[Pulmonary tuberculosis and problems of its revealing in elderly and senile patients].

Analysis of the revealed for the first time pulmonary tuberculosis in persons of the elderly and senile age has shown that this age category composes 5% among all the patients over 18 years old and it makes up 19,2% of the cases with fibro-cavernous tuberculosis and 25,6% of postmortem diagnosis. A severe structure of clinical forms and features of TB process in 114 hospitalized patients over 65 was determined; this results from the violation of required terms of preventive X-ray examination. These patients appear to be highly dangerous epidemiologically. Advantages of active TB identification in persons of the elderly and senile age were proved. We've come to the conclusion that elaboration of effective measures to improve active identification of this disease is extremely necessary; we've proposed some specific steps aimed at increasing of timely identification of TB in this age group.

[Clinical picture and diagnosis of cancer of lung in persons of elderly and senile age with residual tubercular changes].

Clinical and roentgenologic manifestations of cancer of lung developing from residual tubercular changes in 32 patients of elderly and senile age were analysed. Clinical and roentgenologic and laboratory criteria of diagnosis of the associated process were determined. Causes of the late diagnosis of cancer of lung were disclosed; it was caused by the low level of work at the medical institution following up the patients suffering from tuberculosis and having residual changes, namely, lack of regular preventive X-ray examinations which occurs in 3/4 patients with the associated process. We came to the conclusion that patients of the elderly and senile age with residual tubercular changes should be referred to the risk group of developing cancer of lung and it's necessary to display oncology alarm to them.

[The organization of prevention of tuberculosis among medical university students].

The article deals with the analysis of 94 cases of tuberculosis among students of Krasnoyarsk state medical university in 1987-2010. The characteristics of disease structure and the outcomes of treatment are established The importance of mandatoty annual fluorography of students as a group with higher risk of tuberculosis infection is proved The tuberculin sensitivity and tuberculosis mycobacteria contamination of students of curative and pediatric faculties are examined. It is demonstrated that teaching in medical university is to be considered as a risk factor of primary tuberculosis infection with consequent development of disease. The proposal was made to organize a specific prevention (BCG revaccination) for medical universities students especially during the period of epidemiologic troubles.

[The specific features of new-onset tuberculosis in medical workers of the Krasnoyarsk Territory].

The occupational pattern and clinical characteristics of 587 medical workers detected as having tuberculosis over 13 years in the Krasnoyarsk Territory are analyzed. The distinctive features of the pattern of clinical forms of a tuberculous process and its characteristics have been identified in the medical workers as compared with nonmedical workers and regional differences have been also revealed. The reasons are shown for higher tuberculosis morbidity in physicians. There is evidence for the leading role of exogenous superinfection and its nosocomial pattern in the development of tuberculosis in medical workers. Pitfalls associated with the fact that the administrators of therapeutic-and-prophylactic and medical facilities exercise lax control over regular fluorographic studies of medical workers have been established in the organization of active tuberculosis detection. The findings are as a basis for developing a new guideline for the detection and prevention of tuberculosis in medical workers under the established epidemic situation.

[Age- and sex-specific features of new-onset pulmonary tuberculosis in the Krasnoyarsk Territory].

A total of 1150 cases of new-onset pulmonary tuberculosis were analyzed. A higher liability to the disease was shown in young females and males of ripe age. There was evidence for that the severer pattern of clinical forms and the nature of the process were directly proportional to the age of patients. Age-specific differences were found in the ways of detecting the disease and in the regularity of control fluorographic studies. The inclusion of persons aged 60 years or older into an increased risk group was justified. A severer pattern of clinical forms and characteristics of the process were established in males, which are largely caused by that the latter had irregularly underwent control fluorographic studies. Age- and gender-specific features of tuberculosis, which are typical of this region, have been identified.

[Comparative characteristics of disseminated pulmonary tuberculosis in patients isolating Mycobacterium tuberculosis with a high and low viability].

The specific features of disseminated pulmonary tuberculosis were studied in patients isolating Mycobacterium tuberculosis (MBT) with a high (n = 135) and low (n = 50) viability. The degree of the pathogen's viability was shown to determine the clinical characteristics of a specific process and the efficiency of its treatment. It is speculated that there is a direct relationship between the viability ofmycobacteria and their virulence. There are differences in the nature of primary drug resistance in MBT with their varying variability.

[Risk factors for tuberculosis, specific features of its detection and course]. / Faktory riska razvitiia tuberkuleza, osobennosti ego vyiavleniia i techeniia.

Risk factors for tuberculosis were ranged in 112 new cases. Under the present conditions, the tuberculous process were shown to run by manifesting significant symptoms associated with the predominance of exudative inflammation, with considerable extension of the process, and a high frequency of lung tissue destruction. Bacterial isolation was massive, accompanied by primary drug resistance in 35%. The author shows it necessary to activate work on the detection and prevention of tuberculosis.

