[Recurrence of pulmonary tuberculosis: in- and outpatient data]. / Retsidiv tuberkuleza legkikh po kliniko-dispansernym dannym.

Diagnosis recrudescent pulmonary tuberculosis shows different flaws: on the one hand, the progression of early untreated tuberculosis can be mistaken for a recrudescence, on the other, changes are interpreted as a recrudescence if there is no clinical and X-ray evidence for the reactivation of the process. All cases of recrudescent tuberculosis should be reexamined by a medical commission, which allows the above errors to be avoided. If a patient with chronic alcoholism and mental disease has recrudescent tuberculosis, a narcologist and psychiatrist must participate in working out a comprehensive treatment policy.

[Drug resistance of Mycobacterium tuberculosis and its significance in the hospital practice]. / Lekarstvennaia ustoichivost' mikobakterii tuberkuleza i ee znachenie v praktike dispansernoi raboty.

The author describes the trends in frequency and nature of primary drug resistance throughout the last 3 decades. Favourable trends in 1980s changed for negative tendencies in 1990s which reflects deterioration of epidemiological situation by tuberculosis. Earlier establishment of drug resistance is possible basing on its direct determination in the conditions of massive bacterial discharge. In new-onset contacts antibioticogram should be primarily copied from that of contamination source, in recurrent disease antibioticogram should correspond to that obtained in the same patient at first test.

[Treatment of patients with pulmonary tuberculosis and mental disorders]. / Lechenie bol'nykh tuberkulezom legkikh, stradaiushchikh psikhicheskimi zabolevaniiami.

In combined treatment of pulmonary tuberculosis and mental disease cessation of bacterial discharge was achieved in 79.5%, caverns closure in 73.8% of patients. The above percentage for chronic destructive tuberculosis reached 51 and 5.8%, respectively. However, positive results did not persist long

[Clinical course and symptoms of lung tuberculosis in patients with schizophrenia]. / Klinicheskie proiavleniia i techenie tuberkulëza lëgkikh u bolnykh shizofreniei.

Schizophrenics with multiple diseases are shown to have advanced tuberculosis with active bacterial discharge and rapid progression. There is a relationship between tuberculosis and schizophrenia.

[Current status and perspectives in hospital treatment of patients with tuberculosis complicated with alcohol abuse]. / Sostoianie i perspektivy statsionarnogo lecheniia bolnykh tuberkulëzom, zloupotrebliaiushchikh alkogolem.

The authors show a rise in the prevalence of tuberculosis among alcoholics. In the past decade, the specific proportion of these two concurrent diseases has reached 30% among the groups registered in the tuberculosis dispensaries. In a great number of patients, the disease was accompanied by bacterial secretion and decay. The therapeutical efficacy of compulsory treatment inpatients who refuse to take drugs has proved to be low. A daytime hospital can be one of treatments of such patients as the second stage of therapy after tuberculosis patients suffering from alcoholism have stayed in a twenty-four-hour hospital.

[Pulmonary tuberculosis in patients with mental disorders, drug addiction and substance abuse]. / Tuberkulez legkikh u bol'nykh s psikhicheskimi zabolevaniiami, narkomaniei i toksikomaniei.

The clinical manifestations, course and outcomes of pulmonary tuberculosis were studied in 215 patients with concurrent severe mental diseases (112 had schizophrenia and 103 other organic diseases of the central nervous system). The patients had mainly disseminated pulmonary tuberculosis with copious bacilli excretion and destruction. Their clinical manifestations and the course of a specific process were mainly progressive. Fatal outcomes were most common in tuberculosis patients with concurrent drug addiction and toxicomania. It is recommended that patients with mental diseases, narcomania and toxicomania should undergo a prophylactic fluorographic screening twice a year. Treatment of patients with tuberculosis and concurrent mental diseases should be combined and carried out by a psychiatrist (narcologist) jointly with a phthisiatrist.

[Intolerance to antituberculous drugs and methods of its elimination]. / Lekarstvennaia neperenosimost' protivotuberkuleznykh preparatov i metody ee ustraneniia.

