In some infectious diseases, the number of T- and B-lymphocytes is significantly reduced which is associated with a high risk of the disease progression. The article reviews the effect of two RNA-containing viruses on the specific immune system: SARS-CoV-2 and HIV, as well as parameters of T- and B-cell neogenesis of TREC and KREC, which are markers of immunological disorders and can be used for prognosis for these infections.

The objective: to study clinical and laboratory specific parameters of the COVID-19 course in patients with TB/HIV co-infection, to analyze changes in the lungs caused by COVID-19 in patients with pulmonary tuberculosis and concurrent HIV infection.

Subjects and Methods. 68 HIV-infected patients aged 18-66 years old were included in the study, they all were admitted to the Novosibirsk State Regional Clinical Tuberculosis Hospital, Novosibirsk, with confirmed COVID-19 from May 2020 to May 2021. Clinical manifestations, CD4 count and HIV RNA level, and the presence of secondary infections were assessed.

Results. In patients with severe and profound immunodeficiency, coronavirus infection was more often mild to moderate, and in immunocompetent patients – moderate to severe. However, patients with profound immunodeficiency were at greater risk of an adverse outcome due to lymphohematogenic progression of tuberculosis and concurrent opportunistic infections.

Conclusion. When diagnosing and treating COVID-19 in patients with comorbid HIV infection and tuberculosis, it is important to consider the form of tuberculosis and CD4⁺ count.

The presented clinical case demonstrates a rare combination of arterial and venous thrombosis in a patient with severe COVID-19 coronavirus infection and a fatal outcome. The clinical manifestations of thrombosis were acute irreversible ischemia of the lower extremities, acute impairment of cerebral circulation, and venous thrombosis of the left lower extremity. These thrombotic complications were caused by virus-induced coagulopathy deteriorated by such risk factors as an old age, comorbidities and delayed prescription of anticoagulants. The mechanisms of thrombotic complications in patients with COVID-19 are complex and require further investigation.

The objective: to analyze results of stabilizing techniques in the surgical treatment of tuberculous arthritis of appendicular joints, to define their place in treatment of tuberculous arthritis.

Subjects and Methods. Data of 8 patients who underwent surgery for tuberculosis of appendicular joints were analyzed during the study. 7 patients suffered from tuberculosis of rare localization: ankle – 3 cases, foot – 1 case, wrist – 3 cases. And 1 patient suffers from tuberculosis of the knee joint, underwent arthrodesis, which eventually failed, had quadriceps fibrosis with no patella. At the time of the study, athroplasty couldn’t be performed in all 8 patients, so stabilizing surgery including arthrodesis was the method of choice. With the active tuberculosis disease and an extensive bone defect of the joint in 5 patients, static cement spacers loaded with anti-tuberculosis drugs were used. Spacers were used both for two-stage surgical treatment (2 cases) and one-stage (3 cases).

Results: in all 8 cases, the stable eradication of tuberculosis infection was achieved with a follow-up period from 6 months to 7 years, average duration of follow-up made 2.2 Ѓ} 1.4 years. In 5 patients with tuberculosis of the ankle, foot and former knee joint, the support ability of the extremity was restored. With the stabilization of the wrist in a functionally advantageous position, all 3 patients showed a significant improvement in hand functions. After the spacer was installed, all patients were scheduled for the second stage of the operation but 3 of them achieved a good functional result, thus it was possible to avoid the next stage. The main criterion for stabilizing surgery of joints may be the impossibility of performing arthroplasty in cases of extensive bone defects as well as in case of persistent loss of anatomical structures.

The objective: to study the frequency, structure and impact on the surgery outcome of intra- and postoperative complications after lung resections for fibrous-cavernous tuberculosis.

Subjects and Methods. A retrospective cohort analysis of intra- and postoperative complications was performed in 847 patients who underwent surgery for fibrous-cavernous pulmonary tuberculosis. Their influence on the surgery outcome was determined in accordance with the modified Russian classification of surgical errors assessment by R. M. Satava and the Accordion classification for severity of surgical complications. It has been established that the most dangerous complications that adversely affect the result of the operation are the following: injury to the cavity, vessels of the root of the lung and systemic circulation, empyema of the pleural cavity, exacerbation of tuberculosis, and pulmonary heart. These complications caused an unfavorable outcome in all 47 patients with such an outcome and led to a fatal outcome in 22 (78.6%) patients out of 28 deceased patients. Additions to the Accordion classification of postoperative complications are proposed taking into account the specific features of surgeries for tuberculosis.

The objective: to develop methodological approaches for assessing patient population in a TB unit based on models of patients who died in a TB hospital.

Subjects and Methods. A retrospective study included 413 patients who died in a TB hospital during periods of varying HIV infection prevalence. As a methodological approach to assessing the structure of this group of patients, 4 models of clinical situations have been proposed. The models considered severity and presence of tuberculosis infection, HIV infection, lesions of the central nervous system and concomitant non-communicable diseases. As an example of proposed clinical models, a comparison was made of deceased patients in a TB hospital in two periods – 2007 and 2017, which differed mainly in the prevalence of HIV infection among TB patients.

The article describes risk factors for the development of intestinal indigestion syndrome (IIS) in 109 patients with tuberculosis while they were receiving anti-tuberculosis chemotherapy (ATCT) and the results of assessment of the intestinal microbial population in 30 patients with tuberculosis before chemotherapy start. The following factors made significant contribution to development of intestinal indigestion syndrome: HIV infection, the number of doses of anti-tuberculosis drugs taken, and chronic gastrointestinal diseases. Even before the start of chemotherapy, the patients had disorders of the intestinal microflora, which were characterized by a decrease in the quantity of obligate bacteria, and higher frequency and number of facultative and transient bacteria.

This literature review presents data from 57 publications on vaping and e-cigarette-associated lung injury or EVALI (e-cigarette or vaping use-associated lung injury) that was first reported in 2019. The article describes the epidemiology of EVALI, the mechanism of injuring effects of vaping on the lungs, clinical signs, diagnosis and diagnostic criteria, therapy and subsequent management of patients with EVALI.

This review presents data from 29 publications on the use of mesenchymal stem cells in the therapy of tuberculosis of various localizations. It also describes some mechanisms of interaction between mesenchymal stem cells and M. tuberculosis.