Therapy For Pulmonary Tuberculosis Research Articles

Proapoptotic Bcl-2 inhibitor as host directed therapy for pulmonary tuberculosis.

Mycobacterium tuberculosis establishes within host cells by inducing anti-apoptotic Bcl-2 family proteins, triggering necrosis, inflammation, and fibrosis. Here, we demonstrate that navitoclax, an orally bioavailable, small-molecule Bcl-2 inhibitor, significantly improves pulmonary tuberculosis (TB) treatments as a host-directed therapy. Addition of navitoclax to standard TB treatments at human equipotent dosing in mouse models of TB, inhibits Bcl-2 expression, leading to improved bacterial clearance, reduced tissue damage / fibrosis and decreased extrapulmonary bacterial dissemination. Using immunohistochemistry and flow cytometry, we show that navitoclax induces apoptosis in several immune cells, including CD68 + and CD11b + cells. Finally, positron emission tomography (PET) in live animals using novel, clinically translatable biomarkers for apoptosis ( 18 F-ICMT-11) and fibrosis ( 18 F-FAPI-74) demonstrates that navitoclax significantly increases apoptosis and reduces fibrosis in pulmonary tissues, which are confirmed using post-mortem studies. Our studies suggest that proapoptotic drugs such as navitoclax can improve pulmonary TB treatments, and should be evaluated in clinical trials.

18F]FDG PET and CT findings at therapy completion of pulmonary tuberculosis: comparison between HIV-positive and HIV-negative patients and impact on treatment response assessment

Abstract Background [18F]FDG-PET/CT is a sensitive non-invasive tool for assessing treatment response in patients with pulmonary tuberculosis. The data on the performance of [18F]FDG-PET/CT for response assessment among patients infected with the human immunodeficiency virus (HIV) is limited. Here, we investigated the differences between PET and CT lung findings on end-of-treatment [18F]FDG-PET/CT among HIV-positive versus HIV-negative patients who completed anti-tuberculous therapy for pulmonary tuberculosis. Methods Patients who completed anti-tuberculous therapy for pulmonary tuberculosis and declared cured based on negative clinical and laboratory assessments for active pulmonary tuberculosis were prospectively recruited to undergo [18F]FDG-PET/CT. Patients were classified as having residual metabolic activity if PET metabolic activity was demonstrated in the lung parenchyma or complete metabolic response if there was no abnormally increased [18F]FDG avidity in the lungs and compared the CT features. We identified 10 CT lung changes, five were associated with active pulmonary tuberculosis (nodules, micronodules in tree-in-bud pattern, consolidation, pleural effusion, and [18F]FDG-avid mediastinal/hilar lymphadenopathy) and the rest were associated with inactive sequelae of prior pulmonary tuberculosis (cysts, cavities, fibrosis, bronchiectasis, and calcifications and compared their incidence between HIV-positive and HIV-negative patients. Results Seventy-five patients were included with a mean age of 36.09 ± 10.49 years. There were fifty HIV-positive patients, all of whom were on antiretroviral therapy and with a median CD4 + T-cell of 255 cells/µL (IQR: 147–488). Fifteen HIV-positive patients had detectable HIV viremia with a median viral load of 12,497 copies/mL (IQR: 158–38,841). There was a significant difference in the incidence of residual metabolic activity and complete metabolic response between HIV-positive and HIV-negative patients. (P = 0.003) HIV-positive patients were more likely to have [18F]FDG-avid lymphadenopathy and HIV-negative patients had a higher incidence of cystic lung changes. The pattern of CT lung changes was otherwise not different between HIV-positive and HIV-negative patients. (P > 0.05) Conclusions The incidence of residual metabolic activity and complete metabolic response on end-of-treatment [18F]F-FDG-PET/CT are similar between HIV-positive and HIV-negative patients. The incidence of [18F]FDG-avid mediastinal/hilar lymphadenopathy is more prevalent among HIV-positive patients. The pattern of lung changes was largely similar between HIV-positive and HIV-negative patients, indicating that the presence of HIV coinfection may not influence the interpretation of end-of-treatment [18F]F-FDG-PET/CT obtained for pulmonary tuberculosis treatment response assessment.

