[The efficiency of ultraviolet autologous blood irradiation used in the complex therapy of infiltrative pulmonary tuberculosis in children and adolescents].

The purpose of the investigation was to study the clinical efficiency of ultraviolet autoblood irradiation (UVABI) used in the complex therapy of children and adolescents with infiltrative pulmonary tuberculosis. A controlled randomized study of the results of treatment in two groups of patients who had or had not received UVABI during the standard complex therapy was carried out by the experiment-control principle. The groups were randomized (first - second). In 91.9% of the children and adolescents with infiltrative tuberculosis, the process was accompanied by impaired immune defense with bacterial isolation in 68.0 to 54.1% of cases; every two patients had drug-resistant Mycobacterium tuberculosis. The use of UVABI in the complex therapy of patients with tuberculosis was ascertained to promote a rapid, two-fold more frequent bacterial isolation cessation resulting in a epidemic danger reduction in the patients, to have a positive impact on the formation of immune defense, mainly of a phagocytic link, in children and adolescents, to exert a detoxifying effect, to favor a better tolerability of antituberculous drugs, to cause positive X-ray changes, and to improve the quality of life. The clinical and laboratory effectiveness and safety of UVABI allow recommendation that the latter be introduced into a treatment protocol for children and adolescents with infiltrative pulmonary tuberculosis.

[Roncoleukin in enhancing the efficiency of complex therapy for infiltrative pulmonary tuberculosis in adolescents].

Seventy-eight patients, aged 15.69 +/- 0.15 years, who had infiltrative pulmonary tuberculosis, were examined. Roncoleukin was given intravenously in 20 patients of them (Subgroup 1a), in an indirect lymphotropic fashion in 30 patients (Subgroup 1b); 28 adolescents were treated with the conventional treatments (Group 2). A decay phase was recorded in 33 (66%) from Group 1 and in 16 (57.1%) from Group 2. On admission, all 78 (100%) patients had immunological disorders that required immunomodulation. Roncoleukin caused positive clinical and X-ray changes that were more pronounced in Subgroup 1b: bacterial excretion cessation was recorded in 100% of patients in Subgroup 1a (p < 0.05); in 94.4% in Subgroup 1b (p < 0.05), and in 68.7% in Group 2; decay cavities closed in 69.2, 60, and 37.5% in Subgroups 1a and 1b and Group 2. At the same time, the duration of a procedure considerably reduced, which positively affected adolescents' compliance.

[The diagnostic value of adenosine deaminase coefficient in patients with tuberculous exudative pleurisy].

The authors examined 51 patients aged 37.74 +/- 2.17 years who had tuberculous pleurisy and aged 49.8 +/- 4.6 years who had nonspecific pleurisy. Group 1 comprised 18 patients with isolated tuberculous exudative pleurisy. Group 2 included 13 patients with tuberculosis complicated by tuberculous pleurisy. Group 3 consisted of 10 patients with nonspecific exudative pleurisy. Catarrhal endobronchitis was the leading form of tracheo-broncheal tree lesion among patients with tuberculous exudative pleurisy (n = 20 (64.5%)). The activity of adenosine deaminase (ADA) was 2.18 +/- 0.73, 2.41 +/- 0.80, and 2.47 +/- 1.52 U/l in Groups 1, 2, and 3, respectively. Thus, the measurement of bronchoalveolar fluid ADA separately from other parameters is of no informative value in the differential diagnosis of the etiology of pleurisy. While analyzing the parameters, the authors introduced the coefficient of ADA (CADA) that was calculated using the formula: K(ADA) = ADA/cytosis. In patients with tuberculous pleurisy, K(ADA) was 0.65 +/- 0.17 (this was 0.52 +/-0.13 in isolated tuberculous exudative pleurisy and 0.84 +/- 0.36 in tuberculous exudative pleurisy complicated by pulmonary tuberculosis (p < 0.05), and 0.20 +/- 0.06 in nonspecific pleurisy (p < 0.05). The ADA coefficient of 0.52 or more confirms the tuberculous etiology in isolated pleurisies and permits a differential diagnosis to be made between specific and nonspecific pleurisy with and without lung changes.

[The clinical picture and course of sarcoidosis under the conditions of the West Ural]. / Klinicheskaia kartina i techenie sarkoidoza v usloviiakh Zapadnogo Urala.

The specific features of the clinical picture and course of respiratory sarcoidosis (RS) and the efficiency of its treatment were studied in its new cases living in the Perm Region (the West Urals). There was a higher incidence of RS in inhabitants from towns with developed heavy industry, mainly in females. Primary chronic RS was prevalent (89.9%). The therapeutic efficiency was 69.5%. The outcomes of treatment were worse when the disease was untimely detected. Cure rates were higher and slightly lower when corticosteroids as tablets were used in the continuous (87.5%) and intermittent (89.9%) regimens, respectively, in combination with pathogenetic agents and treatments aimed at preventing the development of postsarcoid pneumosclerosis.

[Optimization of indirect endolymphatic injection of isoniazid in pulmonary tuberculosis]. / Optimizatsiia nepriamogo éndolimfaticheskogo vvedeniia izoniazida pri tuberkuleze legkikh.

The authors have substantiated and studied the use of lymphotropic (interstitial) injection of 1% isoniazid solution in the complex therapy of patients with pulmonary tuberculosis. The method provides active interstitial functioning of the diseased organ. This leads to a substantial improvement of immediate results of treatment in patients as accelerated closure of decay cavities and double cessation of bacterial isolation.

[Clinical presentation and course of sarcoidosis under the conditions of the West Urals]. / Osobennosti kliniki i techeniia sarkoidoza v usloviiakh Zapadnogo Urala.

The specific features of the clinical presentation and course of respiratory sarcoidosis (S) and the efficiency of its treatment were studied in 109 new cases in the Perm Region. The incidence of S is higher among residents from towns with developed heavy industry, mainly in females. Primary chronic S was predominant (89.9%). The efficiency of treatment in the patients was 69.5%. The results of treatment were worse in the untimely detection of S. The recovery rates were higher with corticosteroid tablets used continuously (87.5%) and those were lower with their intermittent use (82.9%).

[The status of the external respiratory function in patients with tuberculosis of the lungs and pre-roentgenologic pneumoconiosis changes]. / Sostoianie funktsii vneshnego dykhaniia u bol'nykh tuberkulezom legkikhs dorentgenologicheskimi pnevmokonioticheskimi izmeneniiami.

The ventilation function was studied in 103 pulmonary tuberculosis patients of pneumoconiosis-risk occupations in the absence of pneumoconiosis and in 51 patients who were not exposed to dust. Patients of "dust" occupations were found to have a decrease in the parameters of external respiration and bronchoscopic findings more often showed chronic bronchitis. The initial signs of pneumoconiosis were revealed in the histological examination of surgically removed lung segments in 83.4% of the patients.