[Respiratory disorders of post-COVID-19 syndrome].

AIM: Assess the functional state of trespiratory system and effectiveness of therapeutic tactics for broncho-obstructive syndrome (BOS) in patients in the post-COVID period. MATERIALS AND METHODS: A two-center cohort prospective study included 10 456 and 89 patients, respectively. A comprehensive assessment of the respiratory system included clinical, laboratory and functional data, spirometry, body plethysmography, and a study of diffusive capacity of the lungs (DLCO). Therapy consisted of budesonide suspension or fixed combination beclomethasone dipropionate/formoterol (EMD BDP/FORM). RESULTS: The frequency of BOS in the cohort was 72% (7497 patients). In 13% (n=974) of cases, bronchial asthma was diagnosed for the first time, in 4.4% (n=328) - chronic obstructive pulmonary disease. Risk factors for the development and decrease in DLCO in the post-COVID period were identified. In the group of complex instrumental examination of lung function, the absence of violations of spirometric data and indicators determined by body plethysmography was determined. CONCLUSION: Risk factors for BOS in post-COVID period are atopy, a history of frequent acute respiratory infections, smoking, blood eosinophilia, moderate and severe forms of COVID-19. The advantage of a fixed combination of EMD BDP/FORM in MART mode compared with nebulized suspension budesonide + solution of salbutamol in treatment of BOS was shown. Risk factors for DLCO disorders were established: severe COVID-19, hospitalization in the intensive care unit, the need for additional oxygen therapy.

[Diagnostics of early signs of ocular pathology in patients with HIV/tuberculosis co-infection]. / Diagnostika rannikh priznakov patologii organa zreniia u patsientov s koinfektsiei VICh/tuberkulez.

INTRODUCTION: The current epidemic situation in Russia is characterized by increasing rate of co-infection (HIV/tuberculosis). Damage to the organ of vision is more common among patients with this pathology, presenting significant difficulties in diagnosis of the ophthalmic manifestations. High-tech imaging method - optical coherence tomography (OCT) allows exploration of the eye tissues with high accuracy and depth, as well as evaluation of the structure of the choroid and microcirculation parameters of the anterior and posterior eye segments.

Personalized Clinical Diagnosis in Data Bases for Treatment Support in Phthisiology.

The decision-making is a key event in the clinical practice. The program products with clinical decision support models in electronic data-base as well as with fixed decision moments of the real clinical practice and treatment results are very actual instruments for improving phthisiological practice and may be useful in the severe cases caused by the resistant strains of Mycobacterium tuberculosis. The methodology for gathering and structuring of useful information (critical clinical signals for decisions) is described. Additional coding of clinical diagnosis characteristics was implemented for numeric reflection of the personal situations. The created methodology for systematization and coding Clinical Events allowed to improve the clinical decision models for better clinical results.

[Clinical and morphological parallels in the validation of surgical treatment of nephrotuberculosi].

AIM: To Study clinical and morphological variants of kidney tuberculosis (KTB), for grounding a tactics of surgical treatment. MATERIALS AND METHODS: There were 107 examined patients (patients with cavitary lesions of kidneys: cavernous and multi-cavernous), operated in different phases of KTB. There were 56 men (52,3%) and women - 51(47,7%). The mean age of patients was 57,6 years (23-84 years). All the patients had a complex examination, including X-ray and ultrasound investigations, computer tomography ( was performed selectively), bacteriological examinations of urine and morphological examinations of removed kidneys or their parts. RESULTS AND DISCUSSION: Surgical interventions were as follows: open surgery nephrectomy 86/107 (80,4%), open organ-sparing surgery (resections of kidneys) 21/107 ( 19,6%). Mycobacterium tuberculosis were revealed by cultural method in 68,6% of cases in patients with cavernous KTB and in 76,3% of cases in patients with multi-cavernous KTB. In appliance with pathomorphological results of presented specimens, there were revealed 3 groups, each one with its own properties of cavern wall. I group (74 specimens) - stage of active progressing KTB, II group (20 specimens) - stage of intermediate activity, III group (13 specimens) - stage of healed caverns. Performed morphological investigations allowed us grounded a rational tactics of surgical treatment. It was defined that the longer specific anti-TB therapy was carried out the less frequency of TB progression we would have. However when it presented isolated cavitary lesion (isolated cavern), the performance of adequate and long courses of chemotherapy is not worth to do. Only surgical interventions (resection of infected tissue) with the anti-TB therapy allowed to reach the satisfactory results in treatment of KTB.

Draft Genome Sequence of Mycobacterium tuberculosis Strain E186hv of Beijing B0/W Lineage with Reduced Virulence.

We report a draft genome sequence of Mycobacterium tuberculosis strain E186hv, belonging to the Beijing B0/W lineage and isolated from a patient from Kurgan, Russia. This clinical isolate showed a reduced virulence phenotype unusual for this lineage and resistance to isoniazid, rifampin, ethambutol, pyrazinamide, and ofloxacin. We analyzed single nucleotide polymorphisms (SNPs) associated with virulence.