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BACKGROUND: Essential TB care in the European Union/European Economic Area (EU/EEA) comprises 21 standards for the diagnosis, treatment and prevention of TB that constitute the European Union Standards for Tuberculosis Care (ESTC).METHODS: In 2017, we conducted an audit on TB management and infection control measures against the ESTC standards. TB reference centres in five EU/EEA countries were purposely selected to represent the heterogeneous European TB burden and examine geographic variability.RESULTS: Data from 122 patients, diagnosed between 2012 and 2015 with multidrug-resistant TB (n = 49), extensively drug-resistant TB (XDR-TB) (n = 11), pre-XDR-TB (n = 29) and drug-susceptible TB (n = 33), showed that TB diagnosis and treatment practices were in general in agreement with the ESTC.CONCLUSION: Overall, TB management and infection control practices were in agreement with the ESTC in the selected EU/EEA reference centres. Areas for improvement include strengthening of integrated care services and further implementation of patient-centred approaches.

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A total of 16 patients with pulmonary resections for MDR-TB are included in a retrospective study for a period of 7 years. They are 9 (63.4%) male and 7 (36.3%) female with an average age of 32.6 years. Unilateral cavitary lesions are visualized in all patients. Bilateral changes are found in 9 (55.5%) patients, but the contralateral lesions are predominantly nodules and fibrosis. Multi-drug resistance was observed to an average of 4.4 anti-TB medicines. The mean duration of the preoperative re-treatment regimens is 4.9 months. Despite the preoperative anti-TB treatment, 8 (50%) of our patients are positive at the time of surgery. The following operations are carried out: lobectomy (68.75%), lobectomy with S6 (6.25%) and pneumonectomy (25%). No intraoperative and 30-day postoperative deaths are observed in our cohort. Postoperative complications are found in 4 (25%) of the cases. The mean postoperative in-hospital stay is 10.2 days. The postoperative anti-TB regimens are administered for at least 18 months, but in most of the patients their duration is 24 months. Postoperative follow-up is possible in all patients for the mean period of 34 months. Relapse of the disease is found in 3 (18.75%) preoperatively positive patients. Late mortality is observed in 1 (6.2%) patient 9 months after pneumonectomy due to relapse and empyema development. Eight (50%) of the patients are under follow-up program without medication. The rest 5 (31.25%) patients are negative but still on anti-TB regimens. In conclusion, we feel that pulmonary resections are of a paramount importance as an adjunctive method in the complex treatment of MDR-TB with good postoperative results.

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Short (up to 60 s) supramaximal (about 400 W on the average) exercise is accompanied by specific biochemical processes in the working muscles and by a general increase in energy metabolism. Outwardly, this is manifested by an excess post-exercise oxygen consumption (EPOC). Since its actual measurement is time consuming and associated sometimes with difficulties, we propose a fixed 3-min test for EPOC prediction. The measured volumes of oxygen consumption are related to the corresponding periods in a coordinate system as reciprocal values. The linear equation, whose parameters were calculated by the method of least squares or were determined graphically, provided for prediction of the EPOC volume with satisfactory accuracy and precision. The obtained increase of the predicted values over the actually measured values was below 5%, and the correlation coefficient r = 0.98. Other parameters of the recovery process were also calculated, such as tau (half-time) of EPOC and the rate constant k.

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Radiopreventive and radiotherapeutic efficacy of nuclyderm-gel was studied on tails of mice exposed to fractionated gamma-radiation of 90 Gy (15 + 30 + 45 Gy) and 75 Gy (45 + 30 Gy). Daily seven-day treatment with nuclyderm-gel prior to irradiation with increasing doses (15 + 30 + 45 Gy) and the subsequent continuous therapy were shown to delay and reduce skin reactions. Nuclyderm-gel was particularly effective when used therapeutically. The treatment of exposed areas, with the three-fold dose fractionation, was the optimum therapy scheme.

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The process of epithelialization and the antiseptic effect of nucliderm-gel applied locally have been studied on 63 oncologic patients subjected to radiotherapy. In all cases under study, nucliderm-gel promotes skin epithelialization and has a high antiseptic effect as compared with the drugs applied hitherto.

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The effect of medazepam in a model of isolation aggression in mice was studied according to Yen et al. It was established that the mean effective dose of medazepam was 250 micrograms/kg and the therapeutic index (LD50:ED50) 6200. The simultaneous biochemical investigations showed a reduction of the affinity and number of benzodiazepine receptors in the brain of aggressive animals. Medazepam 10 mg/kg p.o. led to the restoration of the number of benzodiazepine receptors at a single and 10-day treatment.