The frequency of adverse reactions to antituberculous drugs was 33.6%, according to the materials of mass screening of Group I contingents of the dispensary record (259 patients) at various levels of treatment (hospital, polyclinic, sanatorium). At the polyclinic level which in all cases was nearly used after hospital, the frequency of adverse reactions was half as much as at the hospital level which was due to the use of the intermittent method and, in most cases, at least 2 drugs. The abolishing action of sodium thiosulphate, splenin, hyperbaric oxygenation and their various combinations was found to be higher than that of antihistaminics used in allergic reactions, hemodez or a 5% glucose solution applied in toxic reactions. Hemosorption and hyperbaric oxygenation are more effective for the alleviation of adverse reactions than splenin and sodium thiosulphate. Toxic reactions are better arrested by hemosorption and sodium thiosulphate, while the allergic reactions by hyperbaric in combination with splenin, sodium thiosulphate or hemosorption.

[Improving the diagnosis and treatment of pulmonary tuberculosis among the inmates of reformatory institutions of the Ministry of Home Affairs]. / Sovershenstvovanie vyiavleniia i lecheniia tuberkuleza legkikh sredi kontingentov ispravitel'no-trudovykh uchrezhdenii MVD.

According to the data given by the authors, the tuberculosis morbidity rate in the populations under surveillance of the Ministry of Home Affairs was over that in the general population. High morbidity of such persons is often contributed to their antisocial way of life, and alcohol and drug addiction. Full coverage of these groups by means of X-ray screening, when they are held prisoners during the investigation period, makes it possible to detect all cases with active tuberculosis, to prevent the admission of undetected patients to the reformatory schools and thereby to stop the transmission of tuberculous infection. The observations should be conducted twice a year since these imprisoned groups may be recognized as being at high risk for tuberculosis. The clinical pattern of pulmonary tuberculosis is unfavorable in the convicted persons. Appropriate three-stage chemotherapy with the use of surgical interventions, if indicated permits one to achieve in the reformatory institutions of the Ministry of Home Affairs a high efficacy of treatment of ++newly-diagnosed pulmonary tuberculosis patients, which concurrently significantly decreases their epidemic danger for the general population when they are let free.

[Incidence of pulmonary tuberculosis associated with chronic alcoholism and a complex treatment of those diseases]. / Rasprostranennost' tuberkuleza legkikh v sochetanii s khronicheskim alkogolizmom i kompleksnoe lechenie étikh zabolevanii.

It was shown that the prevalence of alcoholism among pulmonary tuberculosis patients was high and the outcomes of both the diseases proceeding in the presence of lowered immunity were often unfavourable, including the results of long-term follow-ups. The use of a specially constructed instrument for investigating the neurodynamic characteristics of the cerebral cortex and determination of gamma-glutamyl transpeptidase in the serum promoted diagnosis of prenosological entities of alcoholism. Higher efficacy of alcoholism treatment in the patients with tuberculosis was achieved with narcotic psychotherapy using the mixture of nitrous oxide and oxygen, esperal implantation and application of rifusal, a new preparation, as well as application of extracorporeal hemosorption and enterosorption for eliminating the intoxication. Higher efficacy of tuberculosis treatment in the alcoholic patients was achieved with intravenous drop-wise infusion of antituberculous drugs along with other routes of administration. For increasing the cellular immunity, the patients were treated with chlorophylliptum or T-activin. Continuation of the complex antialcoholic and antituberculous treatment of outpatients along with simultaneous observation by phthisiologists and narcologists provided higher results.

[Alcoholism and pulmonary tuberculosis]. / Alkogolizm i tuberkulez legkikh.

A study of concomitant cases of alcoholism and pulmonary tuberculosis is reported, with reference to the incidence of alcoholism among the patients with pulmonary tuberculosis, causative relationships between the two diseases, clinical manifestations and course of pulmonary tuberculosis and alcoholism where the two are combined, as well as the treatment of alcoholism and pulmonary tuberculosis and its organizational aspects.