Biomedical subjects
Publications and source records attributed to N M Rudoĭ.
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
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.
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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.
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.
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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.
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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.
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.
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.
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Explore the source record for details and available documents.