Tuberculosis

Clin Evid (Online). 2011 Mar 11;2011. pii: 0904.

Tuberculosis (HIV-negative people).

Ziganshina LE, Eisenhut M.

Kazan State Medical Academy, Kazan, Russia.

Abstract

INTRODUCTION: About one third of the world’s population has latent tuberculosis. In 2004, more than 14 million people had active tuberculosis. About 1.7 million people died from the infection in 2006. More than 80% of new cases diagnosed in 2004 were in people in Africa, South-East Asia, and Western Pacific regions.

METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions to prevent tuberculosis in people without HIV infection at high risk of developing tuberculosis? What are the effects of interventions to prevent tuberculosis in people without HIV infection at high risk of developing multidrug-resistant tuberculosis? What are the effects of different drug regimens in people with newly diagnosed pulmonary tuberculosis without HIV infection? What are the effects of different drug regimens in people with multidrug-resistant tuberculosis without HIV infection? What are the effects of low-level laser therapy in people with tuberculosis without HIV infection? Which interventions improve adherence to treatment in people with tuberculosis without HIV infection? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).

RESULTS: We found 32 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.

CONCLUSIONS: In this systematic review, we present information relating to the effectiveness and safety of the following interventions: adding pyrazinamide in chemotherapy regimens lasting up to 6 months, adding rifampicin to isoniazid regimens, benefits of different regimens, chemotherapy for <6 months, daily chemotherapy, direct observation treatment, intermittent chemotherapy for 6 months or longer, isoniazid, low-level laser therapy for pulmonary tuberculosis, regimens containing quinolones, rifampicin plus isoniazid, substituting rifampicin with ethambutol in the continuous phase, and support mechanisms for directly observed treatment.

Clin Evid (Online). 2009 Apr 14;2009. pii: 0904.
 

Tuberculosis (HIV-negative people).

Ziganshina LE, Garner P.

Health Action International, Amsterdam, The Netherlands.

INTRODUCTION: About a third of the world’s population has latent tuberculosis. In 2004, over 14 million people had active tuberculosis. Approximately 1.7 million people died from the infection. Over 80% of new cases diagnosed in 2004 were in people in Africa, South-East Asia, and Western Pacific regions.

METHODS ANDOUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions to prevent tuberculosis in people without HIV infection at high risk of developing tuberculosis? What are the effects of interventions to prevent tuberculosis in people without HIV infection at high risk of developing multidrug-resistant tuberculosis? What are the effects of different drug regimens in people with newly diagnosed pulmonary tuberculosis without HIV infection? What are the effects of different drug regimens in people with multidrug-resistant tuberculosis without HIV infection? What are the effects of low-level laser therapy in people with tuberculosis without HIV infection? Which interventions improve adherence to treatment in people with tuberculosis without HIV infection? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2008 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).

RESULTS: We found 31 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.

CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: adding pyrazinamide in chemotherapy regimens lasting up to 6 months; adding rifampicin to isoniazid regimens; benefits of different regimens; chemotherapy for less than 6 months; daily chemotherapy; direct observation treatment; intermittent chemotherapy for 6 months or longer; isoniazid; low-level laser therapy for pulmonary tuberculosis; regimens containing quinolones; rifampicin plus isoniazid; substituting rifampicin with ethambutol in the continuous phase; and support mechanisms for directly observed treatment.

Probl Tuberk Bolezn Legk. 2008;(4):35-8.

Laser therapy in the complex treatment of prostative tuberculosis at the sanatorium stage of rehabilitation

[Article in Russian]

Shakirov RG, Pavlov VN, Iagafarova RK.