Efficacy and safety of quinolones as potential first line therapy in pulmonary tuberculosis: a meta-analysis.

Tuberculosis is an infectious disease that continues to plague the world today, causing concerns due to its high mortality rate. The therapy regimens used for the treatment of tuberculosis today have demonstrated high efficacy and safety, potentially reducing the disease's burden, but the use of some standardized medications has caused many resistances to emerge. Over the last decade, researchers have been looking for suitable alternatives, with quinolones emerging as the most promising candidate due to their efficacy, safety, and availability. However, their efficacy as a first-line treatment remains debatable.

Hubungan Karakteristik Sosiodemografi dengan Hasil Terapi Tuberkulosis Paru di RSUD Banyumas

Pulmonary tuberculosis (TB) is one of the infectious diseases caused by Mycobacterium tuberculosis and is one of the highest causes of morbidity and mortality rates with a low level of treatment outcome. Indonesia is the second country in the world with the largest tuberculosis burden. This study aims to determine the relationship of sociodemographic characteristics with the results of pulmonary tuberculosis therapy at Banyumas Regional Public Hospital for the period 2019-2021. This study used a case-control method. The inclusion criteria in this study were new pulmonary tuberculosis patients at the Banyumas Regional Public Hospital and patients aged ≥18 years, both male and female. Multi-drug resistance (MDR) TB patients and patients with incomplete medical record data were excluded. There were 166 patients enrolled in this study. Data analysis was performed by univariate analysis and bivariate analysis by chi-square test. The results showed that the sociodemographic characteristics were dominated by male patients (57,2%), patients aged <65 years (66,3%), patients weighing <55 kg (53%), not graduating from college (94%), currently working (64,5%), married (68,7%), have health insurance (94%), and close distance (<10 km) to the hospital (53%). The conclusion is that gender ((P=0,028; OR 2,112; 95%Cl(1,129 – 3,951)), age (P=0,014; OR 2,413; 95% Cl (1,242 – 4,689)), body weight (P=0,000; OR 3,306; 95%Cl (1,748 – 6,252)), and distance from the patient's house to the hospital (P=0,020; OR 2,190; 95% CI (1,176 – 4,077)) have a significant relationship with the outcome of pulmonary TB therapy at Banyumas Regional Public Hospital.

Synchronization of Sputum Conversion and Resolution of Intensive Phase Lesion Areas on Thorax X-rays Determinants of Prognosis for Pulmonary Tuberculosis Therapy

Synchronization of Sputum Conversion and Resolution of Intensive Phase Lesion Areas on Thorax X-rays Determinants of Prognosis for Pulmonary Tuberculosis Therapy

A Study to Assess the Effectiveness of Structured Teaching Programme on Knowledge Regarding Pulmonary Tuberculosis and DOTs Therapy among Tuberculosis Patients Attending Tuberculosis O.P.D at Selected Hospitals in Bhiwani, Haryana

Background of the Study: Tuberculosis is a global public health issue despite the discovery of the causal bacterium over 100 years ago and availability of effective medications and vaccines for prevention and cure. Tuberculosis has a global incidence rate of 119 per lakh, with low-income nations bearing the major burden at 197 per lakh. High-income countries have nine per lakh people, while middle-income countries have 85. Eight out of ten tuberculosis patients are economically productive aged 15-49. It kills more adults than any other infectious disease. India has roughly one-third of the global tuberculosis load. Aim of the Study: The goal of this study is to evaluate the efficacy of a planned education program on students' understanding of pulmonary tuberculosis and the DOTS treatment method. Methodology: This study examined how a comprehensive teaching program improved patients' understanding of pulmonary tuberculosis and DOTS therapy in the outpatient department (OPD) of selected hospitals in Bhiwani, Haryana. To attain the purpose, the researcher used pre-experimental study design. The study included 60 patients at the Directly Observed Therapy Short-course (DOTS) clinic in Bhiwani, Haryana. The researchers selected samples using convenience sampling. A structured knowledge questionnaire was used to collect data in this study. A group of tuberculosis patients provided data for ten days. The pre-test was given on May 17, 2021, before formal education began. Ten days later, the post-test was given. Data was processed and analyzed using descriptive and inferential statistics. Results: The mean pre-test knowledge score was 9.45, with a 2.65 standard deviation. In the post-test, the mean score was 19.40 with a standard deviation of 1.86. The computed mean difference was 9.95. The paired 't' test yielded 24.60 with 59 degrees of freedom. A p-value of 0.01 indicated statistical significance.

