Problemy tuberkuleza最新文献

The social and medical causes of occupational tuberculosis were analyzed by using the results of questionnaire surveys in 300 workers of tuberculosis controlling service. Low salaries, high working load, unbalanced nutrition, poor rehabilitation on vacation are the most important risk factors leading to high rates of both somatic and occupational morbidity in the staff of antituberculosis service.

A procedure has been developed to detect antilysozymatic activity n L forms of Mycobacterium tuberculosis (MBT). A mode of predicting the course of a tuberculosis process in the lungs by the degree of antilysozymatic activity of MBT is outlined. Thus, when the level is 4 micrograms/ml or higher, progression or exacerbation of tuberculosis is predicted, when that of 0-3 micrograms/ml, a good prognosis is expected.

The paper shows that there is an association of the pattern of lung lesion with the endogenous intoxication in adolescents patients with pulmonary tuberculosis. Based on the spectrograms of plasma and the levels of low and medium molecular-weight substances, the authors revealed clinical features in relation to the level of endogenous intoxication and to the values of cellular responses.

Prior to treatment, 48 patients with different forms of pulmonary tuberculosis were examined. Serum iron concentrations, total iron-binding capacity of the serum (STIBC), its unsaturated iron-binding capacity (SUSIB), serum transferrin iron saturation coefficient (SC), total protein in the serum, red blood cells, hemoglobin, colour index were determined. All the parameters under study were in the normal range in patients with a favourable involutional course of pulmonary tuberculosis. In patients with acutely progressive pulmonary tuberculosis, serum iron levels, STIBC, SC were drastically decreased, while SUSIB was in the normal range. All this was attended by phenomena of hypochromic anemia. The pattern of the found changes leads to the conclusion that patients with acutely progressive tuberculosis develop iron-redistributing anemia caused by the changes in the amount and quality of transferrin, iron binding during free radical processes and mobilization of the antioxidant defense system rather than true iron deficiency.

The efficiency of treatment was studied in 149 patients with pulmonary tuberculosis who isolated multidrug resistance of Mycobacteria tuberculosis (MBT). The multidrug resistance of MTB, to at least isoniazid and rifampicin can be associated with both the resistance to other essential (streptomycin, ethambutol) and that to reserve drugs. With this, patients with MBT resistance to a combination of essential and reserve drugs more frequently showed a chronic course of the disease with severe clinical manifestations and more disseminated infiltrative-and-destructive lesions in the lung. Drug treatment regimens using a combination of reserve drug were effective only in patients with MBT resistance to essential drugs while they were little effective in those with resistance to essential and reserve agents. The use of artificial pneumothorax in patients with MBT resistance to essential and reserve agents could cease bacterial isolation in 77.8% of the patients even by ingesting a small number of the drugs. Clinically, the occurrence of MBT resistance to reserve drugs is justified to determine a radically new status in patients in the context of chemotherapy and the whole further treatment in this group of patients. A clinical classification of MBT multidrug resistance is proposed, which identifies two categories of patients with pulmonary tuberculosis: those resistant to essential drugs and those resistant to a combination of essential and reserve drugs.