a patient with hypokinetic circulation leads to the improvement of the central hemodynamic indices (circulating blood volume (CBV), stroke and cardiac indices, lung CBV) due to less peripheral angiospasm, peripheral circulation normalization and better blood supply to the right heart. A fortnight nitrogen regimen in a dosage of 2.6 mg thrice a day makes it possible to normalize the central hemodynamic indices and decrease pressure in the pulmonary artery in patients with pulmonary tuberculosis complicated by a chronic pulmonary heart with a hypokinetic circulation.

[The effect of nitroglycerin on the external respiration function and central hemodynamics in patients with tuberculosis of the lungs]. / Vliianie nitroglitserina na funktsiiu vneshnego dykhaniia i tsentral'nuiu gemodinamiku bol'nykh tuberkulezom legkikh.

To estimate the effect of nitroglycerin (NTG) on the external respiration function and central hemodynamics, 124 patients with various forms of pulmonary tuberculosis and chronic nonspecific diseases of the lungs were examined. The indices of the external respiration function, central hemodynamics, pulmonary artery systolic pressure (PASP), general pulmonary resistance (GPR) and blood gaseous composition were determined before and after NTG sublingual use in a dose of 1 mg. It was noted that improvement of bronchial patency after the use of NTG was not significant and subsequently its indication as an agent arresting bronchospasm is not expedient. A statistically significant decrease in PASP and the indices of central hemodynamics, as well as a decrease in GPR might be considered as a basis for the use of nitrates in prophylaxis and treatment of chronic pulmonary heart in patients with pulmonary tuberculosis.