Problemy tuberkuleza最新文献

Analyzing the results of Mantoux tests with 2 TE made 7 times for 5 years in 750-850 schoolchildren of the settlement of Sulak has demonstrated that the infection rates are on the increase on the one hand, and, due to material and transport problems, the proportion of examinees from a risk group decreases to 10-30% of those to be examined, on the other hand. The authors suggest that the remaining unexamined children should undergo chemotherapy with 2-3 antituberculosis drugs for 3 months so as to perform an examination when the first opportunity occurs. They propose to examine the coverage of children, except for children and adolescents with a hyperergic and increasing reactions and those with a highly positive (15-16 mm) Mantoux test. An algorithm for implementation of the above measures is offered.

The paper analyzes the clinical manifestations of adenogenic tuberculosis, the methods of its diagnosis and treatment in 44 patients (15 males and 29 females) aged 18 to 75 years. The signs of an active tuberculous process were identified in the bronchus and lung of 33 patients and the remaining patients had posttuberculous adaptogenic changes. A bronchological study revealed infiltrative bronchial tuberculosis in 15 patients, bronchial fistula in 4, inflammatory and cicatrical stenoses in 22, broncholiths in 2, and nonspecific bronchitis in 5. The patients with specific active changes received antituberculous chemotherapy with 4 drugs; those with nonspecific lesions had antirecurrent chemotherapy and, in case of an exacerbation of nonspecific recurrent pneumonias and chronic bronchitis, used antibiotics mainly as inhalants.

A rise in the number of patients with disseminated and advanced forms of tuberculosis becomes a great problem in phthisiology. The quality of tuberculosis control depends on the organization of examination of patients with the suspected tuberculosis etiology of the disease. Thus, the authors propose to optimize both general and addressing tuberculosis controlling measures, which include among them to improve general practitioners' qualification as the latter largely determines the efficiency and timeliness of verification of a tuberculous process.

The recent rise in the incidence of allergic diseases, including allergic dermatoses, requires a comprehensive approach to solving a number of problems associated with this disease. Analyzing the case reports of 62 children with allergic dermatoses has indicated that this is a particular contingent of children, which needs a more careful approach to different preventive measures, to interpreting tuberculin reactions and hence to substantiating the use chemotherapeutical prevention. A graded skin tuberculin test and an immunological study should be performed in critical cases.

Eighty-nine patients with alveolitis were followed up. Of them, 60 patients had exogenous allergic alveolitis (EAA) and 29 had idiopathic fibrosing alveolitis (IFA). Transbronchial lung biopsy (TLB) proved to be the most informative method for alveolitis. At the same time a cytomorphologic study of TLB specimens revealed exogenous allergic alveolitis in all phases of the disease in 91.2% of the cases. In idiopathic fibrosing alveolitis, the informative value of TLB was 59.7%.

A comprehensive study was carried out in 95 patients with different forms and stages of osteoarticular tuberculosis by using the thermographic diagnostic technique. The patients' age was 17 to 76 years. The study was undertaken to define the capacities of thermography for differential diagnosis of osteoarticular tuberculosis from noninflammatory disease of the skeleton and to evaluate the efficiency of treatment in phthisiorthopedic patients. The study has provided evidence for that thermography has great capacities to diagnose a specific inflammatory skeleton lesion and to evaluate the efficiency of treatment, which allows one not to carry out expensive and radiation load-carrying X-ray studies in some cases.

Microbiological and histological studies made in patients with active tuberculosis revealed that 65.5% of cases had revertants from ultraminor forms (UMF) of Mycobacteria tuberculosis (MBT), which are typically bacterial in shape and referred to as representatives of the genus Mycobacterium tuberculosis. Cultivation of the diagnostic material containing MBT UMF the enriched liquid nutrient medium could detect rod-shaped bacterial forms of MBT in 18% of the patients with tuberculosis. Inoculation of the MBT UMF-containing material isolated from patients with tuberculosis to guinea-pigs revealed productive sarcoid-like changes in the organs of the experimental animals in 30.6% of cases. A postmortem study of the organs of experimental animals inoculated the material containing "visible, but not growing" mycobacteria detected paraspecific tissue reactions and infiltration of lung tissue by multiple cells of the macrophageal series.