Seventy nine patients with prostatic tuberculosis were examined and treated at the specialized “Glukhovskaya” sanatorium. All the patients were divided into 2 groups: a study group and a control one. In the study group patients, low-intensity laser radiotherapy was additionally performed in combination with etiological and pathogenetical treatments. The performed studies demonstrated that in the patients exposed to low-intensity laser radiation, there was a rapid relief of dysuric symptoms, cessation or diminishment of the signs of copulative dysfunction; positive changes in life quality indices and laboratory parameters were statistically significantly more frequently and more rapidly recorded. Laser therapy simultaneously was found to affect a few links of the pathogenesis of genitourinary tuberculosis, to have limited number of contraindications, to be well tolerated, and to be an effective method of the complex treatment of patients with prostatic tuberculosis during sanatorium rehabilitation.

Lik Sprava. 2007 Apr-May;(3):42-6.

Patients with tuberculosis associated with chronic non-specific lung diseases

[Article in Ukrainian]

Nikolaieva OD.

159 patients have been observed to assess the efficiency of laseropuncture use in a complex treatment of patients with lung tuberculosis and chronic bronchitis. Disbalance in renal meridian (R), urinary bladder (V) and insufficiency of the energy in colon meridian (60.3%) were observed in patients with tuberculosis associated with chronic bronchitis. Medium deviations of electro-skin conductivity from the physiological gape in meridians of GI, IG, F, V, R in patients with tuberculosis associated with chronic bronchitis considerably differ from those data obtained from patients with only tuberculosis. Obtained data testify more severe disorders of energy balance in meridians of patients having except tuberculosis other associated diseases. Medium parameters of deviations from the physiological gape considerably decrease after the course of laseropuncture compared with those patients treated traditionally. Improve of the course of the chronic bronchitis was noted in patients who underwent laseropuncture.

Cochrane Database Syst Rev. 2006 Apr 19;(2):CD003490.

Low level laser therapy for treating tuberculosis.

Vlassov VV, MacLehose HG.

Russian Branch of the Nordic Cochrane Centre, PO Box 13, Moscow, Russia, 109451. vlassov@cochrane.ru

Update of:

  • Cochrane Database Syst Rev. 2002;(3):CD003490.

BACKGROUND: The main treatment for tuberculosis is antituberculous drugs. Low level laser therapy is used as an adjunct to antituberculous drugs, predominantly in the former Soviet Union and India.

OBJECTIVES: To compare low level laser therapy plus antituberculous drugs with antituberculous drugs alone for treating tuberculosis.

SEARCH STRATEGY: We searched the Cochrane Infectious Diseases Group Specialized Register (December 2005), CENTRAL (The Cochrane Library 2005, Issue 4), MEDLINE (1966 to December 2005), EMBASE (1974 to December 2005), CINAHL (1982 to December 2005), Science Citation Index (1945 to December 2005), PEDro (1929 to December 2005), the Central Medical Library of Moscow catalogue (1988 to June 2005), the internet, and reference lists of articles. We contacted relevant organizations and researchers for the original version.

SELECTION CRITERIA: Randomized trials comparing low level laser therapy plus antituberculous drugs with antituberculous drugs alone in people with tuberculosis.

DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality and extracted data, including adverse events.

MAIN RESULTS: One randomized controlled trial (130 participants) conducted in India met the inclusion criteria. This trial was poorly reported, with no information on the generation of allocation sequence or allocation concealment. The trial report did not provide details on the group that each of the participants were randomized into or which group those participants that left the trial were from. This precluded the use of its data on time to sputum conversion and other outcome measures for analysis.

AUTHORS’ CONCLUSIONS: The use of low level laser therapy for treating tuberculosis is still not supported by reliable evidence. Researchers need to focus on conducting well-designed randomized controlled trials to justify the continued participation of volunteers for studies of this experimental intervention.

Photomed Laser Surg. 2005 Dec;23(6):571-4.

Helium-neon and nitrogen laser irradiation accelerates the phagocytic activity of human monocytes.

Hemvani N, Chitnis DS, Bhagwanani NS.

Department of Microbiology and Immunology, Choithram Hospital & Research Centre, Indore, India.

OBJECTIVE: Intracellular survival of mycobacteria within monocytes is a crucial stage in the pathogenesis of tuberculosis. The aim was to check intracellular survival of Mycobacterium fortuitum within the human monocytes exposed to He-Ne and nitrogen laser irradiation.