Ferritin, IL-6 and human-beta-defensin-1 as prognostic markers of the course severity and treatment effectiveness of pulmonary tuberculosis

Current methods of investigation in TB patients, namely sputum microscopy, culture, and molecular genetic methods, although well-studied, have a number of disadvantages, such as low sensitivity, long time required to obtain results, or high cost. Because of this, the search for alternative diagnostic tools and methods for predicting the course and effectiveness of treatment in patients with tuberculosis becomes relevant. In this study, ferritin, interleukin-6 (IL-6), and human-beta-defensin-1 (HBD-1) were selected for comparison of prognostic performance.
 Objective — to investigate the dynamics of ferritin, IL-6, and human-beta-defensin-1 levels against the background of the intensive phase of pulmonary tuberculosis therapy and to identify the most effective marker for predicting the effectiveness of treatment.
 Materials and methods. 100 patients with pulmonary tuberculosis and 20 healthy individuals were included in the study. Examination of patients was carried out according to the current standards of providing medical care to tuberculosis patients. In addition, the patients' fasting blood ferritin, IL-6 and HBD-1 levels were determined at the beginning of treatment and after 60 days. Healthy individuals from the control group had a single determination of ferritin, IL-6 and HBD-1 blood levels on an empty stomach. 
 Results and discussion. At the beginning of treatment, the ferritin level was significantly lower (95.95 ± ± 8.68) ng/ml in patients who later effectively completed the intensive phase of anti-tuberculosis treatment than in patients with ineffective intensive phase of treatment (152.27 ± 8.85) ng/ml. The same trend persisted after 60 days: in the effective intensive phase — (123.87 ± 13.39) ng/ml, in the ineffective one — (239.76 ± 12.91) ng/ml, p < 0.05. In effective intensive phase of antituberculosis treatment, the level of IL-6 was significantly lower. Thus, at the beginning of treatment, it was (82.59 ± 6.89) pg/ml in patients with an effective intensive phase of treatment and (146.42 ± 8.04) pg/ml in patients with ineffective intensive treatment phase. After 60 days, it was (48.88 ± 4.19) pg/ml in patients with an effective intensive phase of treatment and (142.89 ± 9.11) pg/ml in patients with ineffective intensive treatment phase, p < 0.05. The level of HBD-1 was higher when the intensive phase of antituberculosis therapy was ineffective, as when measured at the beginning of treatment (effective intensive phase — (18.71 ± 3.31) pg/ml, ineffective intensive phase — (32.79 ± 8.31) pg/ml), as well as when measured after 60 days (effective intensive phase — (19.93 ± 3.58) pg/ml, ineffective intensive phase — (42.92 ± 12.99) pg/ml, p < 0.05).
 Conclusions. Levels of ferritin, IL-6 and HBD-1 are significantly increased in tuberculosis patients compared to healthy individuals, which allows them to be considered as markers of tuberculosis inflammation. Higher concentrations of these markers, both at the beginning of treatment and after 60 doses, are predictors of failure of antituberculosis therapy. The strongest relationship between the studied markers and parameters of the severity of the tuberculosis process is observed in the study of HBD-1, which allows us to consider it as the most effective marker of the severity of the course among presented ones.

