Problemy tuberkuleza i boleznei legkikh最新文献

The types of lung tuberculomas were determined in 302 patients, with respect to the characteristics of their clinical course and variations in their progression, during clinical, radiological, and morphological follow-ups. Drug-resistant Mycobacterium tuberculosis strains were found 3.4 times more frequently in patients with filled tuberculomas and 1.7 times more often in those with infiltrative-pneumonic types of tuberculomas as compared with layered tuberculomas. Based on the patterns of growth of various types of caseous lesions, a rationale for indications for surgical treatment of lung tuberculomas was developed. The proposed treatment strategy for lung tuberculomas makes it possible to initiate intensive chemotherapy in due time and to improve the efficiency of surgical interventions (98.6%), further reducing the duration of inpatient treatment by a factor of 1.5 and the number of tuberculosis relapses by a factor of 2.

Examination of 296 cases of active forms of tuberculosis in children showed various age-dependent antituberculous measures. 14.8% of the children less than 3 years of age had not been vaccinated against tuberculosis; 19.8% had earlier received chemoprophylaxis; and contact with patients with tuberculosis was detected more frequently (70.4%). Against this background, tuberculosis in infancy was more commonly identified from complaints (48.1%) and less frequently at mass tuberculin diagnosis (19.8%); the generalized forms of the disease and complicated tuberculosis of intrathoracic lymph nodes were more frequently found (16% and 24.7%), a fatal outcome was oftener observed (7.4%). The secondary forms of tuberculosis were revealed in 23.8% of schoolchildren. Overall, the mean size of a papule emerging from the Mantoux test was 12.8 +/- 0.37 mm at the detection of tuberculosis.

Tuberculosis in children and adolescents is closely associated with the tuberculous infection reservoir existing in the Saratov Region. In this region, the tuberculosis epidemiological situation has improved and stabilized in the past 7 follow-up years, which is undoubtedly associated with the better organization of performed tuberculosis-controlling measures.

Eight hundred and thirty autopsy protocols of died patients with schizophrenia from 1952 to 2007 were studied. Respiratory pathology as a cause of death was noted in 29.8% of cases. There are great changes in the study parameters, which have been particularly evident in the past 2 decades: a reduction in the rate of lobar (croupous) and bronchial pneumonia, an increase in the number of cases of active pulmonary tuberculosis and chronic obstructive pulmonary disease, and lung cancer. The higher incidence of the two latter diseases is associated by the author with the side effects of phenothiazine neuroleptics in the long-term treatment of schizophrenia.

The epidemiological situation associated with extrapulmonary tuberculosis was analyzed in the area supervised by the Novosibirsk Research Institute of Tuberculosis (the Siberian and Far Eastern Regions). It was ascertained that despite the fact that the bedspace was sufficient, there was inadequate hospital equipment and low detection rates--this is all with the poor awareness of the problem amongst specialists and the population.

The paper analyzes morphological changes and results of surgical treatment in 515 patients with destructive pulmonary tuberculosis. Two hundred and seventy-four patients underwent mediastinal lymphadenectomy and in 241 patients lung resections or pneumonectomies were not followed by lymphadenectomy or solitary caseous molten lymph nodes were removed during an operation. In disseminated destructive pulmonary tuberculosis, active tuberculosis of intrathoracic lymph nodes (ILN) was found in 97%. The latter's significant signs are an enlarged lymph node of more than 2.0 cm, consolidation, periadenitis, and fluctuation. The incidence, extent, and pattern of ILN lesion varied in a lung tuberculous process depending on its site, form, and inflammation phase.

The paper compares the characteristics of the informative value of tests determining the activity of adenosine deaminase (ADA) activity and the level of gamma-interferon (gamma-IFN) for the differential diagnosis of tuberculous pleurisy (n = 35) and non-tuberculous pleural effusion (n = 53). Both tests were ascertained to have the similar differentially diagnostic capacities with their threshold values of 35 U/l and 180 pg/ ml, respectively. At the same time, the sensitivity and specificity of the ADA test were 98.4% and these of the gamma-IFN test were 94.3 and 96.2%, respectively, with the positive and negative predictive value being 91.3 and 98.3% and 94.3 and 96.2%, respectively, and with the diagnostic value of 94.5% for the ADA test and 96.4% for the gamma-IFN test. There was a high unidirectionality of changes in both values: it was higher than the cut-off points in 94.1% of the patients with tuberculous pleurisy and below them in 88.7% of those with other pleural effusions.

The paper presents the clinical, X-ray, and laboratory characteristics of patients with pulmonary tuberculosis. Both general regularities and differences in the frequency of alleles of the HLA-DQB1* locus have been revealed in the groups of patients with pulmonary tuberculosis as compared with healthy individuals. There are specificities associated with the risk of pulmonary tuberculosis and the variants of the course of infection; thus, allele 05 of the HLA-DQB1* locus is positively associated with the incidence of tuberculosis. Specificity 03 of the HLA-DQB1* locus has been ascertained to be associated with the poor course of the disease. The most pronounced immunological changes have been observed in patients with the poor course of the disease, who are the carriers of specificity 05 of the HLA-DQB1* locus. The totality of immunological parameters and the data of genetic studies provide a basis for using the selective immunomodulator rIL-2 (roncoleukin) in the most seriously ill patients who are carriers of specificity 05.

The clinical and neurophysiological efficiency of high-intensity transpinal rhythmic magnetic stimulation was studied during surgical treatment in patients with tuberculosis spondylitis complicated by neurological disorders. Its highest efficiency was determined in patients with minor neurological disorders, radicular syndrome, and paresis. Magnetic stimulation was shown to affect the regression of neurological symptoms. The use of electric neuromyography allows quantitative assessment of the course of reparative processes in the pathways.