[Diaskintest for tuberculosis in children and adolescents].

To study whether Diaskintest might be used as a criterion for the activity of local tuberculous changes in children and adolescents, the authors examined three groups of patients aged 0 to 17 years: 1) 20 patients with new-onset tuberculosis in the progression phase; 2) 25 patients with new-onset tuberculosis in the regression phase with the signs of consolidation and calcification; 3) 18 tuberculosis dispensary Group IIIB patients who received the basic course of therapy and had residual posttuberculous changes as calcinates and compact foci. Group 3 was found to greatly differ from Groups 1 and 2 in the lower rates of positive reactions, the higher rate of negative reactions, and smaller papulae while the Mantoux test with 2 TE indicated that in Group 3, the papulae were smaller than those in Group 2. Responses to the Diaskintest test versus the Mantoux 2TE test were significantly more pronounced in patients with progressive tuberculosis and less marked in dispensary Group IIB patients who received the basic course of antituberculous therapy. Diaskintest was ascertained to be used in the complex examination of children and adolescents as a criterion for the activity of tuberculous changes in order to choose the tactics of treatment and follow-up of children and adolescents. The application of Diaskintest will allow more objective formation of dispensary Group IIIA of children served by a local phthisiatrician.

[Problems of the concomitance of HIV and tuberculous infection in children (epidemiology, vaccinal prophylaxis, diagnosis, and preventive treatment)].

Tuberculosis and HIV infection become a topical problem not only in adults, but also in children. There is a rise in the number of HIV-infected females of child-bearing age, by increasing the number of babies born to HIV-infected mothers. HIV-positive children are not vaccinated with BCG vaccine before 15-18 months. For this time, they have time to be infected with Mycobacterium tuberculosis and ill with tuberculosis. And since it is difficult to diagnose tuberculous infection in these children (tuberculin tests are frequently negative or not marked), tuberculosis is detected in children late and it takes a severe course. Under these conditions both vaccination against tuberculosis and preventive treatment for latent tuberculous infection are required. The results of the study conducted by the authors are in good agreement with the data available in the literature on the safety of BCG vaccination in HIV-infected children without clinical symptoms of AIDS in the first year of life, including in neonatality.

[Effectiveness of intratracheal administration of contrykal in combined treatment of children with intrathoracic tuberculosis complicated by endobronchial pathology]. / Effektivnost' intratrakheal'nogo vvedeniia kontrikala v kompleksnom lechenii detei s vnutrigrudnym tuberkulezom, oslozhnennym éndobronkhial'noi patologiei.

Local balance in the system of proteinases-inhibitors in bronchial secretion was studied in 97 children with intrathoracic tuberculosis involving the bronchial tree by activity of trypsin-like proteinases (TLP), free antitryptic activity (ATA) and total content of locally synthesized low molecular acid resisting proteinase inhibitors (ARI). In the children with endobronchial pathology there was observed imbalance in the system evident from increasing activity of TLP and simultaneous decreasing of ATA and the content of ARI. The maximum inhibition of ARI local secretion and increasing of the TLP activity were stated in the patients with purulent and specific endobronchitis. In the children with catarrhal endobronchitis the shifts were moderate. Local use of contrykal in the form of ultrasonic inhalations in complex therapy of tuberculosis promoted in short periods reduction of the inhibitory potential, a 2-fold decrease in the terms of clinical recovery from endobronchitis and a decrease in the frequency of marked fibrous lesions in the bronchi and lungs as compared to analogous patients in the control group treated without the use of the proteinase inhibitor.