[Leukinferon in combined therapy for acute pulmonary tuberculosis]. / Leikinferon v kompleksnoi terapii ostroprogressiruiushchego tuberkuleza legkikh.

Experiments on 140 CBA and C57BL/6 mice and studies of 163 patients with acute pulmonary tuberculosis have indicated that leukinferon has a immunomodulating effect on morphological reactions in the lung and on the clinical course of the disease. They have shown that leukinferon plays an important role in the activation of exudate macrophages and in the acceleration of their differentiation in experimental tuberculosis and that there is a rapid elimination of Mycobacterium tuberculosis from the involved organs without production of the L-forms of the causative agent when immunomodulation is used. At months 2-3, the patients with acute pulmonary tuberculosis showed the accelerated processes of detoxification, abacillation, infiltrate resolution, and decay cavity closure during hemo- and immunomodulation with the normalized production of cytokines (gamma-interferon and tumor necrosis factor-alpha). During 6-month therapy, a severe pulmonary process was arrested in 84% of cases and some patients were operated on (76% in the comparison group). The morphological effect of leukinferon was to increase mononuclear infiltration and to normalize a lung connective tissue response, by further decreasing the rate of inflammation.

[Surgical treatment of patients with acute pulmonary tuberculosis]. / Khirurgicheskoe lechenie bol'nykh ostroprogressiruiushchim tuberkulezom legkikh.

The immediate and late outcomes of treatment of acute pulmonary tuberculosis with and without surgical treatments (337 and 271 patients, respectively) were analyzed. The vast majority of patients in both groups were those with caseous pneumonia and fibrocavernous tuberculosis complicated by caseous pneumonia. A complete clinical effect was achieved in 14% of non-operated patients at their discharge, with a hospital mortality of 15.5%. A surgical treatment provided a 6.5-fold early effectiveness with a less (8.6-fold) hospital mortality. In a follow-up periods (up to 11 years), the number of cases of recurrences and progression of tuberculosis in patients in whom surgery was indicated, but non operated cases was 5.7 times higher than that in those radically and arbitrarily radically operated on; 5-, 7-, and 10-year survival rates in the non-operated patients were 1.6, 2.3, and 4.9 times less, respectively (85.7% versus 17.6%).

[Plasmapheresis in the complex treatment of patients with acutely progressive pulmonary tuberculosis]. / Plazmoferez v kompleksnom lechenii bol'nykh ostroprogressiruiushchim tuberkulezom legkikh.

The efficiency of plasmapheresis versus routine methods of detoxification in the complex treatment was compared in 100 patients with acutely progressive pulmonary tuberculosis. After 2 and 4 months, plasmapheresis was found to arrest the intoxication syndrome in 56 and 100% of the patients, respectively. This treatment in these patients resulted in ceased bacterial isolation in 52% of the patients following 2 months and lung cavern closure in 36% of cases after 6 months. This ultimately reduced the time of hospital stay on the average of 2 months, its duration being not longer than 7-8 months.

[Clinical-morphological characteristics and prevention of steroid tuberculosis]. / Kliniko-morfologicheskaia kharakteristika i profilaktika "steroidnogo" tuberkuleza.

The analysis is given of the autopsy material obtained from 39 cases of progressive tuberculosis which developed against glucocorticosteroid treatment of different diseases. In 28 of 39 patients progression of tuberculosis was stated as the main cause of death. There were 12.8% and 43.6% of cases with primary and disseminated tuberculosis, respectively. Clinicoanatomical correlations related tuberculosis onset to the hormonal treatment regimens. Comparison of the final clinical and pathomorphological diagnoses showed that tuberculosis had been overlooked in 51.3% of cases.