Количество страниц: 2 с.
The importance of the problem of preventing and treating tuberculosis in children living in a region with worrying epidemiological situation for tuberculosis has been emphasized. With the study of socio-medical risk factors, new and better approaches to conducting preventive treatment in pediatric population should be enabled. Prediction of outcomes of preventive chemotherapy should lead to better success rates for preventive measures and reduce the risk of development of localized forms of primary tuberculosis
Гуляева, Н. А. Особенности течения первичного туберкулеза у детей в зависимости от эпидемиологической ситуации в регионе / Н. А. Гуляева, М. К. Винокурова // Предупреждение распространения туберкулезной инфекции в циркумполярных регионах России. Актуальные проблемы сочетанных инфекций (ВИЧ/ТБ/гепатиты) — 2018. — С. 36-37.
Количество страниц: 4 с.
Since 2009, Churapchinsky antituberculosis dispensary has been working without inpatient beds. Patients treated on ambulatory basis receive everything necessary at medical posts arranged to deliver directly supervised treatment. Patients who need hospitalization are treated at the Phthisiatry Research-Practice Center in Yakutsk. Over the 7-year period of work without inpatient beds, meaningful improvement in epidemiological situation was observed: key epidemiological indicators decreased by a factor of 1.7-2.2, including the incidence of multidrug-resistant tuberculosis. In large part, this was due to cooperative interagency work, when rural agencies involved in healthcare, sanitation, epidemiology, education, law enforcement, and active community members cooperate at district (or nasleg) administration level. Healthcare workers of Churapchinsky antituberculosis dispensary conduct educational population outreach work on a regular basis, and provide coordination, guidance, and instruction to primary healthcare network of the district. Churapchinsky antituberculosis dispensary is actively interacting with the head facility for tuberculosis, Phthisiatry Research-Practice Center, on the issues related to hospitalization, surgical treatment, and curator advice
Гулька, И. И. Работа Чурапчинского ПТД в условиях без стационара / И. И. Гулька, С. Д. Белолюбская // Предупреждение распространения туберкулезной инфекции в циркумполярных регионах России. Актуальные проблемы сочетанных инфекций (ВИЧ/ТБ/гепатиты) — 2018. — С. 33-35.
Количество страниц: 6 с.
Presented in the article, are activities that the Phthisiatry Research-Practice Center undertook, with support from the Northern Forum, to address the problem of tuberculosis in circumpolar territories. Dedication of the managerial staff, along with focused efforts to make visible the problem of tuberculosis in extreme Arctic and northern circumstances, allowed the Phthisiatry Center earn its place in a number of international and Russian projects, and membership in the working groups of ICS-TB (International Circumpolar Surveillance for Tuberculosis) and Northern Forum. Collaborative projects are intended to thoroughly study the specifics of northern regions, characterize common trends, outline ways to begin to solve problems, expand and contribute to world science the knowledge about circumpolar areas, increase awareness about epidemiological situation in other regions with similar climate, geographic conditions, and common spatial, social, and economic challenges
Винокурова, М. К. Участие НПЦ "Фтизиатрия" в проектах ICS-ТВ и Северного форума по мониторингу инфекционных заболеваний / М. К. Винокурова, А. Ф. Кравченко // Предупреждение распространения туберкулезной инфекции в циркумполярных регионах России. Актуальные проблемы сочетанных инфекций (ВИЧ/ТБ/гепатиты) — 2018. — С. 29-33.
Количество страниц: 4 с.
Presented is a comparative analysis of various techniques to perform reamputation of the main bronchus stump, in 30 patients, who had bronchial fistulas with various localizations and pleural empyema with various severity. High success rate of surgical treatment (90%) was observed in patients treated via pleural space approach during the first three days after bronchial fistula developed, and in the absence of visible manifestations of empyema development. Treatment effectiveness was fairly high (95%) in patients, who had leakage in the left main bronchus stump and signs suggesting presence of chronic empyema, and who were treated using collateral technique of stump amputation. In patients with leakage in right main bronchus stump and chronic empyema, with surgery performed via transsternal-transpericardial approach, treatment effectiveness was 70%. Development of rational tactic for using various surgery techniques to treat main bronchus stumps depending on severity of pleural empyema helped avoid troublesome complications after surgery and achieve the best possible treatment success rate
Винокуров, И. И. Сравнительный анализ различных методов повторной ампутации культи главного бронха / И. И. Винокуров, А. Ф. Кравченко // Предупреждение распространения туберкулезной инфекции в циркумполярных регионах России. Актуальные проблемы сочетанных инфекций (ВИЧ/ТБ/гепатиты) — 2018. — С. 27-29.
