The rate of spread of multiple drug resistant strains is much higher in Siberian and Far Eastern Federal Districts compared to the rest of Russia. In the meantime due to the lack of the unified monitoring system for this group of patients it is impossible to evaluate treatment outcomes.

Basing on the data submitted by 21 regions of Siberia and Far East the treatment e`ciency has been analyzed for patients suwering from multiple drug resistance for all these regions in general and specifically for each region, and the main factors providing the impact on the outcome have been identified.

Half of the registered patients do not receive adequate treatment with second line drugs for various reasons. Treatment e`ciency for the patients enrolled into treatment is almost the same as in the cohorts in the regions where the projects approved by Green Light Committee (WHO) were implemented. 

The study evaluated specific actual psychological status in 34 children at the age from 9 to 12 years old at various stages before the start of anti-tuberculosis therapy. Manifestations of asthenia were observed in the field of the task performance and cognitive function: reduction in the scope and accuracy of the active attention, low tempo of task performance, exhaustion, anergia of mnestic function. In the actual emotional state the expressed stress, high level of excitation and neurophysic stress and low energetic potential were observed. On the average in 8 months of anti-tuberculosis therapy significant changes were observed including both positive and negative shifts in the psychological state of the children. The obtained data provide the evidence on the integral nature of disorders caused by synergy of biological and psychosocial factors.

The sensitivity to tuberculin and recombinant tuberculous allergen was assessed in 433 children with latent tuberculous infection from various epidemic conditions [exposure to a TB case (n = 202), from healthy surrounding (n = 231); changes in the results of diaskintest were assessed in 209 children (when notified and in 12 months). It was found out that expressiveness and changes in the sensitivity to tuberculous recombinant allergen depends on the epidemic conditions to which the child is exposed. The most often the conversion of the diaskintest was observed after preventive treatment in those with doubtful (95.5%) and hyperergic (82.6%) sensitivity. Conversion of the test from negative to positive was most often observed in children from healthy surroundings.

The article presents the results of the study, the purpose of this study is to evaluate the application of the combined low flow anesthesia with sevorane, epidural anesthesia and multi-mode post-surgery analgesia compared to multi-component intravenous anesthesia. 22 patients in the age from 25 to 46 years were included into the study. The physical state of the majority of patients corresponded to ASA II. Results of this study allow recommending the combination of the low-flow anesthesia with sevorane and epidural analgesia in the post-surgery period as a method of choice for surgical treatment anesthesia of tuberculosis spondylitis. This method provides stable intra-surgery state of the patient, it is highly reliable and allows expanding anesthesia area and use of epidural catheter for post-surgery pain relief.

Open prospective comparative randomized study was conducted in order to evaluate e`ciency and safety of various techniques of administration of rifampycin, anti-tuberculosis drug, into the prostate. 36 patients at the age from 32 to 60 years old (38,9 years old on the average) were randomly selected into three groups, 12 patients in each group. All of them were treated with rifampicin in the dose of 0.6 g on the daily basis. The 1st group took the medication per os, the second group received intravenous injections, and the third group received the medication per rectum for 5 days. The method which less inhibited the quality and quantity of ejaculate was considered the safest. The e`ciency was evaluated by the reduction of pyospermia. The confidence of diwerences was evaluated by criteria of χ 2 (Statistica 6).

The most e`cient method of anti-tuberculosis drug administration for prostate tuberculosis patients is the intravenous drip infusion and administration of curative mixture in micro-clysis, the diwerence between these two techniques is insignificant. Per os intake rifampycin is confidently less e`cient compared to intravenous and per rectum administration techniques. The safest method regarding morphology, motility, quantity and concentration of sperms is per os and per rectum administration of rifampicin. Thus the best combination of e`ciency and safety for anti-tuberculosis drugs administration for prostate tuberculosis patients is introduction of curative combination of drugs in micro-clysis. 

Cross screening study of the body composition in 240 adult tuberculosis patients found out significantly lower rates of weight and height, lean and fat mass indices and the value of phase diwerence compared to the population of clinically healthy people examined in health centers. 46 (19.2%) patients out of all examined had cachexia defined basing on the criteria of World Health Organisation (WHO). In addition, 75 (31.7%) of tuberculosis patients had protein debilitation and 39 (16.3%) had lipid debilitation. Diagnostic sensitivity of WHO criteria of cachexia by body mass index when defining protein debilitation made 56%, and when defining lipid debilitation it made 61.5%. Among women the rates of protein and lipid debilitation were similar (29.1% and 26.6%), and among men protein debilitation prevailed (32.9% against 11.2%). Protein debilitation were most often detected in case of multiple drug resistance (in 54.7% of cases), in those receiving repeated treatment after chemotherapy failure (45.9%) and in disseminated forms of pulmonary tuberculosis (44.3%). Examination results of 55 workers of anti-tuberculosis medical units in general corresponded to the reference data of the health centers.

