[Clinical picture and treatment of tuberculosis in HIV-infected patients]. / Osobennosti klinicheskoi kartiny i lecheniia tuberkuleza u VICh-infitsirovannykh bol'nykh.

In the Orenburg Region, HIV-infected individuals fall ill with tuberculosis tens time more frequently than uninfected ones. Thirty five HIV-infected patients with tuberculosis and 32 patients without immunodeficiency (a control group) were examined and treated. Of the clinical forms of tuberculosis, infiltrative tuberculosis was predominant, tissue destruction being seen in half the cases. Extrapulmonary tuberculosis was revealed in 11.4% of the patients. Multidrug resistance was ascertained in 20% of cases. The efficiency of treatment in patients with double HIV/tuberculosis infection was 10-15% lower than that in those without HIV infection.

[Prognostic value of isolation of L-forms of Mycobacterium tuberculosis]. / Prognosticheskoe znachenie vydeleniia L-form mikobakterii tuberkuleza.

A procedure has been developed to detect antilysozymatic activity n L forms of Mycobacterium tuberculosis (MBT). A mode of predicting the course of a tuberculosis process in the lungs by the degree of antilysozymatic activity of MBT is outlined. Thus, when the level is 4 micrograms/ml or higher, progression or exacerbation of tuberculosis is predicted, when that of 0-3 micrograms/ml, a good prognosis is expected.

[The antilysozyme activity of Mycobacterium tuberculosis L forms]. / Antilizotsimnaia aktivnost' L-form Mycobacterium tuberculosis.

The method for the detection of antilysozyme activity (ALA) in M. tuberculosis L forms was developed. The level of ALA in M. tuberculosis L forms isolated from patients with different clinical forms of the disease varied within 1-5 micrograms. M. tuberculosis L forms with the ALA level > 4 micrograms were isolated from patients with the progressing course of the disease. The method for the prognostication of the course of the tuberculous process in the lungs by the results of the antilysozyme test was proposed.

[Differential-diagnostic value of detecting L-forms of Mycobacterium tuberculosis]. / Differentsialno-diagnosticheskoe znachenie obnaruzheniia u bolnykh L-form Mikobakterii tuberkulëza.

A clinical and bacteriological study was made of 144 patients with new-onset pulmonary tuberculosis who had been treated within the first 3-4 weeks in the out- and in-patient settings for non-specific lung disease. Detailed studies found changed variants of the pathogen as L-forms in 28 (19.4%) patients, bacterial forms being undetectable. The paper shows how difficult to diagnose tuberculosis.

[Characteristics of bacterial discharge in patients with different forms of pulmonary tuberculosis]. / Kharakteristika bakteriovydeleniia u bol'nykh s razlichnymi formami tuberkuleza legkikh.

Clinical implications of L-form pulmonary tuberculosis have been investigated in 268 patients. Of them 223 had active respiratory tuberculosis, 45 demonstrated residual disease. New cases of L-form tuberculosis were characterized by poor clinical symptoms and favourable outcomes. Association of L-forms with bacterial discharge produced apparent symptoms and progressive trends. Detection of L-forms in inactive pulmonary process indicated latent activity of tuberculosis apt to recur.

[Clinical significance of drug resistance of tuberculosis mycobacteria and L-forms]. / Klinicheskoe znachenie lekarstvenno-ustoichivykh mikobakterii tuberkuleza i L-form.

The clinical features of a tuberculous process were studied in 101 patients with active pulmonary tuberculosis among whom 76% of the patients lost their social adaptation. The patients were divided into 2 groups: group 1 comprising 61 (60.4%) subjects who excreted tuberculosis mycobacteria and L-forms and group 2 consisting of 40 (39.6%) who excreted only tuberculosis mycobacteria. The frequency and degree of drug resistance were more manifest in 63.8% of the patients of group 1 and in 40% of those of group 2 (p less than 0.01). Drug resistance to relatively new antituberculosis drugs (ethambutol and rifampicin) was found in 30% of the patients. Mixed bacillary population was found 2 times more frequently in patients with serious progressive forms of tuberculosis, which gives evidence to consider it as a prognostically unfavourable indicator.

[Characteristics of the incidence of tuberculosis in Orenburg oblast]. / Osobennosti zabolevaemosti tuberkulezom v Orenburgskoi oblasti.

The trend in tuberculosis morbidity and characteristics of its clinical picture in the Orenburg Region within 1980-1987 were studied. During the 7-year period, there was a decrease in the disease morbidity by 21 per cent in the Region at large and by 10 per cent in the rural areas. A decrease in the proportion of destructive and extended tuberculosis was revealed. The incidence of tuberculosis in the rural population remained high. In the cattle breeders it was 3 times higher than the average figure for the Region. The real level of cattle affection with tuberculosis by the slaughter data amounted to 26 per cent and was by 64 per cent higher than the tuberculin diagnosis data of the veterinary departments. Direct average correlation between the levels of tuberculosis incidence in the cattle and cattle breeders was shown. A high incidence of tuberculosis was stated in urban industrial workers and especially in gas industry workers. In the latter, productive forms of tuberculosis coupled with increased tuberculin sensitivity were mainly diagnosed. Despite the downward trend in the morbidity of tuberculosis in children and adolescents, their contamination remained high. Single cases of tuberculous meningitis and generalized affections were recorded.