Objective: to improve the effectiveness of treatment of new pulmonary TB patients by studying the dynamics of the gut microbiota status and correction of its disorders. Materials and methods. The gut microbiota status was studied in 34 new pulmonary TB patients, which were divided into two groups. Group 1 consisted of 17 new patients, which received corrective therapy of gut microbiota; group 2 consisted of 17 new patients, which did not receive corrective therapy. The comparison group consisted of 27 healthy volunteers. We performed quantitative analysis of gut microbiota composition before and during treatment and evaluated the influence of corrective therapy on TB treatment effectiveness. Results. We established that new pulmonary TB patients had lower levels of bifidobacteria, lactobacteria, typical E. coli, and enterococci before treatment compared to healthy individuals. After the first week of TB treatment these disorders worsened. After one and three months of treatment the levels of normal flora significantly increased in new patients on corrective therapy but did not reach those of healthy individuals. The levels of normal flora continued to decrease in patients without corrective treatment. The levels of Candida fungi decreased during treatment in patients on corrective therapy and increased in patients without corrective therapy. The analysis of severity of dysbiosis in new patients revealed that in most patients, which received complex treatment with microbiota correction, microbiota disorders were alleviated. Patients, which did not receive corrective therapy, demonstrated worsening of the gut microbiota status. Sputum conversion rate was significantly higher in patients, which received corrective therapy of gut microbiota, especially in the early stages of treatment (after two months of treatment – 70 and 33% respectively). Cavity closure rate was also higher in patients, which received corrective therapy. Conclusion. Corrective therapy counteracted intestinal dysbiosis and improved effectiveness of complex treatment of pulmonary TB patients.Keywords: pulmonary TB, gut microbiota, dysbiosis, correction, treatment effectiveness
We studied parameters of clinical and biochemical blood tests in 54 patients with severe course of the disease caused by the novel coronavirus infection (COVID-19), who died in the intensive care unit. We established that COVID-19 patients had a hypercoagulation shift with intravascular coagulation, as evidenced by shortened activated partial thromboplastin time (APTT), elevated fibrinogen and D-dimer levels. We discovered that all patients with severe COVID-19 course had increased values of platelet anisocytosis, which indicated the presence of a hypercoagulation shift. At the same time, most patients had signs of consumption coagulopathy, as evidenced by decreased platelet and plateletcrit indices.
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