The paper presents the current data of clinical understanding of the cough based on the analysis of receptor-reflex mechanisms of the cough development. The role of SAR, RAR pulmonary receptors and C-fibers has been investigated as regards the development of the cough. The clinical variants of the cough development both of pulmonary and extrapulmonary nature have been described. The cough is to be managed only after the diagnosis is definite. In the developed countries the accurate diagnostics of the cough nature makes 25%, often the cough can be caused by the two disorders and more. The variants for diagnostic search of the cough cause have been offered in order to optimize the therapy. The treatment of the cough is to be targeted at the suppression of cough or at the easement of expectoration.

The psychological features of 100 adolescents at the age of 13-17 years old suffering from respiratory tuberculosis have been compared. Personality structure of adolescents with more expressed manifestations of the disease is confidently different regarding the prevalence of main pre-morbid characteristics promoting neurotic features, intra- and inter-psychical conflicts and also various structural and functional somatic disorders. The personal specific features of the patients have been objectivated in the rates of actual psychological status. The detected personal features are considered to be potential pathogenic psychological determinants (as a part of traditional medical, biological and social risk factors of the disease development), and aims of the targeted psychological management.

The efficiency of apical pleurectomy after pulmonary resection due to multiple drug resistant tuberculosis has been analyzed. The time of exudation of pleural fluid and the rate of aerostasis have been compared. The average time of exudation in patients with multiple drug resistance without pleurectomy made 11.9 + 1.9 days (p < 0.05), and with pleurectomy made 6.8 ± 1.6 days (p > 0.05). Thus the apical pleurectomy significantly reduces the time of exudation.

Despite the significant reduction of tuberculosis incidence, the epidemic of tuberculosis is still there in Siberia and Far East.

The changes in gender and age specifics have been analyzed in those suffering from respiratory tuberculosis, female genital tuberculosis and urological tuberculosis in Siberia and Far East for the last 6 years. It has been found out that in case of respiratory and genital tuberculosis there is a stable identical situation with highest incidence in those from 25 to 34 years old. Apparently this stable situation implies well organized early detection.

As regards urological tuberculosis each year the situation is very diverse with the prevalence of incidence varying in the gender and age which from our opinion implies the lack of timely detection. 

The chemotherapy results have been analyzed in tuberculosis patients suffering from multiple drug resistance registered for treatment in the Russian Federation in 2011-2012 compared with the treatment outcomes of MDR patients registered for treatment in the world, BRICS and countries of the former Soviet Union in 2011. Treatment outcomes of XDR TB patients have been analyzed for the first time. Chemotherapy efficiency in MDR TB patients in the Russian Federation in the cohort of 2011 made 37.1%, and in the cohort of 2012 made 39.1%, which significantly lower than in the world in general (47.5%), in BRICS and countries of the former Soviet Union; this low treatment efficiency is mostly due to treatment failures (18.3%) and those died (19.1%). The treatment efficiency of XDR TB patients registered for treatment in the Russian Federation in 2012 made 26.2% versus 22.0% in the cohort of 2011. Considering the significant financial costs spent on the treatment, the chemotherapy efficiency of M/XDR TB patients in the Russian Federation is too low to improve the epidemic situation and some additional measures are to be taken for its improvement.

In order to determine critical concentrations of the second line TB drugs, namely cycloserin and PAS, and to use these critical concentrations for establishment of drug susceptibility testing by the proportional method on the liquid medium of Middlebrook 7H9 in the Bactec MGIT 960, 441 cultures of M. Tuberculosis were tested after inoculation of 2534 samples obtained from 1330 TB patients living in Vladimir Region. Upon results of drug susceptibility testing on solid media 4 groups of M. tuberculosis strains, susceptible and resistant to PAS and cycloserin have been identified. Results of searching for minimum inhibiting concentrations of PAS and cycloserin for these groups of strains in the liquid medium of Middlebrook 7H9 allowed finding critical concentrations for PAS (2.0 mkg/ml) and cycloserin (15.0 mkg/ml).

The articles presents the clinical case of successful use of the native surfactant for the management of severe respiratory insufficiency in the patient suffering from disseminated pulmonary tuberculosis with concurrent HIV-infection.

Бронхиолоальвеолярный рак (БАР)  – первичная злокачественная эпителиальная опухоль, одна из разновидностей высокодифференцированной аденокарциномы легкого. Отличительной особенностью БАР является рост опухолевых клеток одним слоем по стенкам терминальных дыхательных путей и альвеол без прорастания стромы, сосудов и плевры. Эта злокачественная опухоль не образует собственной стромы, а использует в качестве нее альвеолярные перегородки [1, 3, 4].

В 1925 г. после реорганизации Выборгской детской больницы г. Ленинграда в Институт охраны материнства и младенчества (ИОММ) по инициативе его директора Ю. А. Менделевой была создана институтская клиника детского туберкулеза на 60 коек, которая находилась в одном из павильонов по адресу ул. Литовская, д. 2.