Autophagy is an important immune mechanism defining the host resistance to intracellular pathogens and tuberculous mycobacteria in particular. Autophagy is involved into direct elimination of the pathogenic agent, control of immune reactions of the host and maintenance of intracellular homeostasis which is important for mycobacterial persistence. Inhibition of autophagy at the early stages of infection by virulent mycobacterial strains is one of the reasons of poor immune response, and mechanisms defining this response are considered to be promising field to search for approaches centered at the pathogen for the tuberculosis prevention and treatment.

Basing on the data of capital expenses and current costs of Tomsk TB Service in 2011, prime costs of 1 month of treatment of a tuberculosis case in various units of TB Service were evaluated. The prime costs of treatment in the in-patient department as per the 1st, 2nd and 3rd regimens made 23,837 RUR per month and it was 89% higher than the cost of treatment in the day hospital (12,612 RUR), and by 173% higher than the treatment in the polyclinic (8,722 RUR), by 145% than treatment at home (9,717 RUR) and by 91% than treatment within the Sputnik program (12,499 RUR). Treatment as per the 4th regimen turned out to be the most expensive in the in-patient hospital (29,880 RUR) exceeding by 55% the treatment cost in the day center (19,336 RUR), by 112% – in the polyclinic (14,107 RUR), by 71% – treatment at home (17,512 RUR), and by 29% – Sputnik program (23,207 RUR).

The article describes clinical and epidemiological manifestations of tuberculosis in workers of medical units of Kyrgyzstan Republic. When studying the clinical forms of new tuberculosis in workers of medical units and adult population in the Republic in 2009-2013 it was found out that infiltrate pulmonary tuberculosis prevailed in both groups – 62.8 and 58.0% respectively.

The homeostasis state in the peri-operative period was studied in 31 pulmonary tuberculosis patients. It was found out that the volume of peri-operative blood loss was not related to the presence of increased fractional thromboplastin time and hyperfibrinolysis. The following factors were found to be related to intra-operative blood loss: pulmonary surgery in the past; combination of signs – 2A or 2B group of dispensary follow-up, MDR/XDR TB, bacillary excretion, presence of fibrous cavernous pulmonary tuberculosis in the infiltration state, lesions in 10 segments and more. The formulas of linear regression were o`ered allowing predicting the volume of blood loss and duration of the stay in the intesive care department.

In order to develop and to test the technique of restoration/preservation of fertility in prostate tuberculosis patients and to evaluate its e_ciency the open prospective comparative randomized trial was conducted which included 72 prostate tuberculosis patients. The patients were divided into 2 groups: the main group (49 patients) who had standard etiotropic treatment with sperm-protecting therapy, including selzinc plus and chorionic gonadotropic hormone and the comparison group (23 persons), who received etiotropic treatment only. Anti-tuberculosis treatment provided the negative impact on the ejaculate in prostate tuberculosis patients: two month treatment with TB drugs promoted the reduction of sperm number by 23.9% and the number pf actively moving sperms reduced by 10.6%, and the number of normal sperms reduced by 32.3%. The administration of sperm-protecting therapy increased the number of sperms by 47.8%, the actively moving forms of sperms (totally Group A and B) – by 40.5%, and the forms of normal sperms – by 41.9%.

The article describes the investigation of psychological and emotional state of pulmonary tuberculosis patients belonging to various categories having in-patient treatment. The patients who referred to the psychologist for help while having anti-tuberculosis treatment manifested worse psychological dysfunctions compared to the patients who did not require psychological care. After psychological counseling the  patients manifested less destructive behavior and  psychological problems and  the  increase in  the  life quality as per the number of various scores. The positive changes in psychological state of the patients from the main group were confirmed by the elimination of the preceding confident di`erences in rates compared to the patients from comparison group regarding certain parameters of nervous psychological stability. Psychological support during pulmonary tuberculosis treatment is one of substantial tools of treatment e_ciency enhancement.

The article presents the outcomes of using the skin test with tuberculous recombinant allergen in the standard solution (diaskintest preparation) for massive screening of children above 7 years old in Penza Region in 2015. The test with tuberculous recombinant allergen was made in 108,729 people covering 96.6% of the children and adolescents in need of screening. Number of those in whom post-tuberculous changes were detected increased by 75% compared to 2014.

TB doctors and pulmonologists are very well familiar with the issue of differential diagnostics between pulmonary tuberculosis and sarcoidosis. Despite the introduction of new diagnostic tools for disseminated diseases, the absence of pathognomonic, clinical, X-ray and morphological signs of the disease remains to be the big problem resulting in the significant number of diagnostic mistakes (60-75%). The Mantoux test with 2 TU is still used for differential diagnostics between tuberculosis and sarcoidosis. Till present among immunological tests the skin tuberculin test has remained to be the only one for tuberculosis diagnostics. However recently some new highly informative immunological tests have appeared allowing diagnosing tuberculosis on a higher level and thus giving up Mantoux test with 2 TU. The article presents the clinical case confirming the value of immunological tests in differential diagnostics between sarcoidosis and tuberculosis.