Количество страниц: 6 с.
2000 WHO guidelines for treatment of multidrug-resistant tuberculosis recommend chemotherapy duration of 18 to 24 months, while neglecting the use of surgical treatment. In particular, the guidelines contained no optimal time to surgery or surgical interventions for patients with irreversible destructive alterations. We used patterns of morphogenesis in multidrug-resistant tuberculosis to develop an algorithm to organize and manage the surgical treatment of patients. Based on algorithm, patients are distributed depending on their disease course patterns: extensive destructive disease or limited forms of tuberculosis. For patients with extensive destructive tuberculosis, an optimal time for surgery is between months 4-6 during intensive phase, when tuberculosis has proliferative disease course. In patients who have limited localized disease, surgery is optimal between months 3-4 since the start of chemotherapy (90-120 doses). Analysis of surgical treatment results in patients with multidrug-resistant tuberculosis showed high effectiveness of multimodal treatment in 93.1% of patients with extensive disease (exacerbation was observed in 6.9%), and in 97.6% of patients with localized multidrug-resistant tuberculosis (with exacerbation in 2.4%)
Винокуров, И. И. Особенности организации хирургического лечения больных с множественной лекарственной устойчивостью туберкулеза легких в условиях региона Крайнего Севера / И. И. Винокуров, А. Ф. Кравченко // Предупреждение распространения туберкулезной инфекции в циркумполярных регионах России. Актуальные проблемы сочетанных инфекций (ВИЧ/ТБ/гепатиты) — 2018. — С. 22-27.
Количество страниц: 6 с.
Over the period from 2011 to 2016, an increase in proportion of multidrug-resistant cases among pulmonary tuberculosis patients with positive microscopy and/or culture (MTB+) has been observed in Ust-Aldansky district of the Sakha Republic (Yakutia). Proportion of multidrug-resistant (MDR) cases among newly identified patients increased by a factor of 1.2 (from 27.3% to 33.3%), but remained below the all-republic level (34.6%). It should be bared in mind, that in most (68.4%) patients with MDR, resistance is, as a rule, to 3-5 or more antitubercular agents. Effective outcomes in patients, who were started on chemotherapy regimen IV during the period from 2011 to 2014, were observed in 64%, while 4% had treatment failure. We observed high rates of treatment interruptions (12%), mortality from tuberculosis (12%), and proportions of cases transferred out to Directorate of Penitentiary Service (8%), which was attributed to the majority of patients with MDR belonging to socially marginalized population groups (65.8%) often associated with treatment non-compliance and defaulting from regular medical check-ups. Successful treatment outcome in patients with MDR largely depends on well-orchestrated work of all relevant agencies, and primarily, must be supported by heads of local administrations and active members of communities in each of the districts, ‘naslegs', or settlements. All these efforts should be aimed at making sure to hospitalize these categories of patients for motivated long-term treatment
Бурнашев, И. П.Характеристика и исходы лечения больных туберкулезом с множественной лекарственной устойчивостью в Усть-Алданском районе Якутии / И. П. Бурнашев, Л. П. Яковлева // Предупреждение распространения туберкулезной инфекции в циркумполярных регионах России. Актуальные проблемы сочетанных инфекций (ВИЧ/ТБ/гепатиты) — 2018. — С. 18-22.
Количество страниц: 6 с.
