[Intestinal perforation in tuberculosis]. / Perforatsiia kishki pri ee tuberkuleze.

For 5 years the authors observed isolated abdominal tuberculosis in 6 patients. Five of them who were urgently operated upon had perforations of the tuberculous ulcers of the intestine. A specific character of the inflammation was confirmed by histological investigations. Four patients are described in detail. One of them had six perforated tuberculous ulcers of the jejunum. All these patients died. Recommendations are given how to improve the diagnosis of abdominal tuberculosis and treat patients with this severe disease.

[Emergency diagnosis of tuberculosis in patients admitted to the Institute of Emergency Care]. / Neotlozhnaia diagnostika tuberkuleza u bol'nykh, gospitalizirovannykh v Institut Skoroí Pomoshchi.

Tuberculosis was first recognized by a phthisiothera-pist in 52 patients and in 3 cases at autopsy at the admission and resuscitation units. Out of 55 patients, 39 (71 +/- 6.1%) were found to have acute, general processes (subacute dissemination and acute military tuberculosis, caseous pneumonia, multiple preliminary extrapulmonary diseases). Six patients died at the Institute, after referral to tuberculosis dispensaries, there were 11 and 9 deaths at months 1 and 6, respectively. Mortality was 47.3 +/- 6.7%. According to the data of emergency x-ray study, the diagnosis to be correct in 87.3 +/- 4.2%. As high as 25% of new cases of tuberculosis were detected at somatic hospitals in 1992 - 1994. Therefore, all patients admitted for pulmonary complaints of general toxic syndrome should immediately undergo X-ray, sputum test for Mycobacterium tuberculosis, and a phthisiotherapist's examination.

[Effectiveness of fluorography in the prevention and diagnosis of pulmonary tuberculosis and cancer]. / Effektivnost proverochnoi fliuorografii v vyiavlenii tuberkulëza i raka lëgkikh.

Annual fluorographic examinations, involving about 80% of adult population, helped detect 81.6 +/- 0.6% of patients with pulmonary tuberculosis and 37 +/- 0.5% of those with pulmonary carcinoma. Unjustified reduction of the number of prophylactic phorofluorographies resulted in a reduction of the level of diagnosis of these conditions: the share of detected tuberculosis patients reduced to 62.3%. The incidence of bacterial discharge in newly detected cases increased by 19.7%, the disintegration phase increased by 16%. Decrease of the bacillary nucleus parallelled by an almost twofold growth in the number of lethal cases of tuberculosis evidence poor detection of the patients. Reduction in the number of cases of pulmonary carcinoma detected by prophylactic photofluorography resulted in the reduction of operable patients with this condition from 23.5 to 18%. A retrospective analysis of photofluorograms of newly detected patients with destructive tuberculous processes demonstrated the necessity of annual photofluorographic check-ups of the adult population aimed at the detection of pulmonary tuberculosis. The authors emphasize that the intervals between prophylactic check-ups of subjects at risk of developing pulmonary tuberculosis should by no means be prolonged.

[Organization of fluorographic examinations of the population in large cities]. / Ob organizatsii fliuorograficheskikh obsledovanii naseleniia v usloviiakh bol'shogo goroda.

A 5-year experience with fluorographic examination of the population of Leningrad is described. The data show that it is untimely to prolong the intervals between check fluorographic examinations. Difficulties in forming the risk groups are also indicated. Ways for improving organization of fluorographic examinations by using the available reserves are defined. On the whole, the present arrangement of prophylactic fluorographic examinations is rather efficient in regard to early detection of many pulmonary diseases including tuberculosis and peripheral cancer of the lungs.

[Causes of formation of destructive tuberculosis of the lungs]. / Prichiny formirovaniia destruktivnogo tuberkuleza legkikh.

It was shown that irregular fluorographic examinations, undetected pathological processes on fluorograms and their erroneous interpretation were the causes of destructive tuberculosis of the lung. Early detection of tuberculosis was hampered by prior nonspecific diseases of the respiratory organs and underestimation of the process activity especially when chronic bronchopulmonary diseases were associated with residual signs of cured tuberculosis. Recommendations for prophylaxis of destructive tuberculosis of the lung are presented.