Low rates of recurrence after successful treatment of multidrug-resistant tuberculosis in Tomsk, Russia.

SETTING: Tomsk, Russia, where multidrug-resistant tuberculosis (MDR-TB) is prevalent. OBJECTIVES: To report rates of recurrence following successful treatment of MDR-TB in a program providing individualized treatment regimens designed according to the current global standard of care. DESIGN: A retrospective cohort study of 408 adults successfully treated for pulmonary MDR-TB from 10 September 2000 to 1 November 2004, and followed for up to 6 years post-treatment. We used Poisson regression with generalized estimating equations to assess whether recurrence rates changed significantly with time. RESULTS: We analyzed 399 (97.5%) patients with at least one follow-up visit (15 850 person-months of observation [PMO]). Baseline resistance to second-line drugs was common (65.2%); 398 patients (99.7%) were human immunodeficiency virus (HIV) negative. In the first year of post-treatment follow-up, there were six episodes of recurrence (1.4/1000 PMO, 95%CI 0.5-3.0). After the first post-treatment year, there were 21 episodes of recurrence (1.8/1000 PMO, 95%CI 1.1-2.8). The rate did not change significantly with time. CONCLUSION: Individualized regimens designed according to the current global standard of care achieved low rates of MDR-TB recurrence among non-HIV-infected persons treated in a programmatic setting.

[Laboratory service optimization in the implementation of a complex programme for detection and treatment patients with tuberculosis].

The paper presents a model of laboratory service in implementing a complex program aimed at detecting and treating patients with tuberculosis in the Tomsk Region. Organizational, methodological, and managerial measures to set up bacteriological stations and a main (reference) laboratory for microbiological sputum study in Tomsk, intensification of this work at all clinical-and-diagnostic laboratories of general health care facilities have improved the quality of the whole system detecting bacterial isolators and ensured a close organizational and methodological interaction between the therapeutic-and-diagnostic institutions of the general medical system and tuberculosis-controlling service.

[Balanced vegetarian diet in combined rehabilitation of patients suffering from ischemic heart disease]. / Opyt ispol'zovaniia sbalansirovannoi vegetarianskoi diety v kompleksnoi reabilitatsii bol'nykh izhemicheskoi bolezn'iu serdtsa.

The clinical status of 30 patients suffering from ischemic heart disease, their serum lipids and other biochemical parameters, exercise tolerance were studied. 20 patients from the group were on a specially developed antiatherosclerosis vegetarian diet VA-1; the control group comprised 10 patients who had a mixed diet A-1. It is shown that the vegetarian diet used made it possible to normalize the serum lipid spectrum, the levels of the blood pressure, to increase the tolerance to exercise, to eliminate functional disturbances of the digestive system. The investigation demonstrated the effectiveness of the vegetarian diet as a means of rehabilitation of patients suffering from ischemic heart disease.

[Feasibility of correcting lipid metabolism in patients with cardiovascular diseases using a balanced vegetarian diet]. / Vozmozhnosti korrektsii obmena lipidov u bol'nykh s serdechno-sosudistoi patologiei s pomoshch'iu sbalansirovannoi vegetarianskoi diety.

The spectrum of lipids in 20 patients with dyslipoproteinemia type IIa and IIb (group I and group II) was studied. The patients were treated for 24 days with a lactoovovegetarian diet used for the first time in the country. No drugs were employed. A decrease in the levels of cholesterol, atherogenic lipoproteins and atherogenic coefficient was observed after the treatment. The patients, who were offered a questionnaire highly appreciated the diet.