Конференция состоялась в соответствии с приказом МЗ РФ «Об утверждении Плана научно-практических мероприятий Министерства здравоохранения Российской Федерации на 2016 год».

Организаторы конференции  – Министерство здравоохранения Российской Федерации, Министерство здравоохранения Республики Крым, НИИ фтизиопульмонологии ГБОУ ВПО «Первый МГМУ им. И. М. Сеченова», Крымский государственный медицинский университет им. С. И. Георгиевского, Российское общество фтизиатров.

The purpose is to study clinical and X-ray manifestations of local tuberculosis in children of the tender age and to detect risk factors promoting the development of the disease and complicating it, thus the analysis included 82 cases of children cases under 3 years old who had been treated in Children TB Hospital in 2013-2015. Tuberculosis of chest lymph nodes was diagnosed in 68.3%of them, and every fifth child had primary tuberculosis complex. Every other child was suffering from the complicated course of local tuberculosis (n = 42). The following forms were registered: bronchial pulmonary lesions (n = 27), lymphogenic progression (n = 13), including development of disseminated tuberculosis and meningitis. Positive results of sputum tests were observed in 14 (17.1%) children, of them 50% had multiple drug resistance. 10% of children suffering from tuberculosis manifested anergy. The predictors of such course of the disease included the absence of BCG vaccination and super infection with Mycobacterium tuberculosis.

Goal of the study: to detect specific immune response in children with latent tuberculous infection and define factors to forecast the development of the active disease in this group.

Materials and methods. The changes in clinical, X-ray and immunological data were analyzed in 127 children when latent tuberculous infection was diagnosed and after 12 months of follow-up. The number of immunological tests was done for evaluation of humoral and cellular immunity in those suffering from latent tuberculous infection and active disease.

Results. The obtained results showed high negative prognostic relevance of exposure to tuberculosis, concurrent disease, refusal to have preventive treatment and low efficiency of short-course preventive treatment, specific features of humoral and cellular immunity were defined which could be used as additional forecasting criteria for active tuberculosis development in children with latent tuberculous infection. 

Complications after specific prevention of tuberculosis for the last 10 years have been analyzed using the example of a big city. The frequency of severe complications (BCG-ostitis) made 0.004% and the frequency of minor complications (lymphadenitis) made 0.005% and cold abscesses made 0.01% per 100 000 vaccinated children. Often complications were caused by mistakes in the vaccine administration related to premature discharge from maternity hospital and administration of the vaccine in the polyclinic and also concurrent prenatal disorder. The issue of complications caused by anti-tuberculosis vaccination makes no grounds to review the policy of the primary BCG vaccination.

Given the stabilization of tuberculosis epidemiological situation in Saratov Region, there is reduction of tuberculosis incidence both in children and adolescents, which is due to the performed tuberculosis control activities aimed at early detection and prevention of tuberculosis. Cases of 150 children and 125 adolescents treated at the Saratov RTBD from 2009 to 2013 were analyzed. It was found out that preventive detection of tuberculosis was equally efficient in children and adolescents (p = 0.3024). Wide introduction of computer tomography and Diaskintest into practice increased the number of persons followed up as Group 0 twice in 2013 compared to 2009 (p = 0.0038) and it caused the increase in the frequency of tuberculous intoxication (p = 0.0422) and focal tuberculosis in the structure of clinical forms of tuberculosis in children. Exposure to tuberculosis was found in 48.7% of followed-up cases among children and in 25.6% among adolescents. The father was the most common source of infection. The lack of quality immune prevention in children during first 2 years of life promoted the development of local tuberculosis.

Goal: analysis of X ray diagnostics of tuberculosis in children staying in the specialized sanatorium in 2010-2015.

Results. Every year from 19.1 to 66.7% of children suffering from active tuberculosis in Sakha Republic are detected through computer tomography in the specialized sanatorium for children. 

Goal of the study: to investigate the role of skin test with tuberculous recombinant allergen (TRA) in mass screening for tuberculosis in children from high risk groups in Tatarstan Republic.

Materials and methods. Screening of children and adolescents (407,893 persons in 2012-2015) with the use of skin test with TRA in the form of diaskintest was conducted in general medical services. Computer tomography of the chest was prescribed in case of the positive result of the skin test with TRA. The data of 159 children under 14 y.o. falling ill with tuberculosis in 2012-2014 were analyzed.

Results. Annually (starting from 2012) with increase of the coverage with TRA screening of the children population (98,040 persons in 2014) the highest rates of tuberculosis detection shifted from the age group of 7-14 y.o. to the age group of 3-6 y.o., the structure of clinical forms of tuberculosis improved due to elimination of disseminated and complicated forms of tuberculosis. The minimal manifestations of tuberculosis were registered in 88.2% only after computer tomography prescribed after the positive results of TRA test. In 2015 with the increase up to 27.3% of coverage with TRA screening in children starting from 8 y.o., the detection rate of this method compared to other methods increased up to 18.4% in the age group of 8-14 y.o. and up to 33.3% among adolescents. 

Goal: The clinical case is presented to describe the successful use of valve bronchial block (installation endobronchial valve into the bronchus) for treatment of cavities in the 15 year old female adolescent with bilateral pulmonary tuberculosis.

Results. The X-ray examination showed the healing of cavities in 3 months after installation of endobronchial valve. The endobronchial valve stayed in the upper zone left bronchus for 6 months and it was successfully removed through bronchoscopy upon the treatment completion. 

The clinical case demonstrated the intermittent course of primary tuberculosis caused by multiple drug resistant mycobacteria in 8 year old child with concurrent disorders of CNS and locomotor apparatus and living in the social institution of the closed type. The disease was detected in 2 years after the early period of primary tuberculous infection and administered preventive treatment by two anti-tuberculosis drugs. The disease was diagnosed during examination due to aspiration pneumonia with expressed clinical manifestations. Treatment of aspiration pneumonia and multiple drug resistant pulmonary tuberculosis was successfully completed.

The review includes 3 parts. The first part describes the current understanding of the ways of lipid transportation in the human body, structural and functional specific features of various classes of lipoproteins and their role in the adaptation and pathology development. The second part includes the current data about the role of cholesterine and other lipids to the less degree in persistence and replication of tuberculous mycobacteria in the human body. The third part presents the view of various studies of lipid metabolism in case tuberculosis in humans and guinea pigs, conducted in the second half of the 20th cent.