Relationship between knowledge and medication adherence among patients with tuberculosis: a cross-sectional survey

Background: The World Health Organization (WHO) stated that treatment adherence is one determinant of the successful management of pulmonary tuberculosis therapy. Non-adherence can result in recurrence or treatment failure. Knowledge of tuberculosis is crucial for a patient's adherence to treatment, and the level is proportional to the information obtained. This study aimed to determine the relationship between the knowledge level of pulmonary tuberculosis and adherence to anti-tuberculosis drugs (ATD). Methods: This study is a non-experimental quantitative study with analytic correlation and a cross-sectional approach. Sampling was done at the Umbulharjo 1 Public Health Center, Yogyakarta, Indonesia, in November-December 2021, using purposive sampling with 43 respondents. The knowledge level and adherence were measured using a questionnaire and the Morisky Medication Adherence Scale (MMAS-8). Meanwhile, the relationship between the variables was analyzed using the Pearson Product Moment correlation test with a significance level of 95%. Results: The results showed that respondents with high, moderate, and low knowledge levels were 88.37%, 11.63%, and 0%, respectively. Respondents with high, moderate, and low adherence to ATD were 95.34%, 4.7%, and 0%, respectively. Furthermore, analysis of the relationship to taking ATD obtained a p-value of 0.001 (<0.05) and a correlation value (r) of 0.609. Conclusion: Most patients had high knowledge and adherence to medication, and the correlation showed a strong relationship between the variables and taking ATD.

The relationship between knowledge level and adherence to anti-tuberculosis treatment at primary health centers (Puskesmas) in Pekalongan city, Central Java, Indonesia

Background: Adherence is one of the most critical factors in the success of pulmonary tuberculosis therapy. Non-compliance of patients taking anti-tuberculosis drug results in a high rate of treatment failure, increasing the risk of disease severity and death.
 Objective: This study aims to investigate the impact of knowledge level on patient compliance in taking anti-tubercular medication.
 Methods: This observational, cross-sectional study employed a total sampling method. The levels of knowledge and compliance were assessed using a validated questionnaire administered to patients with pulmonary tuberculosis at the Pekalongan City health center (Puskesmas).
 Results: Among the 52 participants, 44.23% (n=23) demonstrated a high level of knowledge, and 86.5% (n=45) exhibited good compliance. Spearman correlation test analysis revealed a significant influence of knowledge level on patient compliance in taking antituberculosis drugs (p=0.001, r=0.341), indicating that higher knowledge levels correspond to better patient compliance.
 Conclusion: The study suggests that patient compliance with antitubercular medication improves as knowledge level increases.

Pharmacological Management of Pulmonary Tuberculosis: A Century of Expert Opinions in Cecil Textbook of Medicine.

Advances in drug therapy for pulmonary tuberculosis have had an extraordinary impact on the incidence of tuberculosis in the United States in the past century, which has decreased from 113/100,000 persons in 1920 to 2.2/100,000 in 2020. Modern treatments have contributed to a remarkable decrease in hospitalizations and mortality and have had a significant impact on the duration and severity of illness, quality of life, and work potential of affected persons. What are the milestones of the changes in the expert approach to the pharmacological management of pulmonary tuberculosis in the past century? To determine the changes in the experts' approach to the management of pulmonary tuberculosis, as presented in a widely used textbook in the United States. The chapters describing the management of pulmonary tuberculosis in the 26 editions of Cecil Textbook of Medicine published from 1927 through 2020. In the preantibiotic era (1927-1943), the Cecil authors emphasized rest, good food, and fresh air as the treatment pillars for pulmonary tuberculosis. The modern era (1947-1971) recorded the discovery of all the drugs that are still used for the initial treatment, in the following order: streptomycin, para-aminosalicylic acid, isoniazid, pyrazinamide, ethambutol, cycloserine, kanamycin, ethionamide, capreomycin, and rifampin. In the postmodern era (1975-2020), therapeutic advances continued with trials of many drug combinations aimed at ameliorating the duration of treatment, drug resistance adverse effects, and poor the recent addition of fluoroquinolones, bedaquiline, and clofazimine. The pharmacological management of tuberculosis has remained archaic until the middle of the 20th century. Fundamental progress occurred in a very short period (1947-1971) and was because of the recognition of the antituberculous effect of many antibiotics and chemotherapy agents. The challenges created by mycobacterial infections resistant to multiple drugs remain and have prompted the addition of new drugs in the past decade.

