[Efficacy of chemotherapy in patients with the newly detected complicated destructive pulmonary tuberculosis]. / Effektivnost' khimoterapii u bol'nykh s oslozhnennym techeniem vpervye vyiavlennogo destruktivnogo tuberkuleza legkikh vpervye vyiavlennogo destruktivnogo tuberkuleza legkikh.

A hundred and fifty-six patients with first detected destructive pulmonary tuberculosis were examined. 43.6% of the patients were found to have various complications: bronchial tuberculosis and exudative pleurisy were more common. All the patients received conventional chemotherapy. The studies have demonstrated that the efficiency of chemotherapy during the complicated course was less than in the uncomplicated one: closure of decay cavities was observed in 69.4% of the patients with specific lesion of the bronchial system, in 78.8% of those with a complication, such as exudative pleurisy (in 81.8% with uncomplicated course). In these groups of patients, cessation of bacterial isolation, as verified both bacterioscopically and culturally, was slower.

[Frequency, pattern, and diagnosis of adverse reactions in patients with pulmonary tuberculosis during chemotherapy with leading drugs]. / Chastota, kharakter i diagnostika pobochnykh reaktsii u bol'nykh tuberkulezom legkikh pri khimioterapii osnovnymi preparatami.

The frequency and pattern of adverse reactions to essential antituberculous agents were studied in 480 patients with first diagnosed and recurrent pulmonary tuberculosis. Adverse reactions were found to occur in 16.9% of cases and to be mainly associated with concomitant diseases of different organs and systems wherein they occurred 15.6 times more frequently, rather than with the number (3-4-5) of used drugs. Adverse reactions were generally caused by an individual drug and predominantly streptomycin. At the same time no significant difference was established in the frequency of toxic (45.5%) and allergic (37%) reactions, but with a rather low frequency of mixed reactions (17.3%). The firstly performed cytochemical and immunological studies of lymphocytes and eosinophils provided new evidence for the pathogenesis of different patterns of adverse reactions. Lymphocytes from patients with toxic reactions showed significant intracellular structural and metabolic disturbances that led to a higher apoptosis of these cells. In patients with lymphocytic allergic reactions, on the contrary, displayed activated processes of anaerobic oxidation and their cytotoxic activity. In both types of adverse reactions, eosinophils exhibited severe intracellular metabolic disturbances that result in destruction and increased apoptosis, which determined the allergic component in virtually all types of side effects. Rational pathogenetic therapy using hormonal, vitamin, and metabolic agents and plasmapheresis could show a 2-fold reduction in the number of patients with adverse reactions without changing the routine chemotherapy regimen and only in 5.6% of cases, the reactions were intractable, which made a specific drug be discontinued and therapy used on an individual basis.