[Pulmonary tuberculosis in adolescents in relation to different degree of drug resistance]. / Techenie tuberkuleza legkikh u podrostkov v zavisimosti ot raznoi stepeni lekarstvennoi rezistentnosti.

Ninety adolescents with bacterial isolates of active forms of pulmonary tuberculosis were followed up. Drug resistance of Mycobacteria tuberculosis was revealed in 57 (63.3%) patients. Primary resistance was determined in 43 (47.7%) patients. The patients had not received antituberculous agents. Complete or partial coincidence of MBT resistance and sensitivity with the data of an infection focus. The course of tuberculosis during adequate treatment by using essential and reserve agents in the adolescents with varying MBT resistance was different. In patients (n = 18) resistant to 1-2 agents, the course of the disease little differed from that in those patients with drug-responding tuberculosis, except for later closure of decay cavities. In patients resistant to 3 drugs or more showed a slow course of the disease with significant residual changes in most patients.

[Approaches to combined therapy of pulmonary tuberculosis in adolescents excreting drug-resistant Mycobacterium tuberculosis]. / Podkhody k kompleksnoi terapii tuberkuleza legkikh u podrostkov, vydeliaiushchikh ustoichivye k khimiopreparatam mikobakterii tuberkuleza.

The data are presented on 138 adolescents with active, advanced tuberculosis. M. tuberculosis were detected in the sputum and bronchial lavage of 75(54.3%) adolescents. 32 patients had M. tuberculosis resistant to drugs. 28 untreated patients demonstrated primary drug resistance (37.5%). Intensive combined treatment with consideration of bacterial resistance, administration of reserve drugs, wide spectrum medicines bring about positive results, but in patients with drug resistance positive dynamics is slow.

[Modern aspects of the combined treatment of pulmonary tuberculosis in adolescents]. / Sovremennye aspekty kompleksnogo lecheniia tuberkuleza legkikh u podrostkov.

The paper presents the follow-up data on 171 adolescents with active pulmonary tuberculosis. Extensive, complicated processes were encountered in 30% of patients. Chemotherapy was used in relation to the severity of disease, to the presence of decay and bacterial isolation, to the sensitivity of Mycobacteria tuberculosis. Most patients received routine treatment regimens including four (n = 66) or three (n = 51) drugs. The treatment involved auxiliary drugs (tarivid, protionamid, amykacin). Pathogenetic treatments (lidase therapy, laser blood radiation, magnetic therapy) were employed. Comorbidity was also treated. Good results were achieved in 95.4% of patients. Hospital treatment decreased by 1.5-3 months.

[Carbohydrate metabolism impairment and specific features of the course of tuberculosis in adolescents with diabetes mellitus]. / Narusheniia uglevodnogo obmena i osobennosti techeniia tuberkuleza u podrostkov, bol'nykh sakharnym diabetom.

The paper deals with the detection of carbohydrate metabolic disturbances in adolescents with tuberculosis and analyzes their impact on the course of a specific process. Borderline carbohydrate metabolic disorders were identified in 10.8% of the 130 patients examined. A trend for tuberculosis to run less favourably was found in patients with carbohydrate metabolic disturbances than in those without these disorders; however, there was no significant difference between the groups. Fourteen tuberculosis adolescents with diabetes mellitus were followed up. Their concurrence showed a severe course. In 33.2% of patients, the course of tuberculosis was poor, by progressing to fibro-cavernous tuberculosis.

[Risk factors and their significance in the development of diffuse forms of tuberculosis in adolescents]. / Faktory riska i ikh znachenie v razvitii rasprostranennykh form tuberkuleza u podrostkov.

Follow-up study of 106 adolescents with advanced and complicated tuberculosis revealed causes and risk factors of the severe disease: late detection and treatment, massive infection, inadequate initial treatment, drug resistance of M. tuberculosis, poor tolerance of chemotherapy, presence of associated diseases and chronic infection foci, harmful habits. Of importance is also age-sex factor, absence of BCG revaccination, low quality of preventive, diagnostic and therapeutic service, inadequate hygienic education of adolescents.

[Differential diagnosis of disseminated processes in the lungs in adolescents]. / Differentsial'naia diagnostika disseminirovannykh protsessov v legkikh u podrostkov.

The paper deals with the data of follow-up of adolescents with disseminated pulmonary processes of different etiology. Among the patients who were treated in the department during the last 10 years disseminated processes amounted to 3.3%, with disseminated pulmonary tuberculosis being recorded in 1.3% and dissemination of the nontuberculous etiology in 2% of the patients. Mucoviscidosis, metastasis, of the thyroid cancer, histiocytosis X, toxoplasmosis and echinococcosis were among the disseminations of the nontuberculous etiology. Basic diagnostic criteria have been determined.

[Optimal measures for early detection and prevention of tuberculosis in adolescents]. / Optimizatsiia meropriiatii po rannemu vyiavleniiu tuberkuleza i ego profilaktike u podrostkov.

Data are given on the examination of 23,507 schoolchildren, students of specialized secondary and technical vocational schools covering 13 regions of the country. It has been found that tuberculosis contamination of adolescents is 30-33%, on average, but it varies considerably depending on the general epidemiologic situation at the place of residence, and the social status of adolescents. As compared to schoolchildren, tuberculosis contamination and the frequency of tuberculin reaction reversion are higher in students of technical vocational schools. The importance of BCG vaccination in adolescents, as the main method for tuberculosis is prevention, is substantiated. About 30% of adolescents, on average, are subject to revaccination. It is concluded that children and adolescents should be revaccinated twice: at 6-7 years (1st form) and 14-15 years (8-9th form).