Proceedings of the 28th European Paediatric Rheumatology Congress (PReS 2022)

Proceedings of the 28th European Paediatric Rheumatology Congress (PReS 2022)

Tuberculosis of the Glans Penis: A Case Presentation with Review Literature

Background: Tuberculosis of the glans penis is a rare occurrence., even in developing nations. Aim and Object: To review the literature and case presentation of Tb of glans penis Methodology: Pakmedinet, Pubmed and google data were searched for Tb of glans penis. Literature Review: Tuberclosis of the penis can be primary or secondary, and it might look like penile cancer, penile ulcers (granulomatous), genital herpes simplex or HIV infection. Tb of the Penis can develop after a individual who had primary pulmonary Tb and can be spread through ejaculation, contamination of endometerium secretions or clothes, as a result of a previous pulmonary Tb or Tb somewhere else. Tb of the Penis is characterised by a tiny nodule on the penis that is either painless or painful, an ulcer, a mass that progressively increasing and be swelling. Palpation of inguinal lymph nodes and erection problems of the penis can or can not observed. Normally, the patient's voiding is normal. Biopsy or acid fast bacilli in penile discharge or positive Elisa serology or PCR for tuberculosis are used to confirm the diagnosis. Needs 6 months, pulmonary tuberculosis therapy. Conclusions: Tb of the glans penis is an uncommon occurrence. After a biopsy, antitubercular medications are the standard treatment, thus doctors should evaluate the potential of Tb of the penis in instances of penile lesions. Keywords: Tb, penis, presentatation management and review litrarature

Right pulmonary arterial thrombus in a patient with tuberculous destroyed lung syndrome: computed tomography angiographic findings and a case report.

Tuberculous destroyed lung syndrome (TDLS) is termed as total lung destruction from recurrent and chronic infections especially tuberculosis (TB). TDLS is almost an entity seen in adults and very rare in children. Pulmonary TB been a chronic infectious disease induces a systemic hypercoagulable state that causes pulmonary thromboembolism. This is a forty-year-old man been managed for pulmonary TB, presented from a peripheral health facility and came for a chest computed tomography angiography (CTA) on account of suspected thromboembolism. The CTA demonstrated a non-enhancing tubular structure/filling defect within the right pulmonary artery consistent with a thrombus. This measured about 51mm x 18mm in craniocaudal and mediolateral dimension. The thrombus is demonstrated to have caused dilatation and blockage of the right pulmonary artery. There is associated extensive destructive interstitial lung fibrosis bilaterally with air containing spaces consistent with the destroyed lung disease. Bilateral pleural thickening with turbid pleural effusion were also demonstrated bilaterally. A drainage tube was also noted within the right pleural space. A diagnosis of right pulmonary artery thrombus in a patient with tuberculous destroyed lung syndrome was made. The patient is currently on combined multi-drug therapy for pulmonary tuberculosis (rifampicin, isoniazid, ethambutol and pyrazinamide) and anticoagulant therapy with heparin to achieve anticoagulation. We present this case of pulmonary arterial thrombus coexisting with tuberculous destroyed lung syndrome due to its rare occurrence.

A Prospective Observational Study of Hepatic Dysfunction in Children on Antitubercular Drugs

The frequency, risk factors, and prognosis of antitubercular drug-induced liver injury (TB-DILI) was assessed in this prospective observational study. All consecutive children < 18 y put on antitubercular therapy (ATT) for pulmonary or extrapulmonary tuberculosis between July 2019 and December 2020 were included. Liver function tests (LFTs) were done at baseline and at 2, 4, 6 wk, and then 2 monthly after initiation of therapy till completion of ATT regimen.A total of 81 children [14.27 ± 3.38 y, 34 (42%) males] were included. Out of the patients enrolled, 10 (12.3%) developed TB-DILI at a median of 8.5 (3-18) d of starting ATT. All patients were symptomatic with the most common symptoms being anorexia and nausea (80%). A higher baseline ALT was independently associated with DILI with adjusted OR 2.1 (95% CI 1.3-3.4), p = 0.01. Eight patients tolerated reintroduction of ATT in a sequential manner, 9-24 d after discontinuation.

