Inadequacy of the current WHO re-treatment regimen in a central Siberian prison: treatment failure and MDR-TB.

Multidrug-resistant tuberculosis (MDR-TB) threatens the progress of global control efforts. Prisons represent a high risk setting for development and transmission of MDR-TB. In a Siberian TB referral prison (Kemerovo region), the treatment failure rate is 35% (June 1996-March 1997), despite implementation of a strict DOTS program and use of the World Health Organization Category 2 re-treatment regimen for all new cases. Among 164 patients (December 1997-March 1998), initial resistance to isoniazid and rifampin is 22.6%. Such a rate is a warning call to reconsider prison control strategies, and importantly, to address the treatment regimens necessary to combat an institutional epidemic of MDR-TB.

[Use of manual reflexotherapy for correcting biomechanical changes in the chest and the functional status of the diaphragmatic neuromuscular complex in patients with tuberculosis]. / Primenenie manual'noi refleksoterapii dlia korrektsii biomekhanicheskikh izmenenii v grudnoi kletke i funktsional'nogo sostoianiia diafragmal'nogo nervnomyshechnogo kompleksa u bol'nykh tuberkulezom.

Abnormal biomechanical changes of the osteoarticular and muscular apparatus of the chest were revealed by the method of manual diagnosis in all 72 examined patients in a tuberculosis clinic. They appeared as various functional blocks in the vertebral motor segments and regional postural muscle imbalance which was attended by lower lung ventilation capacity and dysfunction of the diaphragmatic neuromuscular complex. After the course of manual reflex therapy comprising mobilization, manipulations and postisometric relaxation, 80% of the patients felt easier respiration, lower chest stiffness. There was a significant increase of functional capacities of the external respiratory apparatus in all the patients.