The article describes the retrospective analysis of the long-term changes in the main epidemiological rates of tuberculosis, HIV infection and their co-infection in two regions within Siberian Federal District, and these rates are compared with data for the whole of Russia It was found out that in territories with high risks of tuberculosis and HIV infection even if epidemics of tuberculosis slowed down associated with the reduction in the incidence in all populations, HIV infection still provided a significant impact on the epidemics intensity Tuberculosis situation is getting more tight due to increasing incidence and mortality among the HIV positive and the portion of this cohort among active tuberculosis cases It was supposed that these epidemics integrate with each other if the following conditions were provided: HIV prevalence approached 1%  and tuberculosis incidence 100 per 100000 population in the territory

The article presents the study of the impact of social and medical factors and bad habits on the outcomes of planned surgery in 95 patients with concurrent respiratory tuberculosis and HIV infection The correlation analysis was performed which discovered the factors providing a positive impact on treatment outcomes The following factors have the strongest association with treatment outcome: patient's regular job, family, no alcohol or nicotine addiction, a form of tuberculosis, and administration of antiretroviral therapy It was noted that surgery outcome could be predicted and potential complications prevented

The objective of the study: to classify the pathologic manifestations of asthma using cluster analysis and based on the obtained clusters to substantiate the identification of asthma phenotypes while being at the resort. Subjects and methods. 300 asthma patients who arrived to Yalta for treatment at the resort were examined. Of those with persisting asthma, 55 (18.33%) patients had a mild severity of the disease, 205 (68.33%) had moderate severity and 27 (9%) had the advanced severity of the disease. 13 (4.33%) were found to have intermittent asthma. 42 (14%) patients had the controlled course of asthma, 60 (20%) had it partially controlled, and 198 (66%) patients suffered from the uncontrolled asthma. The cluster analysis was used to classify the manifestations of asthma at the resort. Results. 105 rates were analyzed in 300 asthma patients, who had treatment at the resort. The structure consisting of 7 clusters was formed through cluster analysis. 23 rates had high values of inter-cluster dispersion describing the clinical and functional state of asthma patients, which could be considered as separate clusters. Each cluster had certain disorders of clinical and functional state of asthma patients, typical of this cluster only, thus the generated structure of clusters could be considered to be a classification of asthmatic pathologic manifestations, i.e. asthmatic phenotypes during the stay at the resort. Conclusions. 7 asthmatic phenotypes typical of staying at the resort were identified, characterized by different pathogenetic manifestations, which could be useful when planning sanatorium-resort care for such patients.

The objective: to evaluate the efficiency of chemotherapy with bedaquiline in pulmonary tuberculosis patients with multiple drug resistance Subjects and methods. The chemotherapy efficiency was studied in 70 tuberculosis patients with extensive (XDR) or multiple (MDR) drug resistance who were treated in clinics of Central Tuberculosis Research Institute All patients were divided into 3 groups: Group 1 (10 persons) included MDR TB patients, Group 2 (32 persons) included pre-XDR TB patients, Group 3 (28 persons) included XDR TB patients

Results of the study. High treatment efficiency in this difficult category of pulmonary tuberculosis patients with MDR and XDR was achieved when bedaquiline was added to the chemotherapy regimen Upon the completion of the main treatment course with bedaquiline, in the group of patients with MDR and pre-XDR the sputum conversion was achieved in 100%, and in XDR tuberculosis patients the sputum conversion rate made 893% The long-term treatment course with bedaquiline promoted the fastest sputum conversion, healing of cavities in the lungs of patients with disseminated tuberculosis and XDR, and it was not associated with a higher frequency of adverse events

In order to investigate the duration of the post-vaccinial allergy after BCG vaccination and time of primary infection with tuberculous mycobacteria, the changes in the size of induration of Mantoux test with 2 TU PPD-L were analyzed in 806 children at the age from 5 to 7 years old with the different epidemic background The subjects were divided into 2 groups: Group 1 (n = 618) included children not exposed to tuberculosis, and Group 2 (n = 188) consisted of children with exposure to tuberculosis It was found out that the duration of the post-vaccinial allergy documented after BCG vaccination depended on the quality of immunization and epidemic factor in the child's environment (exposure to tuberculosis) In case of primary infection with tuberculosis, the response to the test with tuberculous recombinant allergen could be negative, which was more often observed in the children not exposed to tuberculosis If the child was exposed to tuberculosis, the value of the test with TRA was increasing in respect of the infectious allergy detection If the conversion of the response to tuberculin was detected, it was necessary to perform a thorough investigation of the infection history and do the test with tuberculous recombinant allergen.

