[Roncoleukin in enhancing the efficiency of complex therapy for infiltrative pulmonary tuberculosis in adolescents].

Seventy-eight patients, aged 15.69 +/- 0.15 years, who had infiltrative pulmonary tuberculosis, were examined. Roncoleukin was given intravenously in 20 patients of them (Subgroup 1a), in an indirect lymphotropic fashion in 30 patients (Subgroup 1b); 28 adolescents were treated with the conventional treatments (Group 2). A decay phase was recorded in 33 (66%) from Group 1 and in 16 (57.1%) from Group 2. On admission, all 78 (100%) patients had immunological disorders that required immunomodulation. Roncoleukin caused positive clinical and X-ray changes that were more pronounced in Subgroup 1b: bacterial excretion cessation was recorded in 100% of patients in Subgroup 1a (p < 0.05); in 94.4% in Subgroup 1b (p < 0.05), and in 68.7% in Group 2; decay cavities closed in 69.2, 60, and 37.5% in Subgroups 1a and 1b and Group 2. At the same time, the duration of a procedure considerably reduced, which positively affected adolescents' compliance.

[Day tuberculous exudative pleurisy: morphological and morphometric aspects].

Visceral pleural pathomorpholodical changes were studied in 50 patients. Group 1 included 25 patients with isolated tuberculous pleurisy; Group 2 consisted of 7 patients with tuberculous exudative pleurisy in the presence of a specific process in the lung; a comparison group comprised 18 who had not died from diseases of the lung and pleura. The exudative productive type of specific pleural inflammation was prevalent in 15 (60%) and 4 (57.1%) patients, respectively. In Group 1, the pleural thickness was 144.0 +/- 3.3 microm, which was 8.3 times greater (p < 0.01) than that in the comparison group (17.35 +/- 4.78 microm). In Group 2, the visceral pleural thickness was 151.1 +/- 3.4 microm, which was 8.7 times greater (p < 0.01) than that in the comparison group and 1.05 times greater than that in Group 1. The study has established that in both Group 1 and Group 2, exudative pleurisy is accompanied by early visceral pleural fibrosing with a tendency to be more pronounced in Group 2 patients, which raises the question as to whether it is necessary to use resolution therapy at the early stages of treatment, to inject isoniazid lymphotropically, and to apply physical methods to prevent pleural cavity obliteration.

[The diagnostic value of adenosine deaminase coefficient in patients with tuberculous exudative pleurisy].

The authors examined 51 patients aged 37.74 +/- 2.17 years who had tuberculous pleurisy and aged 49.8 +/- 4.6 years who had nonspecific pleurisy. Group 1 comprised 18 patients with isolated tuberculous exudative pleurisy. Group 2 included 13 patients with tuberculosis complicated by tuberculous pleurisy. Group 3 consisted of 10 patients with nonspecific exudative pleurisy. Catarrhal endobronchitis was the leading form of tracheo-broncheal tree lesion among patients with tuberculous exudative pleurisy (n = 20 (64.5%)). The activity of adenosine deaminase (ADA) was 2.18 +/- 0.73, 2.41 +/- 0.80, and 2.47 +/- 1.52 U/l in Groups 1, 2, and 3, respectively. Thus, the measurement of bronchoalveolar fluid ADA separately from other parameters is of no informative value in the differential diagnosis of the etiology of pleurisy. While analyzing the parameters, the authors introduced the coefficient of ADA (CADA) that was calculated using the formula: K(ADA) = ADA/cytosis. In patients with tuberculous pleurisy, K(ADA) was 0.65 +/- 0.17 (this was 0.52 +/-0.13 in isolated tuberculous exudative pleurisy and 0.84 +/- 0.36 in tuberculous exudative pleurisy complicated by pulmonary tuberculosis (p < 0.05), and 0.20 +/- 0.06 in nonspecific pleurisy (p < 0.05). The ADA coefficient of 0.52 or more confirms the tuberculous etiology in isolated pleurisies and permits a differential diagnosis to be made between specific and nonspecific pleurisy with and without lung changes.

[Predictive value of endopulmonic cytogram in pulmonary tuberculosis among workers having concomitant chronic bronchitis and engaged into industry with pneumoconiosis hazard].

The study covered influence of quartz industrial dust and concomitant chronic bronchitis on neutrophil--macrophage index in tuberculous workers engaged into pneumoconiosis hazard industry. Increased more than 0.7, the index suggests unfavorable prognosis. Better prognosis requires mandatory examination of respiratory tract and sanation therapy.

[The clinical picture and course of sarcoidosis under the conditions of the West Ural]. / Klinicheskaia kartina i techenie sarkoidoza v usloviiakh Zapadnogo Urala.

The specific features of the clinical picture and course of respiratory sarcoidosis (RS) and the efficiency of its treatment were studied in its new cases living in the Perm Region (the West Urals). There was a higher incidence of RS in inhabitants from towns with developed heavy industry, mainly in females. Primary chronic RS was prevalent (89.9%). The therapeutic efficiency was 69.5%. The outcomes of treatment were worse when the disease was untimely detected. Cure rates were higher and slightly lower when corticosteroids as tablets were used in the continuous (87.5%) and intermittent (89.9%) regimens, respectively, in combination with pathogenetic agents and treatments aimed at preventing the development of postsarcoid pneumosclerosis.

