The article describes the statistic rates reflecting the incidence of tuberculosis of various localizations in the Russian Federation during 2001-2016, putting special emphasis on gender and age. The authors demonstrate the impact of HIV infection on the level of tuberculosis incidence. The article also presents and summarizes data on extrapulmonary tuberculosis, describes the difficulties arising during notification of such cases and limiting the reliability of epidemiological analysis, and gives the estimated incidence.

The article presents the comparative assessment of effectiveness of tuberculosis treatment with empiric chemotherapy regimen IV. The outcomes of treatment with empiric regimen IV of the cases in whom later drug resistance was confirmed were compared with the outcomes of regimen IV prescribed to the patients who had confirmed resistance at least to rifampicin. The outcomes of empiric treatment with regimen IV in the cases without confirmed resistance to rifampicin were compared to outcomes of treatment with regimens I, II, and III, prescribed to those sensitive to rifampicin. No statistically significant differences in the number of favorable treatment outcomes were found which allows concluding that it is advisable to prescribe empiric regimen IV if multiple drug resistant tuberculosis is suspected.

The objective of the study: to investigate ventilatory and gas exchange pulmonary functions in the patients with chronic destructive pulmonary tuberculosis after the successful endobronchial valve block.

Subjects and methods. Data of 85 patients with chronic destructive pulmonary tuberculosis were analyzed; in all of them, cavities in the lungs were healed after the endobronchial valve block, which was confirmed by computed tomography. Of them, 45 were men and 40 were women at the age from 18 to 59 years old (the median age made 30.6± 8.8 years). When examining patients prior to implantation of the endobronchial valve block, 49 patients had normal ventilatory lung capacity (forced expiratory volume per second (FEV1) ≥ 80% due values), 17 patients suffered from moderate disorders (FEV1) made 79-60% due values), while 19 ones had severe disorders (FEV1 ≤ 59% due values). The data reflecting respiratory function and blood gases of all patients were compared before implantation of the endobronchial valve and in 7-10 days after its removal.

Results. In the majority of patients (from 65.9 to 84.7% of patients depending on the parameter) with chronic destructive pulmonary tuberculosis in whom the endobronchial valve block was successful, after the endobronchial valve was removed, no changes in ventilatory and gas exchange functions were registered versus the initial ones. The remaining patients had moderate positive or negative changes. The most dynamic rates reflecting ventilatory and gas exchange lung functions were FEV1, vital capacity (VC), peak expiratory flow (PEF), РаО2 and РаСО2, which changed in 27-43% of patients (depending on the parameter).

According to changes in the integral value of FEV1, ventilatory lung capacity deteriorated in 22.3% of patients and improved in 11.8% of them.

VC increased in 22.3% of patients and reduced in 10.6% of them, which often promoted improvement of blood oxygenation rates: РаО2 increased in 25.9% and reduced in 8.2% of patients, SаO2 increased in 15.3%, and reduced in 3.5% of them. The level of PaCO2 increased in 7.0% of patients, and went down in 20.0% of them.

After the successful endobronchial valve block, improvement of ventilatory lung capacity, determined by FEV1 increase, was more frequent in the patients who had it below the norm initially versus the normal level (23.4% versus 6.1%, p < 0.05), the same was observed in VC (47.3 and 14.3%, p < 0.05).

If the endobronchial valve block is implanted for a longer period of time due to disseminated and severe tuberculosis, the frequency of positive changes of functional rates increases (according to values to FEV1, VC, Tiffeneau's test, PEF), as well as gas exchange parameters (according to РаО2, SаO2 and PaCO2). Should there be indications for implantation of the endobronchial valve block, it can promote not only the healing of cavities and tuberculous lesions, but result in certain improvement of respiratory and gas exchange functions.

The objective of the study: to investigate the impact of migration on tuberculosis situation in the Kaluga Region.

Subjects and methods. The article analyzes the general population of migrants examined for tuberculosis in 2009-2017 in the Kaluga Region, as well as the total number of migrants in whom tuberculosis was detected.

Results. Data on examination of migrants for tuberculosis in the Kaluga Region were analyzed. It was found out that the impact provided by foreign citizens ill with tuberculosis on the local tuberculosis situation was growing. Ethnicity, gender and age structure of migrants ill with tuberculosis were studied as well as a specific clinical course of tuberculosis in foreign citizens.

