[Approaches to combined therapy of pulmonary tuberculosis in adolescents excreting drug-resistant Mycobacterium tuberculosis]. / Podkhody k kompleksnoi terapii tuberkuleza legkikh u podrostkov, vydeliaiushchikh ustoichivye k khimiopreparatam mikobakterii tuberkuleza.

The data are presented on 138 adolescents with active, advanced tuberculosis. M. tuberculosis were detected in the sputum and bronchial lavage of 75(54.3%) adolescents. 32 patients had M. tuberculosis resistant to drugs. 28 untreated patients demonstrated primary drug resistance (37.5%). Intensive combined treatment with consideration of bacterial resistance, administration of reserve drugs, wide spectrum medicines bring about positive results, but in patients with drug resistance positive dynamics is slow.

[Carbohydrate metabolism impairment and specific features of the course of tuberculosis in adolescents with diabetes mellitus]. / Narusheniia uglevodnogo obmena i osobennosti techeniia tuberkuleza u podrostkov, bol'nykh sakharnym diabetom.

The paper deals with the detection of carbohydrate metabolic disturbances in adolescents with tuberculosis and analyzes their impact on the course of a specific process. Borderline carbohydrate metabolic disorders were identified in 10.8% of the 130 patients examined. A trend for tuberculosis to run less favourably was found in patients with carbohydrate metabolic disturbances than in those without these disorders; however, there was no significant difference between the groups. Fourteen tuberculosis adolescents with diabetes mellitus were followed up. Their concurrence showed a severe course. In 33.2% of patients, the course of tuberculosis was poor, by progressing to fibro-cavernous tuberculosis.

[Relationship of tuberculosis course in adolescents with acute phase blood proteins and genetic types of haptoglobin]. / Vzaimosviaz' techeniia tuberkuleza u podrostkov s pokazateliami ostrofaznykh belkov krovi i geneticheskimi variantami gaptoglobina.

The phenotype of haptoglobin (Hp) was determined and Hp and alpha 1-antitrypsin (alpha 1-AT) were many times measured in the sera of 131 adolescents with first identified tuberculosis. The phenotype of Hp was found to produce no effects on tuberculosis morbidity among adolescents, but Hp2-2 carriers fall ill more frequently if they have a baseline gastrointestinal abnormality. In tuberculosis patients with Hp2-2, resolution of infiltrative changes in the lung tissue occurs less rapidly than in those with other Hp variants. Great increases in the serum levels of alpha 1-AT, which reflects the severity of tissue damages, suggest a less favourable prognosis. By the end of sixth-month continuous combined drug therapy, an inflammatory reaction diminishes and the synthesis of acute phase reactants (APR) becomes normal in patients without baseline lung tissue decay. In the presence of the latter, the intensity of inflammation considerably decreases in the first 3 months of combined drug therapy, then becomes steady-state at a definite level, which is potentiated by continuous invasion of proteolytic enzymes. APR monitoring more accurately assesses the time course of therapy-induced changes in the process.

[The detection of mycobacteria in children and adolescents by using the polymerase chain reaction]. / Vyiavlenie mikobakterii s pomoshch'iu polimerazno-tsepnoi reaktsii u detei i podrostkov.

A polymerase chain reaction (PCR) was used for determination of mycobacterial DNA in clinical samples from children and adolescents. The results were positive in 23 and 53% of cases, respectively, while standard microbiological methods failed to show presence of any bacteria in the samples. Case histories contained information on high incidence of positive Mantoux test. Microbiologically the diagnosis was confirmed only in 7 adolescents. In children mycobacteria were not found.

[Characteristics of diagnosis, clinical aspects and clinical course of tuberculosis in adolescents with concomitant diseases]. / Osobennosti diagnostiki, kliniki i techeniia tuberkuleza u podrostkov s nalichiem soputstvuiushchikh zabolevanii.

The authors present the data on special features of the course of tuberculosis in adolescents having other diverse conditions such as nonspecific pulmonary diseases and congenital abnormalities, prior acute respiratory diseases and concurrent iron deficiency anemia. The combination of tuberculosis with other diseases results in a longer course of tuberculosis with slow clinical and X-ray dynamics and in a number of cases (++prior acute respiratory diseases) in bouts of the specific process. The favourable outcomes of the disease are determined by the correct combined treatment of tuberculosis and concurrent diseases. When tuberculosis runs along with congenital abnormalities the effectiveness of treatment is achieved by surgical methods after specific chemotherapy.

[Differential diagnosis of disseminated processes in the lungs in adolescents]. / Differentsial'naia diagnostika disseminirovannykh protsessov v legkikh u podrostkov.

The paper deals with the data of follow-up of adolescents with disseminated pulmonary processes of different etiology. Among the patients who were treated in the department during the last 10 years disseminated processes amounted to 3.3%, with disseminated pulmonary tuberculosis being recorded in 1.3% and dissemination of the nontuberculous etiology in 2% of the patients. Mucoviscidosis, metastasis, of the thyroid cancer, histiocytosis X, toxoplasmosis and echinococcosis were among the disseminations of the nontuberculous etiology. Basic diagnostic criteria have been determined.

[Optimal measures for early detection and prevention of tuberculosis in adolescents]. / Optimizatsiia meropriiatii po rannemu vyiavleniiu tuberkuleza i ego profilaktike u podrostkov.

Data are given on the examination of 23,507 schoolchildren, students of specialized secondary and technical vocational schools covering 13 regions of the country. It has been found that tuberculosis contamination of adolescents is 30-33%, on average, but it varies considerably depending on the general epidemiologic situation at the place of residence, and the social status of adolescents. As compared to schoolchildren, tuberculosis contamination and the frequency of tuberculin reaction reversion are higher in students of technical vocational schools. The importance of BCG vaccination in adolescents, as the main method for tuberculosis is prevention, is substantiated. About 30% of adolescents, on average, are subject to revaccination. It is concluded that children and adolescents should be revaccinated twice: at 6-7 years (1st form) and 14-15 years (8-9th form).