[The use of the medicine Ophtalmoferon for the treatment of conjunctivitis in patients with HIV-infection and tuberculosis]. / Opyt primeneniya preparata Oftal'moferon pri kon"yunktivitakh, assotsiirovannykh s VICh-infektsiei i tuberkulezom.

PURPOSE: To assess the effectiveness of the medicine Ophtalmoferon (eye drops) in the treatment of conjunctivitis of mixed aetiology in patients with first-time tuberculosis (TB) and human immunodeficiency virus (HIV) infection, who have been treated at the Clinical Anti-tuberculosis Hospital No. 4. MATERIAL AND METHODS: The study included 60 patients (42 men and 18 women with mean age of 41.48±1.34 years), who had consulted the ophthalmologist for conjunctivitis. The patients were divided into two groups: the first group - main one (n=32) - received complex local therapy with the medicine Ophtalmoferon; the second group (n=28) - control one - did not receive Ophtalmoferon as a part of complex local treatment. The treatment involved assessment of the effectiveness, tolerability and safety of the examined medicine. RESULTS: Patient examinations were conducted on the first visit, then on the third, fifth and seventh day of treatment. On the third day of treatment as compared to the baseline the burning sensation and pain in the eyes were less severe; in the main group that received the medicine Ophtalmoferon (group 1) the number of patients describing these symptoms as mild (1 point) were 15.6% (pain) and 18.8% (burning), respectively (W=2.15; p=0.03). Severe lacrimation (3 points) remained in 5 (15.6%) patients. On the fifth day there were no main group patients with severe (3 points) or moderate (2 points) lacrimation. On the seventh day complete resolution of subjective symptoms was noted in 71.9% (group 1) and 42.9% (group 2) of patients (χ2=1.39; p=0.238), respectively. There was no lacrimation in 71.9% (group 1) and 35.7% (group 2) of patients (χ2=2.36; p=0.125), no eye redness was noted in 78.1% (group 1) and 28.6% (group 2) of patients (χ2=4.51; p=0.034), respectively. CONCLUSION: The use of the combined medicine Ophtalmoferon in the complex local treatment of conjunctivitis of mixed aetiology in patients with tuberculosis and HIV infection helps to achieve a rapid relief of subjective and objective symptoms with good tolerability of the medicine.

[Chronic course of latent urogenital tuberculosis].

This is a case report of an elderly patient with urogenital tuberculosis and concurrent tuberculosis of peripheral inguinal lymph nodes. The disease manifested by a fistulous form of inguinal lymphadenitis for 10 years and spread to the kidneys and genitals, but the patient did not seek medical attention. Changes on the glans penis prompted him to consult dermatovenereologist. Due to ineffective treatment and uncovering the scar in the inguinal area the patient was send to an anti-tuberculosis institution, where he was diagnosed with tuberculosis involving the kidneys, prostate, epididymis, penis, inguinal lymph nodes. The patient had a history of a contact with the patient with respiratory tuberculosis. Treatment with antituberculosis drugs produced a positive effect.

[EPIDEMIC SITUATION FOR HIV-INFECTION IN SIBERIAN FEDERAL REGION IN 2014].

AIM: Analyze main epidemiologic indicators for HIV-infection on the territory of SFR for the period from 2012 to 2014 with allotment of contributions of regions into the epidemic for development of personalized regional program for further containment of HIV spread. MATERIALS AND METHODS: Data of main statistical forms and monthly reports of all the regions situated on the territory of the district were used. RESULTS: At large, on both the studied territory and some regions a tendency of growth of HIV-infection morbidity with predominant parenteral transmission was detected. HIV-infection continues to be detected most frequently in young able-bodied population. The number of patients detected for the first time at AIDS stage increases annually, and an increase of lethality among HIV-infected was noted. CONCLUSION: Prognostic data for the next year are indicated.

[Comparative characteristics of depressive tendencies in patients with tuberculosis and chronic obstructive pulmonary disease].