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The following methods were used: neuropharmacologic study according to the a modified method of Nikolova, Daleva, orientation reaction according to Boissier and Simon, "open field" according to Fontenay et al. and actographic study. The data from "the free" observation suggested clearly a manifested central stimulating effect of aligeron. The data from the actographic study were similar, which showed an increased motor activity in mice and rats, given doses of 1/100-1/4 of LD50. The stimulating action of the preparation was observed in doses of 1/8-1/6 of LD50 during the experimental procedure "open field". The preparation inhibited orientation reaction in mice. Cinnarizine inhibited the examined indices, obtained by all tests. The complex of the used methods allowed to make an inference that aligeron had central stimulating effect, weaker in smaller therapeutic doses and more manifested in higher doses. Cinnarizine had weak depressive effect.

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The authors carried out studies on the preparation menilon in order to establish eventual correlations between some pharmacological and pharmakokinetic indices. For this purpose they examined the activity of menilon in rats and mice during electric shock and hypothermia and determined the concentrations of the preparation in plasma and brain in rats. The obtained results from the pharmacological investigation revealed manifested action against the seizures after electric shock in both groups of animals. It was established as early as 30 minutes after oral administration of the preparation reached maximal activity after 1-2 hours and disappeared after 6 hours. The authors found strong and continuous hypothermic activity. The hypothermic effect of the doses used was preserved up to the end the 24 th hour. The lowering of temperature in rats was comparatively weaker and shorter. The pharmacokinetic studies showed quick oral resportion of menilon. It was found in plasma and brain of the experimental animals on the 30 th minite after its administration, reached maximal concentration between the first and second hour and still was established on the 24 th hour after administration. The maximal level of the preparation in plasma and brain after oral administration correlated well with the time of maximal activity of its antiseizure and hypothermic effects. The preparation menilon was comparatively slightly toxic.

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The authors examined the influence of the preparation triquinol on the function of the central nervous system, using neuropharmacological and electrophysiological methods. Traquinol in small doses revealed slight stimulating central effect, causing uneasiness, increased reaction to touch and pain, slight exophthalmia, These manifestations were accepted as a sign of the sympathycomimetic action of the preparation. The large doses caused myorelaxing phenomena-reduced spontaneous motor activity, muscular tonus, inhibition of the polysynaptic reflexes. Electroencephalographic examinations showed lowering of the threshold for obtaining the reaction of waking during acute experiments and of the threshold for obtaining desynchronization after exteroceptive stimuli. These data could be explained by the sympathycomimetic effect of the preparation.

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We have studied the influence of synthesized in NIHFI psychotropic drugs echinopsin and adepren for their locomotor activity on white rats in open field and staircase. Comparative parallel experiments were carried out with psychostimulants and antidepressive drugs utilized in therapeutic practice. We found that echinopsin in low doses increases the locomotor activity and in large doses decreases. Its action in open-field and staircase is different from the effect of amphetamine and coffeine which is confirmed by clinical evidence. Adepren decreases the locomotor activity in single application as a result of decreasing of brain noradrenaline which is similar to the effect of MAOI drugs.

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The authors carried out experimental studies with the Bulgarian preparat on Adepren on the behaviour of rats in open field procedure together with parallel electroencephalographic studies and examined the changes in the content of cerebral catecholamines during acute and chronic administration. The preparation after single application had depresive effect on both components of the motor activity: horisontal and vertical. The horizontal component of the motor activity surpassed the norm with almost 20% at the end of the experimental period after chronic administration. There was desynchronizing effect in the KEG recordings. Adepren after acute and chronic application elevated significantly the level of noradrenaline and dopamine in the brain. The obtained results gave a foundation to the authors to suggest that the examined preparation and maoinhibiting effect.

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The authors carried out studies on a group of analgetic preparations (morphine, lydol, thylidine, pentazocine and analgine) by the method of D Amour and Smith, using thermic painful stimulation. The experiments were carried out on white rats-young and adult of both sexes of the strain Wistar. The mean lethal dosis were determined as well as the mean effective doses and therapeutic indices. The experimental results showed that thylidine was the strongest analgetic agent with atherapeutic index of 67. The index of morphine was 63 and was close to that of thylidine, but without statistical significance. The remaining analgetic indices were with low indices: lyndiol-with 5, pentazocine - 12 and analgine - 2. The method used, according to our data, could be applied successfully on rats of both sexes, at various age groups and both strains. The method is convenient for testing analgetic activity of preparations from two basic types of analgetic agents-narcotic and nonnarcotic.

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