[Optimization of chemotherapy regimens in children with primary pulmonary tuberculosis].

The efficiency of treatment was analyzed in 142 children aged 3-14 years who had local forms of primary pulmonary tuberculosis. Therapy was performed according to regimens 3 and 1, by using individual dosage regimens depending on the extent and severity of a specific process, the presence of complications, and age-related features. In minor tuberculosis, solitary calcifications being detected without signs of the activity of tuberculous infection, the basic course of therapy was 6-8 months; it was performed using 2 drugs in individual cases. In disseminated and complicated processes, eliminated intoxication and visible X-ray inflammatory changes were observed in 58.8-61.7% of children by months 3-4 of treatment, which required a longer intensive phase, by administering 3 drugs in the continuation phase till 6-9 months.

[The pathomorphism and diagnosis of tuberculosis of intrathoracic lymph nodes in children]. / Patomorfoz i diagnostika tuberkuleza vnutrigrudnykh limfaticheskikh uzlov u detei.

In the past decade, the leading form of specific lesion in children is tuberculosis of intrathoracic lymph nodes, whose proportion in the pattern of clinical forms is as high as 85.7%. The period of 1990 to 2002 showed a 3-fold increase in the detection of bilateral lesion involving more than 3 groups of lymph nodes; the specific processes were complicated by 3.5 times more frequently. The proportion of generalized forms of primary tuberculosis increased from 5 to 15%. Inclusion of mediastinal computed tomography into a package of studies significantly evaluates the magnitude of enlargement of lymph nodes. The polymerase chain reaction test for MBT DNA in the diagnosis of tuberculosis of intrathoracic lymph nodes in the absence of bacterial isolation yields a positive result in 73.3% of the children, which is an additional tool in the comprehensive study, which verifies the activity of a tuberculous process.

[Principles in the diagnosis of primary and occult manifestation of tuberculous infection in children]. / Printsipy diagnostiki nachal'nykh i malovyrazhennykh proiavlenii tuberkuleznoi infektsii u detei.

An algorithm of complex examination is proposed for early diagnosis of tuberculosis in children with different manifestations of tuberculous infection. The results of clinical and laboratory studies of 209 children by using the most informative values in its diagnosis may establish it in 81.8% of cases in the outpatient setting. While revealing high specific sensitization, some signs of functional disorders or 1-2 direct X-ray signs of an intrathoracic lymph nodal response were detected in 53.1% of the children with suspected tuberculosis, this condition may be interpreted as a borderline between Mycobacterium tuberculosis infection and disease.

[Intoxication indicators in the diagnosis of tuberculosis activity in children]. / Pokazateli intoksikatsii v opredelenii aktivnosti tuberkuleznoi infektsii u detei.

It is suggested to judge on the activity of intrathoracic lymph node tuberculosis by intoxication assessed from the levels of low- and middle-mass substances in blood plasma and red cells. 44 children were examined: 12 children infected with M.tuberculosis, 15 children with active tuberculosis of intrathoracic lymph node tuberculosis, 17 children treated for this disease by routine methods. Higher levels of the above substances were found in children with specific active process. Etiopathogenetic treatment for at least 4 months led to reduction of intoxication which, however, did not reach control concentrations.