[Effectiveness of new diagnostic drug Diaskintest in children for tuberculosis diagnostic].

DST was ascertained to have a high sensitivity in virtually all patients with tuberculosis and a positive reaction was first noted in the infected. With stabilization and regression, the response to DST was much less pronounced than that in clinical and primary infection (that to the Mantoux test being more evident). DST showed its use as a marker of active tuberculosis not only in its local forms, but also in latent tuberculous infection. This makes it possible to apply DST when preventive treatment is performed. The agent may be used to monitor the progress of treatment. DST has a high specificity--healthy individuals had a negative response to DST while the Mantoux test was positive in many cases. The high specificity of DST was suggested by the fact that the persons vaccinated with (this caused BCG ostitis) had a negative reaction to DST while the Mantoux test was positive in all cases BCG-vaccinated BCG. The findings warrant the use of DST for the differential diagnosis of tuberculosis and BCG-associated complications and the possibility of differentiating postvaccinal and infection allergy in children and adolescents.

[Psychoemotional changes in patients with pulmonary tuberculosis during therapy using psychological and neuropsychological methods].

Therapy for pulmonary tuberculosis in patients is complicated by their negative psychoemotional state frequently deteriorated by long inpatient stay. Enhancing the efficiency of rehabilitative measures in phthisiology requires active optimization of the patients' mental state. This problem can be solved by a package of correction measures involving psychological correction with reflex therapeutic normalization of the functional state of the cortical regions of the central nervous system in patients with pulmonary tuberculosis. One hundred tuberculosis patients with decompensated mind, including 60 with OG and 40 with KG, were examined. A noticeable psychoemotional improvement was reliably detected 5 months after complex correction psychological and neuropsychological accompaniments of standard chemotherapy in the OG study.

[Continuous professional education of physicians in childhood and adolescence tuberculosis].

The current approaches to training pediatric phthisiatricians (phthisiopediatricians) are described. In the authors' opinion, completion of a clinical residency in not only phthisiology, but also in pediatrics is optimal to this group of specialists. The training programs for pediatric phthisiatricians differ in relation to the basic specialty: a phthisiatrician or a local phthisiatrician. Topical improvement may be made more frequently, it aims at upgrading qualification in more specialized section on phthisiology, and it is intended not only for pediatric phthisiatricians, but also for pediatricians of children's health care facilities. Training cycles in Moscow upgrades the quality of antituberculous work at the children's facilities. Difficulties in organizing the retraining of physicians of other specialties in phthisiology need normative resolution.

[Tuberculosis and HIV infection: detection, follow-up, treatment: Moscow data].

The paper describes the follow-up and treatment of patients with tuberculosis concurrent with HIV infection in Moscow in 2004-2005. Major epidemiological parameters, such as morbidity, mortality, and prevalence of this comorbidity, are given. Analysis of these indices suggests that the epidemic situation associated with tuberculosis concurrent with HIV infection became worse in the past 2 years. As compared with 2004, in 2005 the number of such patients increased from 294 to 445, including that of first detected patients rose from 123 to 174. In this group of patients, there was a preponderance of young males aged 29 to 39 years. Most patients with this pathology suffered from drug addiction and alcoholism and other concomitant diseases. The bulk of them were unemployed and disabled. In the HIV-infected, the clinical forms of tuberculosis were severe with a predominance of acute and disseminated processes; the rate of drug resistance, including multidrug resistance, was high, which made treatment difficult and resulted in high mortality.

[Results of implementation of the subprograms "Goal-oriented medical examination of the Moscow population for early tuberculosis detection"].

The implementation of the subprograms "Goal-oriented medical examination of the Moscow population for early tuberculosis visage a differential screening of the population in relation to the risk of tuberculosis; fitting of health care facilities with current digital fluorographic equipment; improvement of an epidemiological screening of patients with tuberculosis. Over 7 years of implementation of the Program, advances were made: the population's coverage with preventive examinations increased by 11%; that of detively; the active detection of patients with respiratory abnormalities and those with pulmonary tuberculosis increased by 2.0 and 2.4 times, respectively; the proportion of tuberculosis patients actively detected rose by 1.5 times; 151 digital fluorographs and 11 X-ray units were purchased; a program for machine fluorography study accounting was worked out.

[Validity of the causes of death from tuberculosis as evidenced by medical death certificates]. / Dostovernost' prichin letal'nogo iskhoda ot tuberkuleza po dannym "meditsinskikh svidetel'stv o smerti".

Despite the violations made in filling in "Medical Death Certificates", the rate of tuberculosis mortality forms with a high degree of significance. To minimize the above pitfalls, it is necessary to keep a computer-aided record of deaths from tuberculosis, which involves the standardization of entries of a postmortem diagnosis, by decoding it in accordance with the lines of item 1 (a, b, c) of the "Certificate".

[Influence of social factors on tuberculosis mortality, effectiveness of sociomedical preventive measures in Moscow in the 20th century]. / Vliianie sotsial'nykh faktorov na smertnost' ot tuberkuleza, éffektivnost' mer mediko-sotsial'noi zashchity v Moskve v 20m stoletii.

The correlations between the time series of weather values of sociodemographic, socioeconomic, and epidemiological parameters of tuberculosis (death rates) in the 20th century were studied. Analysis of population indices confirmed the association of migratory processes and the intensity of the tuberculosis epidemic situation, as well as the significance of these processes for Moscow, the necessity of their notification for assessing the sociodemographic situation to plan tuberculosis-controlling measures. The study has indicated that there is a relationship of the salary/wage that determines the income of the bulk of the population to tuberculosis mortality rates and that regulation of a migratory process, population density, and improvement of living conditions are of considerable importance in the prevention of this disease. Comparative analysis of the data in the periods when the whole contemporary rather effective complex of tuberculosis-controlling measures (1953-2000) and when the above complex were only formed (1910-1953) has demonstrated the economic efficiency of the above measures. It is stated that the system of sociomedical protective measures is a real factor that may rather effectively withstand the poor social conditions promoting the spread of tuberculosis.

[Organization of early detection of patients with tuberculosis in Moscow]. / Organizatsiia rannego vyiavleniia bol'nykh tuberkulezom v Moskve.

The tuberculosis mortality rate is largely determined by the organization of early identification of patients with this disease in the general population. At present the volume of prophylactic surveys has reduced, but, nevertheless, they are the method of choice in detecting tuberculosis in time. Since the prevalence of tuberculosis greatly differs in different populations, prophylactic examinations must be differential in relation to the risk of disease or epidemiological hazards. Increasing the coverage of prophylactic examinations of risk groups by 10% allows one to increase the identification of patients with tuberculosis by 1.6 times in them, that by 8.0% enhances it by 1.9 times. Since the socioeconomic conditions have changed and the logistics is poor, the most effective existing actions should be taken.