Objective: to analyze the initial life quality in children and adolescents when using various methods of tuberculosis detection

Subjects and methods. Using the questionnaire of Pediatric Quality of Life Inventory (PedsQL) life quality was assessed in 90 adolescents in the age from 13 to 17 years old

Results. The impact of a chronic disease on the life quality of children and adolescents had some relevance to gender: boys' sufferings were mostly physical while girls had rather emotional problems Adolescents at the age of 15-17 years old reported much low life quality compared to the children of 13-14 years old Groups of children detected by self-referral for medical care had lower life quality rates compared to the average ones in all examined children Such aspects as school and physical functioning were compromised the most in children and adolescents detected through diaskintest and digital fluorography While the children detected by self-referral reported their emotional and psycho-social well-being to be the worst one, and the latter had the abrupt reduction of those parameters in adolescents with disseminated and destructive forms of tuberculosis The wider and more invasive testing methods were, the more severe reduction of life quality was observed Thus the priority is to be given to diagnostics with diaskintest versus diagnostics by self referral

Objective: to evaluate the structure of clinical forms of tuberculosis and other concurrent conditions in children with urogenital disorders in order to improve the management tactics for such patients 1165 children in the age from 0 to 14 years old were enrolled into the study, Group 1 included children with urogenital disorders (n = 157), and Group 2 included children with no urogenital disorders (n = 1,008) In Group 1, urogenital infections were documented in 204% of children, pyelonephritis in 318%, dysmetabolitic nephropathy in 38%; renal cyst in 32%; glomerulonephritis in 25%; renal abnormality in 127%, vesicoureteral reflux in 57%, rickets-like diseases in 06%, vulvovaginitis in 57%, phymosis in 153%, synechia in 38%, varicocele in 13%, monorchia in 06%, ovarian cyst in 06%, and menstrual disorders in 19% Respiratory tuberculosis was less common among the children from Group 1 (701 and 892%; χ2 = 40545, p = 0000), while extrapulmonary tuberculosis prevailed (178 and 55%; χ2 = 29612, p = 0000) Except urogenital disorders, the concurrent conditions were equally frequent among the children from Groups 1 (803%) and 2 (806%) (χ2 = 0000, p = 0984) Urogenital disorders were confidently more often combined with blood circulation disorders and endocrine pathologies Thus, children with urogenital disorders more often developed extrapulmonary forms of tuberculosis or combinations of pulmonary and extrapulmonary forms Urogenital disorders in children ill with tuberculosis were more often combined with blood circulation disorders and endocrine pathology.

From 2016 to 2016, 85 cultures of non-tuberculous bacteria were isolated in 65 patients in Mari El Republic. Of them, 15 (23.1%) were diagnosed with tuberculosis and received the relevant treatment. In all other cases (76.9%), non-tuberculous mycobacteria were detected in the patients suffering from non-specific respiratory diseases and presenting respiratory complaints. The analysis of age and gender structure of those in whom non-tuberculous mycobacteria were detected showed that elderly people prevailed (from 55 to 64 years old). Cultures of M. intracellulare were the most prevalent among non-tuberculous mycobacteria if they were detected repeatedly in the patients in whom mycobacteriosis was suspected. M. gordonae was prevalent among those in whom mycobacteria were detected only once which could be regarded as carriage or contamination. Mycobacteriosis was diagnosed in 22 out of 65 patients, in whom non-tuberculous mycobacteria were isolated (33.8%). Mycobacterioses were caused by the following species: M. intracellulare (77.3%), M. avium (18.2%), M. kanzasii (4.5%).

The objective of the study: to define indications for discontinuation of a drug causing adverse reactions during chemotherapy in tuberculosis patients. The frequency, severity, and outcomes of adverse reactions with anti-tuberculosis drugs discontinued and not were analyzed in 435 new tuberculosis patients. The severity of AE was assessed using modified criteria of NCI CTCAE version 4.0 and DMID. In 69.2% of patients (95% CI 64.7-73.3%) AE resulted in the discontinuation of at least one drug and it was associated with the significant increase of the intensive phase duration. Severe AE (severity grades 3-4) were observed in 54.3% of patients (95% CI 49.6-58.9%). In 17.0% of cases, the discontinuation of drugs could have been avoided, in 20.9% the drug had to be discontinued due to the risk of complications and irreversible damage of organs as per the signs of grade 2 of severity. The continued in-take of anti-tuberculosis drugs in case of AE of severity grade 3-4 was associated with negative changes in 20 out of 62 cases (32.2%). Indications for discontinuation of anti-tuberculosis drugs in the intensive phase of treatment include grades 3-4 of severity, the risk of irreversible damage of an organ and life-threatening conditions. Discontinuation of the drug can be discussed in case of some moderate adverse events should all available conservative measures fail.

The article presents 3 clinical cases of treatment of drug resistant tuberculosis in children and adolescents, illustrating the variants of the individual approach to treatment of tuberculosis with multiple/extensive drug resistance  In order to improve treatment outcomes, bronchologic methods were used for the collection of specimens for bacteriological tests, chemotherapy regimens were adjusted in a timely manner, valve bronchial block (implantation of endobronchial valve) was used in one the patients to promote the cavity healing, the other patient underwent VATS resection of the upper lobe of the left lung due to numerous large foci As a result, it was possible to use a short course treatment in those patients