The review analyzes the major foreign publications on the iron exchange in mycobacteria for the recent years. The issues of iron absorption by tuberculous mycobacteria, its preservation and regulation of their metabolism have been reviewed. Deeper and more detail description of the above process will provide new opportunities for therapeutic interventions into it and assist in development of new tuberculosis treatment techniques.

The article describes the results of the correlation analysis of the standardized rate of treatment defaulters and rates reflecting the interaction between the doctor and the patient, medical and economic rates and the rates reflecting the tuberculosis epidemic situation. The correlation has been found between the part of treatment defaulters and the number of doctors per one patient and regularity of the meetings of the doctor and patients, tuberculosis mortality rates, prevalence of tuberculosis with bacillary excretion, rate of reduction in the prevalence of multiple drug resistant tuberculosis and the number of rates reflecting the treatment efficiency. No correlation has been found between the part of patients defaulting from treatment with medical and economic rates, incidence, frequency of relapses and primary multiple drug resistance. Reduction of the part of treatment defaulters will promote the implementation of the tasks of the Russian state health care policy.

Costs of out-patient patient-centered activities introduced into the existing standard model of the tuberculosis treatment have been evaluated in Tomsk TB Service. Additional measures enhancing compliance in the patients included the following: timely detection and management of side effects of chemotherapy, social support to the patients, treatment at home, psychological support and treatment by the Sputnik team of most socially vulnerable patients.

The average additional costs for the patient-centered activities per 1 patient treated as per regimens I, II, III made 1367 RUR a month; per 1 PR TB patient – 2978 RUR; and per regimen IV – 4865 RUR. Patient-centered activities performed during the out-patient stage of treatment made 7% out of the total treatment costs for regimens I, II, III; 14% when treating polyresistant TB; and 16% for regimen IV. 

Lethal outcomes were studied in 704 tuberculosis patients in Kemerovo Region over 2 periods of time: 1995-1997 – 255 cases (including 229 with autopsy) and 2012-2014 – 449 cases (including 413 with autopsy) in three in-patient units of Kemerovo Regional Clinical TB Dispensary (continuous sampling). The number of those died during the second period increased due to co-infection of HIV and tuberculosis. During the second period there was an abrupt increase in disseminated forms of tuberculosis while the number of fibrous-cavernous forms went down, which was due to specific features of tuberculosis in HIV patients given the severe immune deficiency in them. At the same time the increase in the disseminated forms of tuberculosis was detected during the 2nd period in the HIV negative patients.

The goal of the study: to define theoretic correlation between BODE index in men with chronic obstructive pulmonary disease (COPD) and risk of osteoporotic fractures assessed as per bone mineral density and FRAX integral rate.

Materials and methods. 125 men suffering from COPD smoking for a long period of time (the smoker index of 240 and time of smoking (packs/years) of 40) were included into the study. 10 year risk of osteoporotic fractures was assessed by FRAX software. The respiratory function was evaluated by the multi-module unit of MasterLab/Jaeger type. BODE index was defined in the patients.

Results. The minimum level of BODE was observed in those suffering from COPD of the 2nd stage – 2.23 ± 0.88. In case of the 3rd stage of COPD BODE made 5.05 ± 1.19, in the 4th stage of COPD it made 7.0 ± 1.0. The maximum risk of fractures was detected in the patients of the 4th stage of COPD. The minimum risk of fractures was diagnosed in the patients of the 2nd stage of COPD. The confident correlations were found between BODE and bone mineral density (r = -0.71, p < 0.005), as well as confident correlations between BODE and the risk of fractures (r = -0.54, p < 0.05). Conclusions. The correlation has been found between BODE index and the risk of fractures. 

The article offers a new method for calculation of incidence of complications after primary anti-tuberculosis vaccination. Using the example of analysis of continuous sampling of complications after anti-tuberculosis vaccination (n = 110) in Irkutsk Region in 2005-2014 the article shows the advantage of the offered method compared to the existing ones.

Goal of the study: to define specific manifestation of non-tuberculous diseases, due to which the patients were referred to a TB hospital.

Materials and methods: retrospective analysis of 230 case histories of those suffering from non-tuberculous diseases detected in TB hospital and 123 pulmonary tuberculosis patients. Clinical and X-ray manifestations of pulmonary tuberculosis were compared to manifestations of the diseases most prevalent in the practice of a TB doctor – community acquired pneumonia, respiratory sarcoidosis, malicious tumors of the lungs.

Results. The similarity of clinical and X-ray manifestations, single positive microscopy for AFB result in over diagnosis of pulmonary tuberculosis in those suffering from sarcoidosis, community-acquired pneumonia and malicious pulmonary diseases and it is the reason why these patients are referred to TB hospital.

Goal of the study: to investigate the structure of patients referred with the suspicion of tuberculosis to the differential diagnostics department of TB dispensary.

Materials and methods. The analysis included investigation of medical documents of 990 patients admitted to the hospital in 2012-2014 with the suspicion of tuberculosis to the diagnostic department of TB dispensary.

Results. No active tuberculosis had been confirmed in 506 (51.1%) patients out of 990. Out of those patients 29.4% of cases had pneumonia or other inflammatory disease, in 18.9% – post-tuberculous changes, 12.7% – lung cancer, 6.5% – respiratory tuberculosis. The time of diagnosis for each nosology without invasive methods of sample obtaining was analyzed. 

Treatment outcomes of 226 patients have been analyzed. Treatment and diagnostic algorithm has been developed for the management of patients with severe concurrent injury and dominating chest trauma. The indications for the following interventions have been formulated: emergency thoracotomy, emergency and urgent video-assisted thoracoscopy, local fibrinolytic therapy in case of clotted hemothorax and post-traumatic pleural empyema, valve bronchial block in tension and continuously persistent pneumothorax, osteosynthesis of fragmentary costal fractures. Using minimally invasive treatment techniques allowed decreasing the number of surgeries in the patients and increasing the number of recovered patients when discharged from the hospital.

The article describes the clinical case of the successful cure of disseminated pulmonary tuberculosis (caseous pneumonia) with multiple drug resistance in the patients with several concurrent diseases: COPD, pulmonary emphysema, respiratory failure of the 1st phase, hypertension of the 2nd phase, coronary heart disease, cardiosclerosis, drug-induced hepatitis. Tuberculosis chemotherapy was accompanied by the intensive hepatotrophic, cardiac and urinative therapy with potassium-sparing diuretics. When drug-induced hepatitis developed the extracorporal methods namely discrete machine plasmapheresis were used.