[The diagnosis and course of progressive disseminated pulmonary tuberculosis].

A hundred and forty-six patients with disseminated pulmonary tuberculosis were examined. Hematogenous disseminated tuberculosis at this stage was ascertained to run more frequently as acute and acutely progressive. The proportion of lymphogenous tuberculosis was shown to increase among all the types of disseminated pulmonary tuberculosis. Identification of the lymphobronchogenic type of disseminated pulmonary tuberculosis is recommended.

[Diagnostic features of newly diagnosed tuberculosis on different accounts of consulting with a physician]. / Nekotorye osobennosti vyiavleniia tuberkuleza organov dykhaniia.

The specific features of diagnosis were studied in 209 patients with tuberculosis at 9 phthisiological stations of the Yaroslavl Region in 1998-2002. In 96.2% of the patients, tuberculosis was found to have been newly diagnosed in general polyclinics and polyclinics. Only in 3.8% of the patients, the diagnosis of tuberculosis was made at prophylactic fluorography performed on the patients' initiative. A retrospective assessment of outpatient records indicated a significant delay in establishing tuberculosis, by using adequate diagnostic criteria if a physician had professional skills. The authors arrive at the conclusion that dispensary should assume the functions of phthisiopulmonological centers that will secure the continuity of early diagnosis of tuberculosis and its early treatment.

[Experience with using anti-TB preparations (rifabutin)]. / Opyt monitoringa ispol'zovaniia protivotuberkuleznykh preparatov (na primere rifabutina).

The study deals with the first experience of practically using a computer program designed to monitor the treatment process with a subsequent analysis of the efficiency of an anti-TB therapy with regard for different characteristics of patients. The efficiency of chemotherapy was compared (by using the clinical, microbiological and laboratory criteria) in two patients' groups, i.e. a control group (standard chemotherapy regimens) and a group, whose patients received rifabutin. Subgroups were isolated from among the last mentioned patients according to the below factors: primary and secondary therapy courses, completed and interrupted chemotherapy courses, and patients with multidrug resistance who discharged M. tuberculosis. Statistically reliable advantages of rifabutin were shown in respect to the arrest of bacterial discharge during a sufficiently prolonged (at leas 4 months) treatment course applicable to primarily diagnosed patients including those with multidrug resistance and M. tuberculosis. Disadvantages related with the application of rifabutin (a lack of clear-cut indications and abuse of treatment terms virtually in 50% of cases), which reduces the efficiency of its prescription, were equally detected.