[Tuberculosis in the staff of health care facilities in the students of medical educational establishments: clinical and social aspects]. / Kliniko-sotsial'nye aspekty tuberkuleza u personala meditsinskikh uchrezhdenii, studentov i uchashchikhsia zavedenii meditsinskogo profilia.

A total of 199 cases of tuberculosis were analyzed in medical workers. The age-sex-specific, professional and clinical structure of patients is presented. The predictors of the disease are revealed. In the present poor tuberculosis epidemiological situation, all those engaged in the public health care are noted to be at risk for this disease. A scheme of preventive measures is proposed.

[Clinical and social aspects of pulmonary tuberculosis in young women]. / Kliniko-sotsial'nye aspekty tuberkuleza legkikh u zhenshchin molodogo vozrasta.

The factors predisposing to tuberculous infection, ways of its detection, and specific features of the course were studied in 133 women aged 18 to 30 years. The severity of a clinical pattern in the patients and the high rate of detection of drug-resistant strains of Mycobacteria tuberculosis were found. The causes of untimely and late detection of the disease were clarified. Measures to improve the detection of the disease are proposed.

[Specific features of thanatogenesis of respiratory tuberculosis in penitentiaries]. / Osobennosti tanatogeneza tuberkuleza organov dykhaniia v penitentsiarnykh uchrezhdeniiakh.

The causes of death were analyzed in 112 patients treated at the interregional tuberculosis hospital. Some peculiarities in the thanatogenesis of pulmonary tuberculosis were revealed in penitentiaries: the deceased had more commonly infiltrative and disseminated tuberculosis than fibrocavernous, there was a high incidence of complications in 75% of dead persons who had exhaustion and cachexia that resulted in reduced defensive forces. The high (17%) pulmonary bleeding as a cause of death in three fourths of the those who died resulted from acute progressive tuberculosis.

[Causes of death of patients with tuberculosis]. / Prichiny smerti bol'nykh tuberkulezom.

The authors analyzed 310 case histories of patients who had died from tuberculosis. The factors predisposing to death were shown to be poor social being, bad habits, severe tuberculosis, and concomitant diseases. Among them there were prevalent fibrocavernous or disseminated tuberculosis that was complicated by the development of caseous pneumonia in every four patients. The main causes of death were progressive tuberculosis (52.7%), cardiopulmonary failure (26.9%). Generalized tuberculosis was responsible for death in 6% of the patients.

[Clinical and social characteristics of patients with infiltrative pulmonary tuberculosis]. / Kliniko-sotsial'naia kharakteristika bol'nykh infil'trativnym tuberkulezom legkikh.

The social status and specific features of infiltrative pulmonary tuberculosis were studied in 105 patients. Young males, villagers, and laborers, unemployed, homeless, alcoholics, patients with concurrent diseases, those at risk in particular,were found to more frequently fall ill. The severity of clinical manifestations are associated with more extensive involvement and high lung tissue decay.

[Course and outcome of miliary tuberculosis in adults at present]. / Techenie i iskhody miliarnogo tuberkuleza u vzroslykh v sovremennykh usloviiakh.

Study of the clinical features of the course of miliary tuberculosis in 19 patients between the ages of 16 and 72 years has demonstrated that it begins more commonly with extrapulmonary symptoms and has quite diverse manifestations which makes diagnosis difficult and calls for a more accurate analysis of the clinical manifestations of the disease.

[Risk factors in the development of pulmonary tuberculosis and the characteristics of its course in people over 50]. / Faktory riska v razvitii tuberkuleza legkikh i osobennosti ego techeniia u lits starshe 50 let.

Study of the onset and course of pulmonary tuberculosis in 121 patients between the ages of 50 and 75 years showed that 31.4% of the patients belonged to a high risk group of tuberculosis. Study also revealed a high frequency of occurrence of disseminated and fibrocavernous tuberculosis, the predominance of disseminated processes, frequent destruction of lung tissue, massive bacilli excretion and marked clinical manifestations of the disease, which develops in more than half of the patients in the period between the established terms of prophylactic fluorographic examination.

[Disseminated pulmonary tuberculosis in young people]. / Disseminirovannyi tuberkulez legkikh u lits molodogo vozrasta.

The problem of diagnosis and course of disseminated tuberculosis was studied in 209 patients at the age from 18 to 29 years. The terms of planned prophylactic fluorographic screening were not observed and as a sequel extensive involvement of the lungs was found more that in 50% of the patients. Young patients show an inadequate towards the severity of the disease, use their own discretion in ceasing treatment. This in the cause of low efficacy.

[Tuberculosis first detected in subjects over 70 years old]. / Vpervye vyiavlennyi tuberkulez u lits starshe 70 let.

Characteristics of the tuberculosis process were studied in 43 patients at the age of 71 to 84 years. Patients with extended extrapulmonary tuberculosis and concomitant diseases predominated. Analysis of the causes of the late tuberculosis detection is presented and it is indicated that efficient prophylactic examination of the persons of this age group is needed. Investigation of the clinical picture of tuberculosis in the patients over 70 years revealed a number of peculiarities in its process under conditions of the Krasnoyarsk Territory.