[Analysis of tuberculosis morbidity in the southeastern district of Moscow]. / Analiz zabolevaemosti tuberkulezom v Iugo-Vostochnom okruge Moskvy.

The present-day poor epidemiological conditions are marked by an increase in tuberculosis detection rates (1.43%) with low coverage (28.0%) of the population with preventive fluorographic surveys and a high proportion (39.0%) of young patients (aged 18-39 years) among new cases. The shares of advanced and acute forms of tuberculosis were 7.2 and 11.4%, respectively. A decay phase was detected in 50.6%, 52.6% of patients isolated bacteria. In children, tuberculosis morbidity increased by 28.6% mainly among the unregistered extrafamilial contacts. Most patients (75.8%) detected upon their referral to the polyclinics and general hospitals had a high proportion of extrapulmonary tuberculosis. Thus, the above trends of morbidity show its high potential level.

[Characterization of epidemic foci of tuberculosis and improvement of the follow-up of children and adolescents from the environment of patients with tuberculosis]. / Kharakteristika épidemicheskikh ochagov tuberkuleza i sovershenstvovanie dispansernogo nabliudeniia za det'mi i podrostkami iz okruzheniia bol'nykh tuberkulezom.

Despite unfavorable socioepidemiological conditions, there are potentials of reducing tuberculosis morbidity in the epidemic foci of children and adolescents (by more than 3.5 times). For this, all the children and adolescents from the foci of infection should be thoroughly examined and followed up and educational and preventive measures including intensified antituberculosis propaganda should be made in these foci.

[New methods of prevention, diagnosis and treatment of tuberculosis in children]. / Novye metody profilaktiki, diagnostiki i lecheniia tuberkuleza u detei.

The follow-up included two groups of schoolchildren: 862 were repeatedly given BCG and 725, BCG-M vaccines. It was demonstrated that both vaccines had the same effectiveness and the latter could also be used. Upright tomographic findings in 70 children showed that it was highly informative for the diagnosis of intrathoracic tuberculosis in children, especially for that of bronchoadenitis. Monitoring of 315 children with destructive pulmonary processes (157 of them had lesions of tuberculous etiology) made it possible to define risk factors of destructive tuberculosis contamination (in particular, genetical predisposition), the diagnostic criteria and high diagnostic value of the enzyme-linked immunoassay (96%). Ultrasound examination of the liver in 121 tuberculosis children enabled one to diagnose the type and etiology of liver affection, to control its state during treatment, to specify the side effects of the drugs and to modulate the therapy. The course and outcomes of tuberculosis were found to be affected by liver affections. The parenteral administration of isoniazid in combination with other drugs was shown to be highly beneficial in disseminated form of tuberculosis in children.

Peculiarities of dermatomyositis (DM) in early age.

The peculiarities of beginning of disease, clinical factors of risk in 70 children (aged under 8) with dermatomyositis are discussed. We have followed up 70 children (40 girls and 30 boys) with dermatomyositis at the age of 14 months to the age of 8 years. Most of the children were born in normal time, they have normal life functions during the first year of life. The most frequent intercurrent diseases were respiratory infections, angina; the chicken-pox was frequent too. 12 children had food allergy and 20 children-drug allergy. The most frequent factors preceded dermatomyositis were respiratory diseases and inoculations. Assembling of genealogical anamnesis was made according to "family portrait". 14 families of children with dermatomyositis (369 relations in I-IV degree of relationship) were examined. Genealogical investigations revealed the high frequency of rheumatological pathology in proband's families. Small anomaly of development among probands (M +/- m = 12.5 +/- 0.6) exceeded these quantity comparing to the control group (n = 60). Dermatollphyics (98 indices on each child) contained a number of peculiarities for forming the group of risk. Onset of disease was acute or subacute in 2/3 of children. Primary chronic onset and the progress of the disease took place in 10 cases. An acute onset of dermatomyositis was characterized by fever, myaglia, arthralgia, bright skin symptoms: widespread purple violet face erythema, a "butterfly wing" or "paraorbital glasses", palmal erythema and widespread vascular manifestations on face, chest, back and limbs in the form of net--"livedo reticularis".