BACKGROUND DATA: Tuberculosis remains one of the most important infectious diseases for developing countries. Low-level laser therapy (LLLT) has been tried to treat tubercular cavitory lung disease with encouraging results. The in vitro photobiological effect of low level laser radiation on the intracellular mycobacteria needs to be evaluated before we could go for large clinical trials.

METHODS: The aliquots of human monocytes from peripheral blood of healthy volunteers and tuberculosis cases were exposed to He-Ne or nitrogen laser beam. The non-irradiated monocytes from the same source served as controls. The monocytes were then challenged with M. fortuitum, and surviving mycobacteria within monocytes were subjected to viable counts.

RESULTS: Enhanced killing of mycobacterial cells was seen among monocytes exposed to He-Ne and nitrogen laser irradiation.

CONCLUSIONS: He-Ne and nitrogen laser irradiation activates the monocytes to increase intracellular killing of mycobacteria.

Urologiia. 2004 Jul-Aug;(4):34-7.

Male genital tuberculosis in West Siberia

[Article in Russian]

Kul’chavenia EV, Khomiakov VT, Zhukova II.

Clinical picture and structure of male genital tuberculosis were analyzed basing on case histories of Novosibirsk regional tuberculous hospital (outpatient department): 42 patients with tuberculous epidydymitis and 58 patients with prostatic tuberculosis. Efficiency of combined etiopathogenetic treatment was estimated in 91 patients admitted to the Urogenital clinic of Novosibirsk Research Institute of Tuberculosis. These patients received polychemotherapy alone (control group) or in combination with laser therapy (study group). Combination of polychemotherapy with laser radiation proved more effective than polychemotherapy alone.

Indian J Chest Dis Allied Sci. 2003 Jan-Mar;45(1):19-23.  

 

Role of gallium arsenide laser irradiation at 890 nm as an adjunctive to anti-tuberculosis drugs in the treatment of pulmonary tuberculosis.

Puri MM, Arora VK.

Department of Tuberculosis and Chest Diseases, LRS Institute of Tuberculosis and Allied Diseases, Sri Aurobindo Marg, New Delhi, India.

BACKGROUND: Tuberculosis is a global emergency with about nine million people developing disease every year. The long duration of treatment has emerged as a major obstacle in the control of tuberculosis. There is a need for development of new drugs and or shortened therapy.

METHODS: The present study was carried out to explore whether any benefit could be achieved by the addition of low level energy laser therapy (LLLT) to the conventional anti-tubercular chemotherapy. One-hundred-thirty new sputum smear positive patients of pulmonary tuberculosis were enrolled to evaluate the bio-stimulatory effects of Gallium Arsenide laser irradiation at 890 nm, as an adjuvant therapy. These patients were randomly divided into two groups to receive either LLLT or sham irradiation (control) concomitantly with anti-tuberculosis chemotherpy.

RESULTS: The patients treated with semiconductor laser as an adjuvant therapy along with anti-tuberculosis drugs had a faster clearance of tubercle bacilli from the sputum as compared to the control group (P value at :45 days=0.1392, 60 days=0.0117, 75 days=0.00805, 90 days=0.00739).

CONCLUSIONS: These findings provide preliminary evidence that low level laser therapy with Gallium Arsenide laser may be a promising adjunctive therapy for patients with tuberculosis. Faster conversion of sputum should prevent the development of resistant mutants.

Probl Tuberk Bolezn Legk. 2003;(6):28-33.

Combined low-intensity laser radiation in renal tuberculosis

[Article in Russian]

Parmon EM, Borshchevski? VV, Kamyshnikov VS, Bortkevich LG.