Kazakhstan has one of the highest incidence of multiple drug resistant tuberculosis in the world. The goal is to describe isolated of M. tuberculosis circulating in the Southern regions of Kazakhstan basing on MIRU-VNTR-profile and spectrum of gene mutations responsible for resistance to the first and second line drugs. 58 clinical isolates of M. tuberculosis with extensive drug resistance were collected. Genetic analysis was conducted by sequencing of genes of rpoB, katG, embB and inhA-fabG of operon and genes of gyrA, gyrB and rrs. The replacement of asparaginic acid with cysteine in the 94th codon of gyr4 gene was found out, which has not been described in literature before. Mutations dominated in the 315th codon of katG (n = 53; 91.4%), in the 531th codon of rpoB (n = 45; 77.6%), in position 1 401 of A/G gene rrs (n = 33; 56.9%) and in the 94th codon of gyrA. MIRU-VNTR typing showed that the majority of isolates belonged to W-Beijing family (n = 53, 94.4%). W-Beijing family often manifests resistance which can explain the increase of drug resistant tuberculosis incidence in the Republic.

The e`ciency of medication of remaxol for the management of liver lesions induced by anti-tuberculosis drugs was studied in 177 respiratory tuberculosis patients, divided into 3 groups: 1st group included 68 patients with no history of viral hepatitis and HIV infection; 2nd group included 52 patients with tuberculosis and HIV co-infection (patients from the 1st and 2nd groups received 10 day treatment with remaxol in case of drug-induced liver lesions) and 3rd control group included 57 patients (who received adamethioninum – heptor for management of the drug-induced liver lesions). 4.4% of patients from the 1st group, 7.6% from the 2nd group and 5.3% of control group manifested the improvement of the functional liver tests by the 18-20th days of the follow-up. In case of expressed concurrent conditions (viral hepatitis, diabetes etc.) and low improvement of aminotransferase level the duration of treatment of remaxol was extended up to 15 injections. Given the obtained results remaxol can be recommended for treatment of drug-induced liver lesions caused by the intake of anti-tuberculosis drugs. Tuberculosis patients with concurrent chronic alcohol addiction, HIV-infection, decompensated diabetes with low improvement of functional liver tests can be recommended to have longer treatment courses with remaxol: 15 infusions and more.

The article describes the stages and main principles of functioning of the pedagogical school for teaching in tuberculosis control issues. Given the pathomorphism of this disease and transfer to new educational standards it is owered to follow priorities of pedagogical principles of the Russian higher medical school, introducing innovative techniques of information presentation and formation of the specialists’ skills.

The articles presents a rare clinical case of the lung cancer with metastases into skin and soft tissues which was initially diagnosed as disseminated pulmonary tuberculosis with two-fold bacillary excretion; it shows the opportunities for rapid diagnostics of the lung cancer in a peripheral TB dispensary.

Инвазивный аспергиллез легких (ИАЛ) объединяет все формы аспергиллезной инфекции, протекающей с пенетрацией грибов через эпителиальный барьер дыхательных путей. Аспергиллез – заболевание, вызываемое плесневыми грибами рода Aspergillus, поражающее преимущественно органы дыхания – легкие и околоносовые пазухи. Его считают второй по  частоте после кандидомикоза микотической инфекцией. Аспергиллы встречаются повсеместно. В быту их можно встретить в виде белой и зеленоватой плесени на овощах, фруктах, гнилом дереве. Особенно насыщен спорами грибов воздух во влажных, плохо вентилируемых помещениях. В связи с этим существует реальная угроза заражения аспергиллами, хотя у лиц без иммуносупресии аспергиллез встречается значительно реже. ИАЛ впервые был описан в 1953 г. [9]. В качестве важнейшей проблемы медицины он рассматривается в последние 30 лет после доказательства принципиальной излечимости гемопоэтических опухолей с помощью химиопрепаратов. Развитие и массовое применение интенсивной химиотерапии и аллогенной трансплантации гемопоэтических клеток увеличило в сотни раз число заболевших. Любая пневмония, развившаяся у пациента с агранулоцитозом, с большой вероятностью имеет аспергиллезную этиологию [1, 2].