Chronic obstructive pulmonary disease (COPD) and tuberculosis are socially significant diseases that can develop at any age, and require long-term, sometimes lifelong, therapy. Diseases will inevitably cause a deficiency of oxygen in the body that can cause disorders of the nervous system, from the mood changes to reduce intelligence, especially in the elderly. According to the results of the study the majority of patients with COPD and a third of patients with tuberculosis, there are significant problems of the emotional plane, especially in older and elderly expressed in the presence of depressive tendencies (from subdepressive states to real depression), and almost half of the patients in need of specially organized psychological or medical assistance.

[Ocular tuberculosis]. / Tuberkulez glaz.

Ocular tuberculosis (OTB) is a specific infectious (bacterial) disease dealt with by ophthalmologists and phthisiatricians. This is a serious illness with chronic, persistent course and extremely doubtful prognosis. Chemotherapy, even if effective, can still be followed by a decrease in visual acuity. Clinical recovery is often unstable. Ocular tuberculosis is largely associated with permanent disability and, as a result, a decline in quality of life of these patients. Statistical reporting does not always reflect the true prevalence of the disease as it sometimes develops in patients with pre-existing specific pulmonary involvement. This article discusses all pathogenetic mechanisms of OTB that have been described so far. Attention is paid to modern diagnostic methods, including spectral optical coherence tomography. Positive results of endonasal electrophoresis for the treatment of OTB are described.

[Assessment of factors influencing the outcome of new-onset infiltrative pulmonary tuberculosis].

AIM: To identify predictors for the poor outcome of infiltrative pulmonary tuberculosis (IPTB). SUBJECTS AND METHODS: The social, epidemiological, and medical risk factors and clinical features of IPTB were assessed in 130 first detected patients. The findings were classified using a cluster analysis and then a variance analysis, followed by the ranking of its results. RESULTS: The primarily diagnosed disseminated destructive process with respiratory and cardiopulmonary failure, excretion of both resistant and multi-resistant pathogenic bacteria had a strong impact on the poor outcome of tuberculosis (TB) in the first detected patients. Its outcome was also influenced by a set of social factors, such as poor material living conditions, stay in corrective labor facilities, and a lack of education. The unfavorable outcome of TB was significantly due to organizational factors, such as bad habits; refusal to undergo fluorography during a few years; and a medical factor as comorbidities. CONCLUSION: Based on the identified factors, the authors formulated recommendations for working with the first detected IPTB patients at risk for a poor disease outcome.

[Prevention of neuro- and cardiotoxic side effects of tuberculosis chemotherapy with noopept].

The study evaluated clinical efficiency of noopept used to prevent adverse side effects of antituberculous agents. It included 60 patients with newly diagnosed respiratory tuberculosis. Those in group 1 (n = 30) received 10 mg of noopept twice daily during the first month. The treatment promoted functional normalization of vegetative nervous system and antioxidative systems, reduced manifestations of anxiety, decreased frequency of adverse neuro- and cardiotoxic responses to antituberculous drugs.

[Changes in the patients' mental status in the tolerability of antituberculous drugs].

The impact of disease and treatment on the mental status of patients with infiltrative pulmonary tuberculosis was studied. The study included 39 patients, chemotherapy in whom was complicated by the development of adverse reactions and 33 patients who had no adverse reactions. In new cases of tuberculosis, anxiety and personality disorders before chemotherapy were ascertained to be a response to first diagnosed tuberculosis and forced long-term in the inpatient setting. The development of adverse reactions caused by antituberculous agents during therapy was accompanied by impairments in psychological adaptation processes, the preservation and worsening of anxiety and personality disorders, which determines it necessary to include additional drug and psychotherapeutic correction methods into a package of therapeutic measures in tuberculosis.

[Influence of adverse reactions due to chemotherapy on life quality indices in patients with infiltrative pulmonary tuberculosis].

The study included 72 patients with infiltrative pulmonary tuberculosis who were divided into two groups: a study group (n = 39) showing adverse reactions to antituberculous drugs and a control one (n = 33). Examination of life quality parameters by MOS SF-36 scale revealed a reduction in the parameters characterizing the physical and psychosocial status of the patients, which was more pronounced in those with adverse reactions to chemotherapy within the first 2 months of treatment. The revealed changes make it necessary to implement additional therapeutic and psychotherapeutic measures in the first months of treatment for tuberculosis.