Combined external radiation in the projection of the kidneys and intravascular laser blood radiation by applying an AZOR-2K apparatus were used in the combined treatment of 54 patients with tuberculosis of the urinary system. Analysis of the biochemical and immunological parameters of the patients’ peripheral blood before and 3 weeks and 3 months after the combined treatment provided evidence suggesting a decrease in the magnitude of lipid peroxidation, an increase in the antioxidative status, and a reduction in the level of metabolites that affect on the development of the intoxication syndrome. The clinical findings suggest that the combined treatment has a beneficial impact on the course of renal tuberculosis, as appeared as better functional indices of urinary organs.

Probl Tuberk. 2002;(8):16-8.  

 

Efficiency of supra-venous blood laser radiation used in the treatment of disseminated pulmonary tuberculosis in adolescents.

 [Article in Russian]
 

Rusakova LI, Dobkin VG, Ovsiankina ES.

In 19 of 40 adolescent patients with disseminated pulmonary tuberculosis, supravenous blood laser radiation was used in the complex treatment 2-3 weeks after the initiation of chemotherapy. The use of this type of laser therapy enhanced the efficiency of the treatment, accelerated positive changes of tuberculosis by 2.5-3.5 months, as evidenced by clinical and laboratory parameters, led to a smooth course of tuberculosis to develop less pronounced residual changes in the lung.

Cochrane Database Syst Rev. 2002;(3):CD003490.  

 

Low level laser therapy for treating tuberculosis.

 Vlassov VV, Pechatnikov LM, MacLehose HG.

Russian Branch, The Cochrane Collaboration, PO Box 54, Moscow, Russia, 127238. vlassov@cochrane.ru

BACKGROUND: The main treatment for tuberculosis is antituberculous drugs. Low energy laser therapy is used as an adjunct to antituberculous drugs, predominantly in the former Soviet Union and India.

OBJECTIVES: To assess the benefits and harms of low level laser therapy for treating tuberculosis in randomized and quasi-randomized controlled trials. To seek information about potential benefits or harms from observational studies.

SEARCH STRATEGY: We searched the Cochrane Infectious Diseases Group specialized trials register (up to June 2001), the Cochrane Controlled Trials Register (Issue 1, 2001), MEDLINE (1966 to December 2001), EMBASE (1988 to December 2001), CINAHL (up to November 2001), PEDro (up to November 2001), the Science Citation Index (up to December 2001), National Centre for Science Information at the Indian Institute of Science (15 April 2002), electronic catalogue of the Central Medical Library (Moscow; 1988 to January 2002), the internet using ‘Google’ (21 January 2002), and reference lists of articles. We contacted relevant organizations and researchers.

SELECTION CRITERIA: (1) Randomized and quasi-randomized controlled trials comparing low level laser therapy with no low level laser therapy in people with tuberculosis. We also conducted a subsidiary analysis of of the potential benefits and harms from observational studies.

DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality and extracted data. We contacted study authors for additional information. Adverse event information was collected from the studies.

MAIN RESULTS: No randomized or quasi-randomized controlled trials met the inclusion criteria for the review. The potential benefits and harms from 29 observational studies involving over 3500 people are described.

REVIEWER’S CONCLUSIONS: We have not identified any well designed trials using low level laser therapy (LLLT) to treat tuberculosis. Therefore, the use of LLLT to treat tuberculosis is not supported by reliable evidence.

Urologiia. 2001 Nov-Dec;(6):13-7.

Low-intensity laser irradiation in patients with urinary tuberculosis

[Article in Russian]

Parmon EM, Borshchevski? VV, Bortkevich LG.

Combined surface radiation of renal projection area and intravascular laser radiation of blood (AZOR-2K unit) were used in combined treatment of 54 patients with urinary tuberculosis. Analysis of immunological and hematological indices of peripheral blood of patients before and after the combined treatment showed that low-intensity laser radiation activates local system of T-helpers which after specific antigenic impact differentiate into T-helpers-1. The latter synthesize in loco gamma-interferon, TNF-alpha and beta and IL-2 stimulating bactericidal mechanisms directed at destruction of M. tuberculosis and resolution of the infection focus.

Probl Tuberk. 2000;(1):14-7.  