The objective of the study: to compare the effectiveness of tuberculosis chemotherapy and treatment outcomes in the pregnant patients versus those nonpregnant.

Subjects and methods. Medical records of 218 HIV negative women ill with tuberculosis were analyzed: TB + Pregnancy Group included 109 pregnant tuberculosis patients; and TB Group included 109 nonpregnant female tuberculosis patients. The patients from TB Group were enrolled in order to match patients from TB + Pregnancy Group regarding the age, social status, specific features of the disease, lung tissue destruction, bacillary excretion, and drug resistance profile.

During treatment of tuberculosis, 72.5% (n = 79) of patients from the main group got pregnant. Pregnancy resulted in delivery in 67.0% (n = 73) of women, and in 23.0% (n = 25) of women, it was electively terminated before the 12th week of pregnancy.

First line drugs were prescribed to 55.0 and 42.2% of patients from Groups 1 and 2 (pχ2 > 0.05); combinations of first line and reserve drugs (due to resistance to isoniazid) were used in 22.0 and 37.6% (pχ2 > 0.05) respectively; and reserve drugs (due to MDR/XDR TB) were used in 22.9 and 23.9% (pχ2 > 0,05) of patients. The main course of tuberculosis treatment lasted for 11.6 ± 4.7 months in the pregnant patients and 14.3 ± 3.8 months in those nonpregnant. And pregnant patients had one forth part of their chemotherapy coinciding with their pregnancy.

Results: Only pregnant patients developed hepatotoxic reactions to anti-tuberculosis drugs. In HIV negative patients, treatment effectiveness was compatible in the pregnant and nonpregnant patients (58.7 ± 4.7 and 61.5 ± 4.7%, pχ2 > 0.05). Mortality due to progression of tuberculosis in the pregnant did not exceed the mortality in the nonpregnant ones (5.5 ± 2.2 and 7.4 ± 2.1%, pχ2 > 0.05). The frequency of relapses was the same in the pregnant women receiving anti-tuberculosis therapy and those nonpregnant (3.1 and 4.4%, pχ2 > 0.05).

In Moscow in 2017, the project named Moscow Screening for Lung Cancer was started using low-dose computed tomography (LDCT) for selective screening for lung malignant tumors in the out-patient facilities and polyclinics.

The main goal of the project: to improve early detection of lung cancer and reduce mortality caused by this disease in the long term.

The objective of the study: to assess the importance of incidental findings during selective screening for lung cancer by LDCT in Moscow.

Subjects and Methods. The retrospective study included 254 randomly selected LDCT, which were performed as a part of the screening program. During the repeated examination of images and protocols, all abnormalities were taken into account (but for foci in the lungs evaluated as per LungRADS-2014).

Results. When analyzing the dissemination and character of incidental findings, detected by LDCT screening, it was found out that such findings had high clinical and/or predictive value in the majority of cases. The following disorders were detected the most often (% of those with incidental finding): coronary artery calcium - 49.3%; thickening of bronchial walls - 34.9%; bronchiectasis - 34.9%; emphysema - 21.6%.

During primary interpretation of LDCT results, less attention was paid to description of abnormalities but for foci evaluated as per Lung RADS-2014. Further research and organization are needed to provide detection and reasonable routing for those with incidental findings.

Conclusions. Incidental findings occur in 87.1% of cases during selective screening for lung cancer by LDCT. The majority of incidental findings are located in the cardio-vascular (75.4%) and respiratory (68.3%) systems, and they possess clinical and predictive value.

When treating tuberculosis patients with multi-component chemotherapy it is necessary to use medications in order to manage or minimize side effects. The review presents research findings on the effect of pyridoxine and its derivatives on the nervous system and their interaction with the agents of isonicotinic acid hydrazide. The review tells about combination drugs containing pyridoxine and pyridoxine hydrochloride used for treatment of tuberculosis.

The article presents the review of current publications, clinical recommendations and guidelines written by foreign authors and devoted to treatment of drug resistant tuberculosis with delamanid. According to the publications, delamanid and its combinations with other anti-tuberculosis are highly effective when used for treatment of respiratory MDR tuberculosis: 74.5% of patients achieved the complete sputum conversion by the 6th month of treatment.