[Antibiotic-associated diarrheas in phthisiatric care: standardization of their diagnosis, treatment, prevention, examination of health care quality].

The authors propose a phthisiological care-adjusted standard of the diagnosis, treatment, prevention of antibiotic-associated diarrhea. They have developed a standard-driven algorithm of expert assessment of the quality of medical aid to this group of patients.

[Infiltrative pulmonary tuberculosis in persons over 60 years of age].

To study the specific features of infiltrative pulmonary tuberculosis and its treatment efficiency in patients over 60 years, the authors analyzed case histories of 80 patients who were divided into 2 groups: 1) 40 patients aged 60 years or more and 2) 40 patients aged 18 to 50 years. The types of adaptive reactions (L. Kh. Garkavi et al., 1977) and those of the body's responsiveness (N. A. Brazhenko, 1987) were studied; the leukocytic shift index (N. I. Yabluchansky, et al., 1983) was calculated. The efficiency of treatment was evaluated from the results of control bacteriological and X-ray studies conducted after 2-, 5-, and 8-month drug therapy. The persons over 60 years of age were significantly more frequently (p < 0.05) diagnosed as having concomitant diseases (mainly coronary heart disease (65%), arterial hypertension (50%), chronic bronchitis (50%), atherosclerosis of central and peripheral arteries (35%), and adverse reactions caused by antituberculous drugs (75% versus 40%; among them there were prevalent neurotoxic and cardiotoxic reactions). Despite the fact that the results of treatment in this group of patients did not differ from those in young persons, which may be attributable to better compliance in patients above 60 years of age.

[Adverse neurotoxic reactions of chemotherapy for tuberculosis and their treatment].

A hundred and sixty-five first detected patients with pulmonary tuberculosis, receiving routine chemotherapy regimens were followed up for 4 months. Neurotoxic reactions of the central and peripheral nervous systems, which required isoniasid discontinuation, were developed in 13.3 and 11.5% of the patients, respectively. Therapy for neurotoxic reactions used cortexin in the study group (n = 22) and gamma or vitamins B in combination with glutaminic acid in the control group (n = 19). Cortexin used in the therapy of neurotoxic reactions produced a beneficial effect and permitted 90.9% of the patients to continue to use isoniazid while 42.2% of the controls resumed using isoniazid.

[Role of disorders of metabolism in rat myocardium and endotoxemia in the pathogenesis of post-resuscitation cardiodepression]. / Rol' narushenii metabolizma v miokarde krys i éndotoksemii v patogeneze postreanimatsionnoi kardiodepressii.

The model of 4-min clinical death due to acute blood loss was used to study cardiac contractility, myocardial metabolism and causes of endotoxemia in early postresuscitation period. The investigations were made on the whole body, isolated, isovolemically contracting heart and isolated papillary muscle. A marked reduction in functional myocardial reserves, maximal within the first 24 hours of postresuscitation, with dominant defects in relaxation was seen. Pathogenetic factors responsible for cardiodepression are the following: hypoxia, impairment of bioenergetics, hyperactivation of lipid peroxidation, acidosis, membrane destruction, endotoxemia.

[Disordered cardiac contractility after clinical death caused by acute blood loss]. / Narushenie sokratimosti serdtsa posle klinicheskoi smerti, vyzvannoi ostroi krovopoterei.

The regularities of development of postresuscitation cardiodepression were studied in experiments on outbred male rats resuscitated after 4-min clinical death from acute blood loss. The studies were carried out for the whole organism, isolated isovolumetrically contracting heart, and for the isolated papillary muscle. As a result of acute critical blood loss, the functional reserve of the myocardium dropped and fatigue rapidly developed, progressing to asystole and fibrillation during the maximal exercise. Cardiodepression was expressed most of all during the first day, particularly during the first hours after resuscitation. Later the contractility gradually normalized, and 3 months after resuscitation it did not reliably differ from the control. The disorders involved the relaxation processes most of all.