 

Intravenous laser radiation treatment of acute and progressive forms of tuberculosis in teenagers

 [Article in Russian]
 

Ovsiankina ES, Firsova VA, Dobkin VG, Rusakova LI.

In 25 of 44 teenagers suffering from acute and progressive tuberculosis, intravenous blood laser radiation was included into its multimodality treatment following 2-4 weeks of the initiation of chemotherapy. The use of laser enhanced the efficiency of treatment, accelerated positive changes by 1.5-2 months by major clinical and laboratory indices, made the disease run smoothly and caused less pronounced residual changes in the lung.

Probl Tuberk. 2000;(2):18-21.  

 

Magnetic laser therapy in combination with lymphotropic drugs administration in treating teenagers with common forms of tuberculosis

[Article in Russian]

Ovsiankina ES, Dobkin VG, Kobulashvili MG, Rusakova LI, Gubkina MF.

The paper shows the efficiency of combined use of magnetic laser therapy (MLT) and lymphotropic drug therapy in 40 teenagers with common forms of tuberculosis. The use of laser makes it possible to modify methods of regional lymphotropic therapy, to prolong its use and increase indications for it. MLT in combination with lymphotropic drug therapy accelerates positive changes and hence enhances the efficiency of tuberculosis treatment.

Probl Tuberk. 2003;(6):28-33.  

 

Combined low-intensity laser radiation in renal tuberculosis

 [Article in Russian]

Parmon EM, Borshchevskii VV, Kamyshnikov VS, Bortkevich LG.

Combined external radiation in the projection of the kidneys and intravascular laser blood radiation by applying an AZOR-2K apparatus were used in the combined treatment of 54 patients with tuberculosis of the urinary system. Analysis of the biochemical and immunological parameters of the patients’ peripheral blood before and 3 weeks and 3 months after the combined treatment provided evidence suggesting a decrease in the magnitude of lipid peroxidation, an increase in the antioxidative status, and a reduction in the level of metabolites that affect on the development of the intoxication syndrome. The clinical findings suggest that the combined treatment has a beneficial impact on the course of renal tuberculosis, as appeared as better functional indices of urinary organs.

Urologiia. 2001 Nov-Dec;(6):13-7.  

 

Low-intensity laser irradiation in patients with urinary tuberculosis

 [Article in Russian]

Parmon EM, Borshchevskii VV, Bortkevich LG.

Combined surface radiation of renal projection area and intravascular laser radiation of blood (AZOR-2K unit) were used in combined treatment of 54 patients with urinary tuberculosis. Analysis of immunological and hematological indices of peripheral blood of patients before and after the combined treatment showed that low-intensity laser radiation activates local system of T-helpers which after specific antigenic impact differentiate into T-helpers-1. The latter synthesize in loco gamma-interferon, TNF-alpha and beta and IL-2 stimulating bactericidal mechanisms directed at destruction of M. tuberculosis and resolution of the infection focus.

Probl Tuberk. 2002;(8):16-8.  

 

Efficiency of supra-venous blood laser radiation used in the treatment of disseminated pulmonary tuberculosis in adolescents

[Article in Russian]

Rusakova LI, Dobkin VG, Ovsiankina ES.

In 19 of 40 adolescent patients with disseminated pulmonary tuberculosis, supravenous blood laser radiation was used in the complex treatment 2-3 weeks after the initiation of chemotherapy. The use of this type of laser therapy enhanced the efficiency of the treatment, accelerated positive changes of tuberculosis by 2.5-3.5 months, as evidenced by clinical and laboratory parameters, led to a smooth course of tuberculosis to develop less pronounced residual changes in the lung.

Probl Tuberk. 1998;(4):29-31.

Effects of low-intensity laser irradiation on hormonal responsiveness of patients with pulmonary tuberculosis

[Article in Russian]

Egorova IL, Maliev BM, Sorokina IA, Ermakova GI, Tarnueva OK.

