[Preclinical and clinical trials of the new tuberculosis drug perchlozon].

The paper sets forth the stages of design and introduction of the new Russian tuberculosis (TB) drug perchlozon registered in the Russian Federation in 2012. Based on the results of Phases I-III clinical trials, the authors evaluate the efficacy and safety of the agent and consider the adverse effects of its treatment for respiratory TB. The use of perchlozon as a component of combination therapy versus standard chemotherapy regimens significantly reduces abacillation time in pulmonary TB caused by its drug-resistant pathogen. In terms of the higher prevalence of TB induced by its pathogen resistant to many drugs (with multiple and broad-spectrum drug resistance), perchlozon is an essential drug that has antituberculous activity mainly against multidrug-resistant Mycobacterium tuberculosis strains and gives patients with the severest and epidemiologically poor form of TB the chance to recover.

[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.

[Approach to diagnosing tuberculosis of intrathoracic lymph nodes of a paraaortic group in children].

A hundred and seventeen patients aged 3 to 14 years, with suspected tuberculosis of intrathoracic lymph nodes (ILN) of a paraaortic group in the phase of calcination, were examined at the Clinic of Childhood Pulmonary Tuberculosis, Saint Petersburg Research Institute of Phthisiology. The comprehensive examination made the diagnosis of tuberculosis be cancelled in 35% of cases and confirmed in 65%, by determining the phase and extent of a specific inflammation. In 8.5% the local manifestations of the disease were absent along with the significant symptoms of intoxication and with the activity of tuberculous infection, which gave grounds to establish the diagnosis of tuberculous intoxication. Despite the fact that computed tomography revealed aortic ligament calcification, enlarged mediastinal lymph nodes were detected in 35%. High tuberculous infection activity and mediastinal ILN lesion in different phases of the specific inflammation were found in 15.4%, which was indicative of the chronic course of inflammation. The first detected isolated calcification in the paraaortic group of lymph nodes was diagnosed in 5.9%. The use of the presented complex, the diagnostic efficiency of which was 98%, significantly enhanced the diagnosis and reduced the number of errors in making the diagnosis.

[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.