Problemy tuberkuleza最新文献

The clinical manifestations of renal tuberculosis under the present conditions were studied. Seventy one patients with active renal tuberculosis treated at the Moscow Research Institute of Phthisiopulmonology and at the Pediatric Department, Yekaterinburg Research- and Production Association Phthisiology were followed up. The morbidity rate of urinary tuberculosis was found to directly depends on whether early detection of the disease is organized. Urinary tuberculosis afflicts children and adolescents in all age groups. However, its higher rates are detected in the first decade of life. Renal tuberculosis is accompanied by manifestations of the urinary syndrome in 70.4% of cases and by the presence of Mycobacteria tuberculosis in 100%. A limited renal tuberculous process was detected in 80% of cases in the period of primary infection or in the following 2 years. A generalized renal tuberculous process involving other systems in a child was accompanied by few clinical urinary symptoms and it did not depend on the duration of infection.

Sixty seven patients with sarcoidosis and 12 patients with pulmonary tuberculosis were examined. A control group comprised 9 apparently healthy individuals. The alveolar macrophages (AM) isolated from the bronchoalveolar washing (BAW) of patients with both sarcoidosis and tuberculosis secreted elevated amounts of IL-6 (by 11 and 5.6 times, respectively) as compared to the controls. However, patients with no BAW lymphocytosis there were no great differences in the level of IL-6 production between sarcoidosis and tuberculosis. In this connection, it is not advisable to determine the production of AM cytokines for differential diagnosis of pulmonary sarcoidosis and tuberculosis. There were significant differences in the BAW concentrations of phospholipids in sarcoidosis and tuberculosis. Tests for total lipid phosphorus and cumulative phosphatidylcholine were found to be of the highest sensitivity and may be used for differential diagnosis. In questionable cases if the level of total lipid phosphorus is greater than 21.36 (M P/L (M + 26, there will be 98.3% probability for no tuberculosis in such a patient.

The paper presents the results of a study of the clinical course of tuberculous spondylitis of combined pulmonary tuberculosis in 86 patients admitted from different areas of the Republic of Uzbekistan. Patients with tuberculosis of the spine and lung have been shown to have a more unfavourable course of a specific process in the bony tissue and lung. The tuberculous process is accompanied by severe intoxication, pain syndromes. The severity of the process is aggravated if there are extensive suppurative processes around an osseous focus. These patients have varying severe cerebrospinal disorders. Moreover, patients with combined forms of the process more frequently exhibit concomitant nonspecific visceral diseases.

Clinical, X-ray, and immunogenetic parameters were comparatively assessed in two groups of first identified patients diagnosed at annual fluorographic studies in groups at risk for tuberculosis and in individuals visiting general health care facilities for symptoms of inflammatory bronchopulmonary disease. Great differences were established in the clinical and X-ray manifestations, the course of the disease, and the patients' immunogenetic status in these groups. Tuberculosis in the patients identified on their referral to general health care facilities is characterized by more severe clinical manifestations, a greater spread of inflammatory and destructive changes in the lung, and massive bacterial isolation. There were certain associations of the HLA antigens A2 and A 11 as markers indicative of tuberculosis resistance with the antigens B35 and Cw4 suggestive of predisposition to tuberculosis in patients with chronic bronchitis.

Ninety adolescents with bacterial isolates of active forms of pulmonary tuberculosis were followed up. Drug resistance of Mycobacteria tuberculosis was revealed in 57 (63.3%) patients. Primary resistance was determined in 43 (47.7%) patients. The patients had not received antituberculous agents. Complete or partial coincidence of MBT resistance and sensitivity with the data of an infection focus. The course of tuberculosis during adequate treatment by using essential and reserve agents in the adolescents with varying MBT resistance was different. In patients (n = 18) resistant to 1-2 agents, the course of the disease little differed from that in those patients with drug-responding tuberculosis, except for later closure of decay cavities. In patients resistant to 3 drugs or more showed a slow course of the disease with significant residual changes in most patients.