Inhalable Mannosylated Rifampicin-Curcumin Co-Loaded Nanomicelles with Enhanced In Vitro Antimicrobial Efficacy for an Optimized Pulmonary Tuberculosis Therapy.

Among respiratory infections, tuberculosis was the second deadliest infectious disease in 2020 behind COVID-19. Inhalable nanocarriers offer the possibility of actively targeting anti-tuberculosis drugs to the lungs, especially to alveolar macrophages (cellular reservoirs of the Mycobacterium tuberculosis). Our strategy was based on the development of a mannose-decorated micellar nanoformulation based in Soluplus® to co-encapsulate rifampicin and curcumin. The former is one of the most effective anti-tuberculosis first-line drugs, while curcumin has demonstrated potential anti-mycobacterial properties. Mannose-coated rifampicin (10 mg/mL)–curcumin (5 mg/mL)-loaded polymeric micelles (10% w/v) demonstrated excellent colloidal properties with micellar size ~108 ± 1 nm after freeze-drying, and they remain stable under dilution in simulated interstitial lung fluid. Drug-loaded polymeric micelles were suitable for drug delivery to the deep lung with lung accumulation, according to the in vitro nebulization studies and the in vivo biodistribution assays of radiolabeled (99mTc) polymeric micelles, respectively. Hence, the nanoformulation did not exhibit hemolytic potential. Interestingly, the addition of mannose significantly improved (5.2-fold) the microbicidal efficacy against Mycobacterium tuberculosis H37Rv of the drug-co-loaded systems in comparison with their counterpart mannose-free polymeric micelles. Thus, this novel inhaled nanoformulation has demonstrated its potential for active drug delivery in pulmonary tuberculosis therapy.

Population pharmacokinetics analyses of rifampicin in adult and children populations: A systematic review.

Rifampicin has become an essential component as the first-line therapy for pulmonary tuberculosis (PTB). Several population pharmacokinetic (PK) studies on rifampicin in adult and child populations have been studied previously, therefore the aims of the systematic review were (i) to summarize the relevant published studies and significant covariates that influence the PK of rifampicin across different populations, and (ii) to identify any knowledge gap that requires additional research in the future. A total of 121 relevant population PK articles were systematically identified using PubMed and Scopus from inception to October 2021. Review articles, in-vitro and physiological methods, animal studies and noncompartmental analysis were excluded. Nineteen studies, of which 16 involved adults, two involved children, and one involved both adults and children, were included in the review. The structural model of rifampicin can be described as one compartment with a transient compartment absorption model and first-order elimination in most of the studies. Pharmaceutical formulation, body weight, gender, pregnancy status, diabetes and nutritional supplementation were found to be the significant covariates that affect the PK parameters. External validation of the developed PK model was only conducted in two studies. The source of variability for PK parameters of rifampicin remains inconsistent and poorly understood even though there were many potential covariates investigated in the selected studies. Exploring other possible factors and implementing a strict sampling strategy by considering the induction effects might uncover precise and reliable information. Furthermore, external validation should be frequently conducted to produce better predictability of model performance.

Bruns–Garland syndrome precipitated by anti-tuberculous therapy in a patient with type 2 diabetes mellitus

India has a high prevalence of tuberculosis as well as diabetes mellitus, and both contribute to a major disease burden. Diabetes mellitus increases the risk of tuberculosis. Patients with diabetes are more prone to develop cavitary lesions than non-diabetics. Tuberculosis can worsen the glycemic status of an individual and anti-tuberculous drugs like Rifampicin can interact with oral anti-diabetic drugs, further worsening the glycemic control. This can result in complications related to diabetes, like diabetic amyotrophy. We hereby report the case of a 69-year-old gentleman with diabetes mellitus, who developed uncontrolled blood sugars, leading to Bruns Garland syndrome or diabetic amyotrophy on starting anti-tuberculous therapy for sputum positive pulmonary tuberculosis.