To examine the impact of low-intensive laser radiation (LILR) on endocrine function in patients with pulmonary tuberculosis, the time course of blood levels of thyroid hormones, cortisol, and insulin was studied in 117 patients of whom 64 received complex treatment by using LILR. Pulmonary tuberculosis was ascertained to be characterized by a marked hormonal imbalance, including impaired metabolism of thyroid hormones, hypercorticism, altered pancreatic incretion, which negatively affects the efficiency of antituberculosis therapy. Intravenous and epicutaneous therapy promotes recovery of endocrine responsiveness and enhances the efficiency of treatment in patients with pulmonary tuberculosis.

Probl Tuberk. 1997;(4):23-6.

Use of immunochemical studies to predict the course of fibrous cavernous tuberculosis of lung and postoperative complications in patients on chemo and laser therapy

[Article in Russian]

Sergeeva LV, Dobkin VG, Baenskií AV, Kulikovskaia NV, Litvinov VI.

Central NII of Tuberculosis RAMN, Moscow.

A total of 103 patients with fibrocavernous tuberculosis of the lung were examined. They all received chemotherapy, including 3 – 4 antituberculous agents. Laser therapy was performed with a UZOR-2K low-energy semiconductor laser. In patients with profound changes in the serum level of protein, with high antigenemia and antibody production, the course of the disease was found to be poor; X-ray positive changes were achieved to a lesser extent, bacterial expellation stopped less frequently and more slowly. The decreases in the serum content of the proteins tested, in the level of antigenemia and antibody production which occur with drug and laser therapies are also an important factor of preoperative preparation, which is highly effective in preventing postoperative complications.

Probl Tuberk. 1997;(3):23-4.  

Role of external laser radiation in the multimodality treatment of patients with destructive pulmonary tuberculosis

[Article in Russian]

Abashev IM, Kozlova AI.

Chuvash State University, Cheboksary.

Patients with destructive pulmonary tuberculosis were examined. Comparing those receiving chemopathogenetic, epicutaneous laser and ultrasound therapies showed an increase in the incidence of cavitary scarring in those taking successive epicutaneous laser and ultrasound therapies and exposed to biologically active points. Epicutaneous laser therapy promoted cicatrization of large cavities.

Probl Tuberk. 1997;(2):21-2.

Use of external laser radiation in patients with infiltrative pulmonary tuberculosis.

[Article in Russian]

Vinokurova MK, Gavril’ev SS, Petukhova NI, Baisheva NN.

NPO “Phthisiology”, Iakutia.

A procedure has been developed for the use of semiconductor laser radiation in the combined drug therapy of patients with disseminated infiltrative pulmonary tuberculosis with multiple destructions and massive bacterial excretion, by increasing the number of sessions, which reduces the time of bacterial excretion cessation by 2-4 weeks, decay cavity closure by a months, and hospital treatment by 1.5 months and promotes minimal residual changes in most of them.

Probl Tuberk. 1996;(6):54-7.  

Lasers in combined modality treatment of patients with pulmonary tuberculosis

[Article in Russian]

Dobkin VG, Bagirov MA, Bondarev GB, Sadovnikova SS.

Central NII of Tuberculosis RAMN, Moscow.

Low-energy lasers were used in the combined preoperative treatment and therapy of 548 patients with chronic fibrocavernous tuberculosis. Indications for some types of exposure were defined, namely, transcutaneous exposure of the tuberculous involvement zone, combination of transcutaneous laser exposure and laser puncture, intravenous and endocavitary laser exposure. Low-energy lasers, as a many-factor pathogenetic exposure, are conducive to a more rapid and effective stabilization of tuberculosis progress, which helps sooner prepare the patients to surgical interventions and in some patients even do without them, reduce the number of postoperative complications, and improve the efficacy of surgical treatment of grave patients

J Clin Laser Med Surg. 1996 Feb;14(1):23-5.

Low level nitrogen laser therapy in pulmonary tuberculosis.

Bhagwanani NS, Bhatia GC, Sharma N.

Choithram Hospital and Research Centre, Indore (MP), India.

