[Drug resistance of Mycobacteria tuberculosis in patients with new-onset pulmonary tuberculosis].

Statistics for the last 6 years show a trend to growing number of new cases with tuberculosis of the lungs with drug-resistant pathogen. In recurrent tuberculosis multiple drug resistance (MDR) was three times higher than in new cases. Treatment efficacy depended on MDR and patients' compliance. The results of the basic treatment course were unstable: many patients had exacerbation within 3-4 years after therapy, many patients died, especially those with M. tuberculosis resistant to many drugs.

[Experience in organizing ambulatory control of patients with sarcoidosis in Moscow]. / Opyt organizatsii dispansernogo nabliudeniia bol'nykh sarkoidozom v Moskve.

Dispensary record group VIII for patients with sarcoidosis was introduced in Moscow in 1994 and a center based on the Moscow Research Production Center?? was set up to diagnose and treat such patients. In addition to advisory work, the sarcoidosis center performs organizational and methodological functions. A scheme of subgroup (A, B, and C) distribution of Group III patients by the activity and pattern of sarcoidosis has been developed to have unique follow-up methods. The diagnosis made in the patients and their dispensary registration, the efficiency of treatment, and their movement by subgroups are checked up. This system of a center-dispensary interaction revealed a dynamics in sarcoidosis incidence and prevalence in the city in 1994-1997. Evidence is provided for that it is expedient and timely to organize a follow-up of patients with sarcoidosis particularly when the share of paid medical services is increasing.

[Inpatient treatment of pulmonary tuberculosis: present day status and prospects]. / Statsionarnyi étap lecheniia bol'nykh tuberkulezom legkikh: sovremennoe sostoianie i perspektivy.

Analyzing the duration and efficiency of treatment of 95 inpatients with first detected pulmonary tuberculosis indicated that the mean hospital stay of patients without and with decay was 205 and 291 days, respectively. Medical and social aspects should be considered while defining indications and hospital stay periods in patients with tuberculosis. Long-term hospitalization of the patients is justifiable only in complicated tuberculosis and special circumstances which require direct continuous follow-up.

[Obstructive ventilatory disorders in pulmonary tuberculosis]. / Obstruktivnye narusheniia ventiliatsii pri tuberkuleze legkikh.

The results of the clinico-roentgenologic and functional examination of 434 patients with different forms of pulmonary tuberculosis were subjected to analysis. The obstructive syndrome of ventilation disorders was detected in more than 60% of pulmonary tuberculosis patients. The prevalent significance in its pathogenesis was played by disorders of patency of fine bronchi and air distribution in the lungs. They were associated with extension and activity of the processes and their tendency to acquire a chronic form and with the action of nonspecific factors on the bronchi, which included smoking, work under dust-contaminated conditions, concurrent nonspecific pulmonary diseases, nonspecific changes of the principal bronchi revealed by bronchoscopy and structural nonspecific changes of the peripheral air ways detected by a morphologic study of the resected material. A bronchospastic component was responsible for the broncho-obstructive syndrome in 57% of the patients.

[Modified screening of lung diseases in industrial workers]. / Opyt modifitsirovannogo skrininga zabolevanii lëgkikh rabochikh promyshlennykh predpriiatii.

The paper summarizes the results obtained at examination of industrial workers using a modified screening. This included questionnaires, oriented general examination, evaluation of external respiration with its monitoring during working hours. Such approach proved informative and provided a sufficient symptom complex to make diagnosis of occupational asthma.

[Characteristics of chemotherapy of pulmonary tuberculosis and its effectiveness in patients with diabetes mellitus]. / Osobennosti khimioterapii tuberkuleza legkikh i ee éffektivnost' u bol'nykh s sakharnym diabetom.

Assessment of tolerance to drug preparations and the effectiveness of this therapy in patients with tuberculosis and concurrent diabetes mellitus and with liver abnormality has shown a certain similarity between them, which consists in the fact that these patients were more often given non-conventional combinations of drugs than patients having no combined pathology. The initial regimen of chemotherapy was changed due to a poor tolerance of drug preparations. Prescription of Essentiale in this case to patients with pulmonary tuberculosis and diabetes mellitus is conducive to decline in severity of the adverse reactions to drugs and makes it possible to increase chemotherapy effectiveness.

[Clinical-morphological criteria of drug-induced hepatitis in pulmonary tuberculosis patients]. / Kliniko-morfologicheskie kriterii lekarstvennogo gepatita u bol'nykh tuberkulezom legkikh.

A thorough clinicomorphologic examination of 288 pulmonary tuberculosis patients with hepatic dysfunction revealed drug-induced hepatitis in 16.3% of the cases during their chemotherapy. Drug-induced hepatitis was found to be acute in 29.7%, chronic active in 27.6% and chronic persistent in 42.7% of these patients. Life-time morphologic investigation of the liver biopsy specimens is of primary importance for the evaluation of hepatitis etiology and its progress. The most characteristic morphologic features of drug-induced hepatitis are the presence of eosinophilic leukocytes in lymphomacrophagal inflammatory infiltrates, hyperplasia of smooth cytoplasmic network of hepatocytes and gigantic mitochondria with paracrystals in the matrix, fatty degeneration of hepatic cells as well as the presence of stellate reticuloendotheliocytes with abundant heterogeneous inclusions.