Presented are the results of implementing minimally invasive surgical procedures in osteoarticular tuberculosis at the Department for Osteoarticular and Urogenital Tuberculosis. As was shown, based on retrospective comparative analysis of time to analgesic demands in patients after minimally invasive surgical procedures or surgeries via classical approach, minimally invasive procedures were associated with considerably shorter duration of pain syndrome and analgesic demand, without sacrificing the quality of diagnosis
Бульший, Н. Ю. Современные методы малоинвазивной диагностики и дифференциальной диагностики туберкулеза костей и суставов / Н. Ю. Бульший // Предупреждение распространения туберкулезной инфекции в циркумполярных регионах России. Актуальные проблемы сочетанных инфекций (ВИЧ/ТБ/гепатиты) — 2018. — С. 14-18.
Количество страниц: 4 с.
Presented are trends over time (2012-2016) in key epidemiological indicators for tuberculosis in Megino-Kangalassky district of the Sakha Republic (Yakutia), a region with high risk of tuberculosis transmission. Negative trend to increase in multidrug-resistant tuberculosis has been observed. Nevertheless, by conducting a scope of multifaceted measures, we were able to meaningfully improve treatment effectiveness in new cases, and effectiveness of regular medical check-up of existing pool of tuberculosis patients
Борисова, Е. С. Эпидемиологическая ситуация по туберкулезу и показатели туберкулеза множественной лекарственной устойчивостью в Мегино-Кангаласском районе Якутии / Е. С. Борисова // Предупреждение распространения туберкулезной инфекции в циркумполярных регионах России. Актуальные проблемы сочетанных инфекций (ВИЧ/ТБ/гепатиты) — 2018. — С. 12-14.
Количество страниц: 4 с.
Tuberculosis remains a social disease with a high prevalence over the world. The problem of tuberculosis is inseparable from the deterioration in population socio-economic standard of living. Tuberculosis infection reservoir is currently observed to grow, largely due to risk groups, and primarily, vulnerable, socially marginalized population groups. Socially vulnerable groups include homeless individuals, internal and external (near and far abroad), refugees from zones of ethnic or local military conflicts, unemployed, chronic alcohol and drug abusers, prisoners, and residents of shelters for disabled or elderly people. Social marginalization (so called de-adaptation) is the core underlying reason to why these patient groups have higher detection rates of extensive destructive tuberculosis with advanced stages or with primary drug resistance (including multidrug resistance), associated, as a result, with low success rates of multimodal treatment
Организация и проведение профилактического флюорографического обследования социально уязвимой группы населения г. Якутска / Е. Д. Апросимов, Л. П. Шепелева, А. М. Лукина и [другие] // Предупреждение распространения туберкулезной инфекции в циркумполярных регионах России. Актуальные проблемы сочетанных инфекций (ВИЧ/ТБ/гепатиты) — 2018. — С. 10-12.
Количество страниц: 8 с.
Analysis of trends in statistics for smear-positive patients (MTB+) over the period from 2011 to 2016 showed that number of registered MTB+ patients with active pulmonary tuberculosis had decreased during the study period, both among all cases, and among new cases. Nonetheless, the size of infection reservoir defined as the number of MTB+ patients remains at high levels. We observed high rates of prevalence for drug-resistance, including multidrug resistance and extensive drug resistance (MDR and XDR). Prevalence rates of tuberculosis cases with MDR in Yakutia in the years 2013 to 2015 were higher than the same rates over Russian Federation by factors of 1.7-1.8-1.6, but showed a trend to decrease compared to the rates in the Far East Federal District. High proportion of newly identified patients with MDR among patients with drug-resistant tuberculosis (up to 68.5%) suggests the emergence of a totally new-made tuberculosis infection reservoir with resistance to first-line drugs. The policy pursued and supported in the Sakha Republic (Yakutia) is aimed at strengthening laboratory capabilities, adopting novel diagnostic technologies, improving epidemiologic surveillance, while supporting the currently running state programs against tuberculosis, and considering the currently observed decrease in tuberculosis incidence, this could lead to beneficial effect on existing and future burden of drug-resistant tuberculosis
Микробиологическая диагностика туберкулеза в Республике Саха (Якутия) / Г. И. Алексеева, М. В. Черных, Н. Г. Павлов [и другие] // Предупреждение распространения туберкулезной инфекции в циркумполярных регионах России. Актуальные проблемы сочетанных инфекций (ВИЧ/ТБ/гепатиты) — 2018. — С. 3-10.