We report a technique for treatment of pulmonary tuberculosis that has become resistant to traditional antibiotics. We introduce a needle into the lung that carries the N2 laser to the affected chest cavity. It is irradiated for 10 min and usually only one sitting is required. Clinical improvement occurred in 90% of the patients; 60% of the patients showed improvement on their X-rays. This technique is recommended as an adjuvant to traditional tuberculosis therapy.

Probl Tuberk. 1993;(2):44-6.

Effects of infrared laser irradiation on immunologic reactivity of patients with infiltrative pulmonary tuberculosis

[Article in Russian]

Tuiakov MI, Budchanov IuI, Zhangireev AA, Niiatova AA.

Influence of chemo- and laser therapy on the state of immunologic reactivity was studied in 38 patients with infiltrative pulmonary tuberculosis. It was found that the arsenide-gallium laser used in combined therapy of infiltrative pulmonary tuberculosis produces an immune-stimulating action and has a favourable effect on the course and outcomes of the disease. Infra-red laser radiation produces most favourable effect when it is used two times

Probl Tuberk. 1990;(2):41-3.

Use of laser therapy in combined treatment of pulmonary tuberculosis in children and adolescents

[Article in Russian]

Badalov RK, Tsym VF.

The effect of 0.89 micron wave gallium arsenide laser radiation was studied on 19 patients with various forms of pulmonary tuberculosis. Laser therapy was conducted in combination with antibacterial drugs. Laser skin radiation was projected into the pathologic process. The regimen included 15 sessions at 7-day intervals. The use of laser energy in the complex management of pulmonary tuberculosis patients makes it possible to reduce lung destruction healing and to accelerate normalization of biochemical indices and their hemogram.

COMPARATIVE EFFECTIVENESS DETOXIFICATION TRANSFUSION OF THERAPY (TT) AND INTRAVENOUS OF A LASER IRRADIATION BLOOD (ILIB) IN COMPLEX TREATMENT OF PATIENTS BY A PULMONARY TUBERCULOSIS

P.I.Pitcyco, E.I.Krivoshapova

Kharkov Institute of Physicians Advanced Training, Kharkov. Ukraine

Two groups of the patients infiltrotivc by a pulmonary tuberculosis in a phase of de-cay, MBT+, (discovered Koch’s bacillus), comparable on a floor, age, pronounced in-toxication and syndrome, extent of process in lungs and regime of chemotherapy. I groups 45 patients receiving TT (albumen 5%- 100 ml alternated with hacmodesum 200 ml, daily ?10), II groups – 68 patients, which was carried out ILIB(wavclcngth 0,63 urn, capacity of radiation on an output flexible monofibcr conductor of light 2 mW, duration of a procedure 15 minutes, course 10 sessions). The efficiency of ther-apy was estimated on a reduction intoxication, which degree was defined on a level and structure middle molecules (MM) ( presence of pathological fractions and dis-polypcptidcmy) in whey of blood. MM were studied prior to the beginning and after realisation of rates TT and ILIB by a method hclium-chromatography on hcle “Toyop-carl HW-40F” (Japan). A normal level and structure MM (361 ± 14 cond I. unit) was established with inspection 40 healthy donors. Is established, that at the patients from I groups after realisation of a course TT the general level MM on the average has de-creased from 858 ± 29 unit till 769 ± 31 unit (p<0,05), the frequency dispolypcptid-cmy (from 75 ± 7,3 % till 33 ± 6,7 % has decreased; p<0,001) and pathological fractions (from 60 ± 7,2 % to 40 ± 7,2 %;
p>0,05). After a course ILIB investigated parameters also have decreased: a level MM from 920 ± 36 unit to 584 ± 23 unit (p<0,001), frequency dispolypeptidcmy from 78 ± .6,2% to 31 ± 6,8% (p<0,001) and pathological fractions from 67 ± 6,7% till 24 ± 6,4 % (p<0,001). From the given data it is visible, that the course ILIB in comparison with TT allows more and level of pathological fractions (24 ± 6,4 % against 40 ± 7,2 %).

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