Cavernous ford pulmonary tuberculosis and kumis therapy

Questions of indications and contraindications for kumis treatment are still. are still in the center of attention of insurance and tuberculosis organizations. Existing instructions for the selection of patients and accounting for the results of sanatorium treatment, resp. kumis treatment, do not give satisfactory indications. For kumis treatment, tbc pulm is usually considered indicated. A I, II, III, B I, II, III. Any doctor working on TBK knows that each of these groups (A I, II, III, B I, II, III) can include and usually include pulmonary processes of different genesis, course and immuno-biological nature. So, for example, relatively benign forms of tbc tbc fibrosa densa, tbc fibro- nodosa and prognostically unfavorable phtisis fibro-caseosa and phtisis ulcero-fibrosa forms that are extremely different in clinical course and prognosis according to the existing classification, are included in the same group A II, III or B II, III.

Remote results of treatment in patients with pulmonary tuberculosis and previous ineffective therapy

Until recently, bedaquiline and linezolid were relatively unavailable in antituberculosis dispensaries. Patients that needed these drugs were directed to specialized Federal antituberculosis institutions. The study was aimed to evaluate remote results of the treatment of patients with drug-resistant pulmonary tuberculosis who had previous ineffective therapy at a local antituberculosis dispensary and directed to specialized Federal antituberculosis institutions. A total of 143 patients of both sexes aged 20-60 years old were examined. These patients received therapy at the Tver Regional Clinical Antituberculosis Dispensary in 2010-2014. To increase adherence to the treatment, a complex of measures were taken that included an individual session with a specialist, organization of communication with other patients that received effective therapy for tuberculosis, and watching of an educational video. A complex of measures on an increase in the adherence to the treatment among patients with pulmonary tuberculosis provided positive results in 143 patients. These patients agreed to possible surgical intervention in the Federal Antituberculosis Institution. After the surgical treatment, cavity closure and/or abacillation were registered in 132 patients. Adherence to the consumption of antituberculosis drugs significantly increased in the studied patients.

Laboratory evaluation of the efficacy of Liastene application in complex therapy of multiresistant pulmonary tuberculosis

OBJECTIVE. Evaluating according to laboratory tests the effectiveness of Liasten in the treatment of patients with multidrug-resistant pulmonary tuberculosis (MDR-TB).&#x0D; MATERIALS AND METHODS. Evaluation of the effectiveness of etiotropic and etiopathogenetic therapy in 57 patients with MDR-TB was performed. According to the treatment schemes, patients were divided into groups. The control group (n=22) received individualized antimycobacterial therapy (AMBT) regimens. The experimental group (n=35) received AMBT in combination with Liasten. Evaluation of the effectiveness of treatment regimens was performed on the basis of indicators of general clinical blood tests, immunological and bacteriological studies.&#x0D; RESULTS AND DISCUSSION. In patients of the experimental group, compared with the control in 1.5 times more often found positive changes in the hemogram of blood and ESR (p&lt;0.05-0.001), the establishment of a dynamic balance between the pools of lymphocyte cells CD4+ and СD8+ (immunoregulatory index, p&lt;0.05), an increase in the number of phagocytosis active cells (phagocytic index, p&lt;0.05), the content of cationic lysosomal proteins of granulocyte leukocytes (p&lt;0.05), a 1.4-fold decrease in the cytochemical coefficient of neutrophils (p&lt;0.05), the number of proliferated under the action of PPD-L lymphocytes (p&lt;0.05), normalization of phagocytic counts and total redox activity of neutrophils (p&lt;0.05), increase in frequency and reduction of anesthesia was stated.&#x0D; CONCLUSIONS. Restoration of the body’s immune status, blood hemogram, increase in frequency and reduction of the time of decontamination were more active and occurred 1.5 times more often in patients receiving a complex combination of AMBT with Liasten.