[Clinical and morphological comparisons in pulmonary tuberculosis in workers from pneumoconiosis-risk industries]. / Kliniko-morfologicheskie sopostavleniia pri tuberkuleze legkikh u rabochikh koniozoopasnykh proizvodstv.

The relationship between the efficiency of treatment and the nature of morphological changes in the lung was studied in 125 patients with pulmonary tuberculosis without X-ray signs of pneumoconiosis who worked at coniosis-risk enterprises (CRR). Despite adequate specific and pathogenetic therapy, tuberculomas formed and decay cavities preserved in the patients, in this connection they had surgical treatment. Three types of morphological changes were identified. Quartz-containing industrial dust was found to exert an adverse potentiating effect on the course of tuberculosis in most CRE patients: increases in the delimiting a specific process of respiratory disorders and postoperative complications. These specific features should be borne in mind in drawing up a treatment protocol for patients working exposed to industrial dust.

[Epidemiological features of the pathomorphism of infiltrative pulmonary tuberculosis in the Perm Region]. / Epidemiologicheskie osobennosti patomorfoza infil'trativnogo tuberkuleza legkikh v Permskoi oblasti.

The time course of changes in current epidemiological indices and epidemically significant features of the pathomorphism of infiltrative pulmonary tuberculosis in those living in the Perm Region are mainly characterized by negative trends. They lie in the increase or stable maintenance of high rates of morbidity, mortality, and destructive pattern of a lesion accompanied by bacterial isolation. The reason for the established situation is incomplete realization of potentialities of improving actions to detect the disease early, to optimize diagnosis and medical therapy, and to considerably expand an phthisiosurgical aid.

[Optimization of indirect endolymphatic injection of isoniazid in pulmonary tuberculosis]. / Optimizatsiia nepriamogo éndolimfaticheskogo vvedeniia izoniazida pri tuberkuleze legkikh.

The authors have substantiated and studied the use of lymphotropic (interstitial) injection of 1% isoniazid solution in the complex therapy of patients with pulmonary tuberculosis. The method provides active interstitial functioning of the diseased organ. This leads to a substantial improvement of immediate results of treatment in patients as accelerated closure of decay cavities and double cessation of bacterial isolation.

[Clinical presentation and course of sarcoidosis under the conditions of the West Urals]. / Osobennosti kliniki i techeniia sarkoidoza v usloviiakh Zapadnogo Urala.

The specific features of the clinical presentation and course of respiratory sarcoidosis (S) and the efficiency of its treatment were studied in 109 new cases in the Perm Region. The incidence of S is higher among residents from towns with developed heavy industry, mainly in females. Primary chronic S was predominant (89.9%). The efficiency of treatment in the patients was 69.5%. The results of treatment were worse in the untimely detection of S. The recovery rates were higher with corticosteroid tablets used continuously (87.5%) and those were lower with their intermittent use (82.9%).

[Causes of recurrence of pulmonary tuberculosis: short and long term results of treatment]. / Prichiny retsidivov tuberkuleza legkikh, blizhaishie i otdalennye rezul'taty lecheniia.

The causes of pulmonary tuberculosis recurrences and efficacy of their treatment have been analyzed for 180 patients with pulmonary tuberculosis. The recurrences arise most often secondary to associated diseases (chronic bronchitis, chronic alcoholism, occupational hazards), in subjects who previously have had focal pulmonary tuberculosis (at the sites of posttuberculous changes). Treatment of the recurrences is longer than that of the primary foci, does not prevent residual changes, is not curative in all the cases.

[The status of the external respiratory function in patients with tuberculosis of the lungs and pre-roentgenologic pneumoconiosis changes]. / Sostoianie funktsii vneshnego dykhaniia u bol'nykh tuberkulezom legkikhs dorentgenologicheskimi pnevmokonioticheskimi izmeneniiami.

The ventilation function was studied in 103 pulmonary tuberculosis patients of pneumoconiosis-risk occupations in the absence of pneumoconiosis and in 51 patients who were not exposed to dust. Patients of "dust" occupations were found to have a decrease in the parameters of external respiration and bronchoscopic findings more often showed chronic bronchitis. The initial signs of pneumoconiosis were revealed in the histological examination of surgically removed lung segments in 83.4% of the patients.

[Effectiveness of treatment and working ability disseminated pulmonary tuberculosis patients, working at enterprises, hazardous for developing pneumoconiosis]. / Effektivnost' lecheniia i trudosposobnost' bol'nykh s disseminirovannym tuberkulezom legkikh, rabotaiushchikh na pnevmokoniozoopasnykh predpriiatiiakh.

The outcomes of treatment of disseminated pulmonary tuberculosis in 62 patients of "dust" occupations and 82 individuals unexposed to dust were studied. All the patients were treated with antituberculous drugs for, on average, 162.9 +/- 3.25 days in a hospital. The analysis of long-term results of their treatment revealed that those with "dusty" occupations had an unfavourable course of the specific process and developed complications and relapses of the disease as their length of service in the quartz-containing dusty environment increased. The death of the patients in the main group was frequently caused by a progressive course of destructive tuberculosis.