The objective of the study: to assess efficiency and safety of SQ109 used within standard treatment regimens for multiple drug resistant tuberculosis (MDR TB)

Subjects and Methods A multi-center, double, blind, randomized, placebo-controlled study was conducted in two parallel groups from September 21, 2012 to September 30, 2016, in 6 research centers located in 5 cities of the Russian Federation

Main results 1 Cessation of bacillary excretion confirmed by cultures on liquid media by the end of the 6th month of the intensive phase of chemotherapy in pulmonary MDR TB patients receiving SQ109 was observed confidently more often versus treatment regimens containing only existing anti-tuberculosis drugs: both for ITT population (610% versus 429%, p = 00412), and PP population (797% versus 614%, p = 00486) 2 There were no statistically significant differences in the achievement of sputum conversion between the groups, but by the end of the 8th week, the sputum converted in 52% of patients in the group treated with SQ109 versus 38% in the group taking a placebo The median time of bacillary excretion cessation confirmed by culture on liquid media in SQ109 group made 56 days, while in the placebo group it was 84 days 3 Use of SQ109 along with basic chemotherapy for pulmonary MDR TB did not result in the higher frequency of adverse events, worsening of their severity, development of new variants of adverse events compared to the basic anti-tuberculosis treatment of this group of patients in combination with placebo 4 Results of the study allow concluding that SQ109 is an effective drug, satisfactory tolerated (compatible with tolerability of placebo) being a part of integral etiotropic chemotherapy of pulmonary MDR TB patients

The objective of the study: to assess the prevalence of latent tuberculous infection (LTI) and risk of its development in the inmates servicing their sentence in a penal colony of the Federal Penitentiary System, using the tools of statistics analysis

Subjects and Methods. 232 persons in the age from 18 to 67 (27; 225-35) years old were examined 

Results. Exposure to a tuberculosis case in the past and duration of imprisonment are statistically confident risk factors of developing LTI The use of statistic tools allows predicting the chances of LTI

The objective of the study: to investigate the efficiency of surgical treatment in pulmonary tuberculosis patients and to define main risk factors of tuberculosis re-activation in those who had surgery

Methods The postponed surgery results (in 6-7 years) were investigated in 273 patients, who were operated in 2010-2011 Two groups were formed: Group 1 included patients taken off the register due to recovery, Group 2 included patients who had relapse or exacerbation of the disease after the surgery Those taken off the register due to some other reasons were not included in the comparative analysis

Results. It was proved that postponed treatment efficiency exceeded 90% Tuberculosis re-activated in 77% of cases, in those with multiple and extensive drug resistance (533%), lung tissue destruction (62%), fibrous-cavernous tuberculosis (333%), concurrent conditions (524%) and complications in the early post-operative period (95%)  The re-activation occurred more often after large surgeries including consecutive corrective thoracoplasty Should there be indications for surgery, it is sensible to decide about the surgery within the 1st year of follow-up.

The article presents the analysis of efficiency of skin test with tuberculous recombinant allergen (TRA, diaskintest), as a screening method for tuberculous infection in children and adolescents above 8 years old using Penza Region as an example. In 2016, 112,808 persons were screened with TRA test, 97.5% of children were covered with this test. TRA test proved to be effective for detection of tuberculosis in children and adolescents. When TRA test is used, less than 1% respond positively to it among those screened on a regular basis (in 2015 – 0.97% and in 2016 – 0.86%). The differential approach to the prescription of preventive treatment in risk groups significantly increases the motivation of 92.0% of parents to have it. With a positive result of TRA test, the screening for tuberculosis with this test and multispiral computer tomography of the chest significantly improve the structure of clinical forms of tuberculosis in children and adolescents due to an increase of the number of limited lesions with minimal manifestations.

Objective: to perform retrospective analysis of the ranges, structure, degree of severity and time of development of adverse events in tuberculosis patients with multiple drug resistance on treatment and to assess their impact on chemotherapy duration 

Results. Totally, 1387 adverse events were registered Out of 500 patients, adverse events occurred in 437 (874%) Intestinal (293 patients, 670%) and metabolic (297 patients, 680%) adverse events prevailed Each second patient developed neurological and hepatotoxic adverse events (222 (508%) and 175 (400%) respectively) Dermatological adverse events, ototoxicity, hypothyrosis, and nephrotoxicity were observed in 123 (281%), 114 (261%), 72 (165%), and 56 (128%) patients respectively 21 (48%) patients had adverse events affecting vision 14 (32%) patients suffered from peripheral neuropathy On average, one patient had adverse events affecting three systems of the host If one patient had three different types of adverse events and more, the duration of treatment made more than 700 days Each fourth MDR TB patient (2494%) had severe adverse events

Conclusions. Adverse events occurring during treatment of multiple drug resistant tuberculosis are manifested through arthralgia, intestinal and central nervous system disorders In order to prevent adverse events laboratory abnormalities and clinical manifestations are to be monitored on a regular basis

Prospective integral laboratory and instrumental examinations were performed in 110 infertile women The examined women were divided into 2 groups: the main group included 60 patients with infertility associated with genital tuberculosis, while the control group included 50 women with infertility of non-tuberculous etiology (control group) 16 couples from the main group and 17 couples from the control group had their fertility restored through in vitro fertilization Take-home baby rate, which is the main rate reflecting IVF efficiency was lower in case of tuberculosis-associated infertility compared to the control group (2353% versus 375%), while the frequency of spontaneous abortions was higher (250% and 176%) The lack of timely diagnostics and treatment of latent tuberculous infection (25%) and endometrial lesions (50%) are the main causes of unfavorable outcomes of IVF Pregnancy resulting from IVF in case of infertility due to tuberculosis is associated with high risks of complicated gestation, premature birth, maternal and perinatal diseases.

The article describes a clinical case of 42-year old male patient with necrotising granulomatosis with polyangitis (Wegener's granulomatosis) complicated by pulmonary aspergillosis, and due to the latter a life-saving pneumonectomy had to be done  Microbiological tests of surgery specimens detected the cell crowding of mold fungi of Aspergillus fumigatus The histological tests showed necrotising granulomatosis with polyangitis, formation of cavities with fibrotic walls and fungal population; fibrinous-hemorrhagic pleurisy. In one month after surgery the patient was transferred to the rheumatological ward, where biological anti-B-cellular therapy with rituximab was started with a consequent positive outcome.