Biomedical subjects
Publications and source records attributed to V V Vatutina.
In 156 children with osseous complications due BCG vaccination, the clinical features of disease, radiation and laboratory changes were studied. An algorithm of diagnosis of BCG ostitis and a system of organizational measures whose implementation make it possible to objective the statistical registration of BGC ostitis in Russia are proposed.
Specific features of thoracic tuberculosis were studied in children with various forms of tuberculosis of bones and joints, i.e. tuberculous spondylitis, arthritis and osteitis. Peculiarities of the clinical course and of complications of thoracic tuberculosis were detected in children with the mentioned clinical forms, which are mostly pronounced in spinal tuberculosis and tuberculosis of joints. A complicated course of thoracic process predetermines the duration of treatment and affects the choice of time for surgical intervention.
The outcomes of treatment in 280 children with tuberculosis of bones and joints are analyzed. A general chemotherapy scheme for tuberculosis makes treatment regimens recommend for use in different forms of osteoarticular tuberculosis, which have been differentiated by the site and rate of an osseous and intrathoracic process and by the magnitude of their complications. The regimens differed in dosages, routes, and duration of administration of antituberculous drugs.
Experience in treating 97 children aged 1 to 14 years who had complicated tuberculosis of the spine (n = 74) and large joints (n = 23) in a specialized surgical clinical setting is presented. The developed treatment policy involves early radical reparative or reconstructive surgical intervention and intensive long-term therapy. The treatment allows one to cure 96.3% of children, yielding good functional results in 82.5% of them.
Immunogenetic examination of 146 preschool children with local and multiple tuberculous lesions and 148 controls found out the key role of unfavourable premorbid background (low-quality BCG vaccine, family contacts, associated diseases) in the disease onset. General trends in systemic immunity shifts are characterized. These depend on the age, inflammation phase, severity of clinical symptoms. Representation of antigens HLA DR2, DR5, Cw2, Cw4 indicates that a child has a 5-9 times greater risk to develop tuberculosis. These data should be allowed for in forming groups of higher risk among children.
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Clinical and diagnostic aspects, surgical outcomes, bacteriological findings were investigated for 72 infants under 3 years old operated for tuberculous ostitis. Tuberculin and seroimmunodiagnosis revealed infection allergy in 1/3 of the cases. The treatment comprises radical surgical reconstruction, drug and functional therapy. Tuberculous ostitis may arise due to vaccinal strain of M. tuberculosis.
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