The treatment of tuberculosis under current conditions

Sinitsyn, Mikhail; Калинина, Марина Николаевна; Belilovskiy, Evgeny; Galstyan, Armine; Reshetnikov, M. N.; Плоткин, Д. В.

doi:10.26442/00403660.2020.08.000762

Cited by 5 publications

(1 citation statement)

References 42 publications

(43 reference statements)

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“…The treatment burden in the world has become an issue for WHO, especially for developing countries, and it is significantly prevented from the end of the tuberculosis epidemic in the world [40]. Care and treatment facilities are provided to TB patients free of charge following the WHOrecommended directly observed treatment short-course TB control strategy (DOTS).…”

Section: Open Access Journalmentioning

confidence: 99%

Investigating Empirical evidence on the Epidemiology, Diagnosis and Bibliometric analysis of the 100 topmost cited publications on Tuberculosis Disease

Musa¹,

Fornah

Akintunde

et al. 2023

PASJ

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Tuberculosis (TB) disease remains a growing threat in public health globally. This study explored the epidemiology, diagnosis, management, and bibliometric analysis of the top 100 most cited articles on TB. The study adopted a narrative review and bibliometric analysis to explore publications on TB disease. Publications in the Web of Science were retrieved to provide extensive selection process. The present study of top 100 articles which are mostly cited are reported between 1969 to 2018. Reported documents were published in 37 journals, and a total of 1058 authors contributed with 10.5 authors per document, and 12 countries contributed, with most of TB research originating from the US (N=51) articles. We found 1058 occasional authors, and of these, 971 authors (0.003%) presented only three articles, followed by 11 authors (0.010%) and 18 authors (0.017%), respectively. About (n=34) research was published in General & Internal Medicine and Science & Technology. New England Journal of Medicine with 14 was top journal. The lead research institution was the University of Cape Town. The significant correlations were found between the number of citations and documents per year (r=0.9579, p<0.0001), countries (r=0.9570, p<0.0001), article per journal (r=0.8721, p<0.0001), and authors (r=0.4601, p<0.0001), and documents per Institution (r=0.6159, p<0.0001). A new insight into TB scientific production was through social network. The evidence from this study provides a template for understanding the epidemiology of TB and the trends in research. It also exposes the hotspot of research along with research gaps for future studies.

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Section: Open Access Journalmentioning

confidence: 99%

Investigating Empirical evidence on the Epidemiology, Diagnosis and Bibliometric analysis of the 100 topmost cited publications on Tuberculosis Disease

Musa¹,

Fornah

Akintunde

et al. 2023

PASJ

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Reduction of the risk of bronchopleural complications after pneumonectomy due to the use of intraoperative laser treatment of the stump of the main bronchus

