The article describes the attempt to find common consistent patterns in the spread of infection, typical of Russia. Actions of the Russian Tuberculosis Control Service are compared to the ones of similar services in the world. It has been shown that the comparative cost-effectiveness per one tuberculosis patient in Russia is disparate regarding the changes in epidemiological rates. Changes in quality management parameters are slow. Increase of funding for TB services without optimization of the cost structure and revision of certain positions within the service is not sufficient for successful operation.

Introduction of electronic case histories to medical units including TB units is one of the factors allowing enhancing quality of medical care provision. Use of the electronic case histories provides conditions for information transparency improvement in a medical unit: financial, statistic and medico-technological. Information contained in the electronic case history is important and required both for internal and external use. Use of electronic case histories contributes to reduction of labor costs of workers in medical units, provides fast access of medical personnel to information, formalizes data, provides preservation, invariance and reliability of the information entered into electronic case history during the whole period of storage, regulates the access rights and confidentiality, personifies data and allows unifying health data of all Russian population into one pool.

Efficiency of tuberculosis control measures was comprehensively evaluated in the Russian regions (totally 21 regions) within Siberian and Far Eastern Federal Districts by means of ranging the sets of indicators. Three sets of indicators were used; these indicators reflected the epidemic situation and main rates of operation in the territories upon the outcomes of 2015. Totally 34 indicators were analyzed. The situation varies in different regions of Siberian and Far Eastern Federal Districts, the analyzed indicators significantly differ in the regions depending on the annual results, which first of all witnesses of differences in the quality and efficiency of tuberculosis control activities. Ranging as per indicators' set demonstrates the correlation between the epidemic situation and quality of tuberculosis control activities and stability of their level.

Basing on the data about achievement of targeted rates for efficiency evaluation of the actions aimed at tuberculosis mortality reduction in 2015 and statistic rates for 2014-2015 in 12 regions within Siberian Federal District, the impact of organizational medical activities performed by primary medical services and tuberculosis control services was analyzed in the respect of tuberculosis mortality rate. The article presents results of ranging of regions within Siberian Federal District as per tuberculosis mortality rate and indicators providing impact on the number of those died of tuberculosis.

Individual, metabolically justified prescription of nutritional support at the various stages of peri-operative period results in the trophologic status normalization in those suffering from disseminated fibrous-cavernous pulmonary tuberculosis when applying collapse surgery.

The article presents the data on the use of Gene Хpert MBT-RIF testing in 122 patients. In 69 (56.6%) patients the diagnosis of tuberculosis was confirmed, and some other non-tuberculous pulmonary diseases were verified in 53 (43.4%) patients. Efficiency of tuberculous causative agent detection by Gene Xpert was compared to routine bacteriological methods. The sensitivity of this method made 63.8%, specificity made 98.1%, prognostic value of the positive result - 97.8%, prognostic value of negative result - 67.5%. Factors associated with positive results of this method are presented.

112 tuberculosis patients with burdened allergic history were examined with the purpose to study clinical and laboratory manifestations of drug-induced nephropathy, they made main group and 157 patients without allergy made control group. Drug-induced renal lesion in tuberculosis patients with multiple allergies can be manifested in various ways: from microhematuria, minor eosinophilia and cutaneous allergic syndrome to major disorders of nitrogenous excretion, filtration and resorption function of kidneys leading to the development of acute and in some cases chronic renal failure. Laboratory rates reflecting renal function returned to normal later after recovery from other drug-induced complications not related to kidneys. Rifampicin was responsible for the development of nephropathy in the majority of patients, and in single cases it was streptomycin.

Goal: to evaluate the efficiency of peribronchial lymphotropic therapy in pre-operative preparation of the patients with the instable or complicated course of pulmonary tuberculosis.

Materials and methods. Intermediate treatment outcomes of 99 pulmonary tuberculosis patients who had continuous pre-operative preparation have been analyzed. During chemotherapy peribronchial lymphotropic therapy was used in 53 patients, and inhalations of anti-tuberculosis drugs were used in 46 patients.

Results. The average duration of treatment in both groups made 3.5 months. Use of peribronchial lymphotropic therapy during the pre-operative period in the most severe patients allowed achieving results comparable with inhalation treatment of pulmonary tuberculosis patients belonging to less severe category. 

The article presents clinical and X-ray data of 123 patients suffering from pulmonary tuberculosis. The duration of diagnostic period has been evaluated from the first manifestations of the disease till confirmation of diagnosis, dates of advising by TB doctors and referral of patients for medical care. Factors associated with duration of diagnostic period have been analyzed.

Prostate tuberculosis was confirmed by morphological testing during life time in 77% of those died of tuberculosis of any localization and in 28% of respiratory tuberculosis patients. Prostate tuberculosis occupies the important place from social and medical point of view, since it leads to infertility and sexual dysfunction and also it can be sexually transmitted. Detection structure of prostate tuberculosis has been analyzed for Novosibirsk Region.

The article presents brief data from the literature about the history of BCG vaccine development (Bacille bilie' Calmette-Gue'rin), results of meta-analyses aimed at the evaluation of BCG-therapy efficiency in Ta-T1 bladder cancer. Below one can read descriptions of clinical cases when side effects and complications of this method developed according to the literature data and results of authors' personal observations. The main reason of low level of BCG-therapy use in Russia is low awareness of medical workers about the legal grounds for application of this method. The article gives the list of acting legal acts regulating provision of epidemiological safety when applying BCG-therapy and describes the technique for using this method in municipal polyclinics in compliance with the above legal acts.

The article describes the clinical case of effective treatment of the tuberculosis patient suffering from extensive drug resistance of M. tuberculosis. It describes modern approaches to diagnostics and treatment of multiple drug resistant tuberculosis, the best chemotherapy regimen including new effective anti-tuberculosis drugs, supplemented by valve bronchial block, and demonstrates the feasibility of integral approach to treatment of tuberculosis.

Despite certain achievements in care provision to those with severe chest injury the problem of managing flail chest is far from being resolved. Traditional management includes forced continuous artificial pulmonary ventilation in order to provide internal pneumatic stabilization of the chest. However the results of this approach can not be recognized as satisfactory due to high frequency of complications, need for tracheostomy, long-term stay of such patients in the intensive care department, development of nosocomial infections.

Early restoration of the chest carcass with the help of costal valve fixation by the plate with angular stability allows reducing the duration of the artificial pulmonary ventilation and decreasing the frequency of potential respiratory and pleural complications. 

The article presents the clinical case when the patient was admitted to Novosibirsk Tuberculosis Research Institute, Russian Ministry of Health, in September 2013 from the territory supervised by the institute (Sakha Republic) with the advanced form of generalized urogenital tuberculosis, complicated by terminal renal failure and tuberculosis colitis. The patient had been treated for urogenital infections - veiled manifestations of tuberculosis, with no success for 10 years, he underwent a number of surgeries. Tuberculosis was diagnosed histologically when intestine fistula developed.