Asoyan

Лепеха

Sadovnikova

et al. 2022

vmirvz

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Purpose of the study: due to the intraoperative technique of treating the stump of the main bronchus with a high-energy laser LSP-30 during pneumonectomy, to increase the effectiveness of the treatment of patients with destructive widespread pulmonary tuberculosis.Materials and methods. The results of treatment of 112 patients were analyzed. All patients underwent lung removal due to widespread destructive tuberculosis. Patients were divided into main and control groups. The first group, the main one, consisted of 58 patients selected prospectively with a high risk of bronchopleural complications, of which 63.8% (n = 37) of patients had signs of hemoptysis and episodes of pulmonary hemorrhage, which required urgent and sometimes emergency surgical intervention. In 36.2% (n = 21) of patients, limited empyema of the pleural cavity without bronchopleural fistulas was determined radiographically. All patients of the main group after the stage of lung removal before the formation of a stump, the mucosa of the main bronchus was irradiated with a high-energy laser LSP-30 with a wavelength of 930 nm. 54 patients of the control group, selected retrospectively, in whom the course of the fibroticcavernous tuberculosis passed without complications and the HA stump after pneumonectomy was formed without the use of laser irradiation. There were no endoscopic signs of active tuberculous inflammation of the tracheobronchial tree in patients of both groups. A number of patients, in the main group in 5.2% (n = 3) and in the control group in 3.7% (n = 2), showed signs of scarring of the bronchus after tuberculosis. These patients, as part of preoperative preparation, underwent endoscopic biopsy of the main bronchus mucosa in the scar areas, and only after histological confirmation of the absence of active tuberculous inflammation, pneumonectomy was performed.Results. Pronounced post-thoracotomy pain syndrome in 5.2% (n = 3) of patients in the main group and in 9.3% (n = 5) of patients in the control group, for the relief of which narcotic analgesics were used for a long time. Progression of respiratory insufficiency, as a result of accession of nonspecific pneumonia of the only lung in 5.2% (n = 3) of patients of the main group and in 7.4% (n = 4) of patients of the control group, which was resolved by additional resuscitation and avoided mortality. Formation of residual pleural cavity on days 7–21 of the postoperative period in 6.9% (n = 4) of patients in the main group and in 1.8% (n = 1) of patients in the control group in the apex of the hemithorax, which required several sessions of thoracocentesis for the complete elimination of residual pleural cavity. The formation of a pulmonary hernia and the displacement of the mediastinal organs towards fibrothorax, in 5.2% (n = 3) of patients in the main group and in 1.8% (n = 1) in patients of the control group, this complication is the main manifestation of postpneumonectomy syndrome. Progression of tuberculosis in the only lung in 5.2% (n = 3) of patients of the main group and 3.7% (n = 2) of patients in the control group. This complication was revealed radiographically, despite the anti-tuberculosis therapy carried out in the postoperative period in accordance with the sensitivity of Mycobacterium tuberculosis, identified from the surgical material. Intrapleural bleeding in the early postoperative period was detected in 3.7% (n = 2) of patients in the control group, and no such cases were detected in the main group. All cases of intrapleural bleeding in the control group were urgently stopped.Conclusions. The effectiveness of surgical treatment of patients with widespread destructive pulmonary tuberculosis in the volume of pneumonectomy using intraoperative laser treatment of the mucosa of the main bronchus was 98.3%, while in the control group, where the intraoperative technique was not used, it was significantly lower – 87.1% (p < 0.01). A high percentage of cases of histological detection of an inflammatory process on the resection line is a scientifically substantiated confirmation of the need for intraoperative laser treatment of the main bronchus mucosa by the proposed method in patients with widespread destructive tuberculosis during pneumonectomy.

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Bedaquiline in the complex treatment of HIV-associated respiratory tuberculosis

Мордык

Иванова

Sitnikova³

et al. 2022

Medicinskij sovet

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Introduction. The continued decline in the number of patients shedding multidrug-resistant mycobacteria (MDR MDR), which has continued since 2018, determines the priority of measures to improve the effectiveness of treatment of newly diagnosed patients, including HIV-associated tuberculosis, with the mandatory inclusion of new anti-tuberculosis drugs in the treatment regimens of patients. drugs.Aim. To evaluate the efficacy and safety of bedaquiline in the complex treatment of patients with HIV-associated respiratory tuberculosis.Materials and methods. In the prospective study was included 60 patients with newly diagnosed HIV-associated respiratory tuberculosis, randomized into 2 groups: group 1 – 30 patients who received bedaquiline in the combination of anti-tuberculosis drugs; group 2 – 30 patients who received therapy without the addition of bedaquiline. Bacterial excretion was detected in all patients of the 1st and 2nd groups, the MBT drug sensitivity test confirmed the presence of pre-XDR MBT. Patients in both study groups received antiretroviral therapy. The follow-up period for patients was 12 months.Results. In the group of patients treated with bedaquiline, higher treatment results were noted both in terms of the criterion “closing of decay cavities” (by 14.7%) (p > 0.05) and by the criterion “cessation of bacterial excretion” (by 23.3%) ((p <0.05).Conclusions. The high clinical efficacy and safety of the use of bedaquiline in the complex treatment of patients with HIV-associated respiratory tuberculosis has been demonstrated. The data obtained make it possible to recommend the use of bedaquiline in the treatment of patients with newly diagnosed HIV-associated tuberculosis, isolating MBT with pre-XDR, to increase the effectiveness of the main course of chemotherapy, prevent the amplification of MBT drug resistance and develop extensive MBT drug resistance.

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The treatment of tuberculosis under current conditions

Cited by 5 publications

References 42 publications

Investigating Empirical evidence on the Epidemiology, Diagnosis and Bibliometric analysis of the 100 topmost cited publications on Tuberculosis Disease

Investigating Empirical evidence on the Epidemiology, Diagnosis and Bibliometric analysis of the 100 topmost cited publications on Tuberculosis Disease

Reduction of the risk of bronchopleural complications after pneumonectomy due to the use of intraoperative laser treatment of the stump of the main bronchus

Bedaquiline in the complex treatment of HIV-associated respiratory tuberculosis

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