Extrapulmonary tuberculosis is an "awkward" issue of public health: it can't be screened for, it is difficult to diagnose, bacteriological verification does not exceed 46% while the part of patients with isolated extrapulmonary lesions remains low among other cases of tuberculosis. The existing system of dispensary follow-up provides a significant impact on extrapulmonary tuberculosis incidence since according to its requirements, one (major) site of the disease is to be notified, which is usually respiratory tuberculosis. And specialists treating extrapulmonary tuberculosis are responsible for consulting of all tuberculosis patients relevant to their specialization.

The objective of the study: to analyze the staff of specialists managing extrapulmonary tuberculosis patients in Siberia and the Far East.

Subjects and methods. Special questionnaires filled in by specialists from TB dispensaries from Siberian and Far Eastern Federal Districts were analyzed; statistic reports (Form 8) from these Russian regions were studied.

Results. In 2017, 550 people developed isolated extrapulmonary tuberculosis. Since 2008, bone and joint tuberculosis (40.7%) has been prevailing followed by urogenital tuberculosis (20.4%). 94 extrapulmonary tuberculosis specialists work in Siberian and Far Eastern Federal Districts, and 36.2% of them have been working for more than 30 years. Phthisioosteologists make 20.2% and urologists – 26.6%. Every forth specialist (28.7%) specializes in two fields, one of them is phthisiology.

The excessive number of urologists can be explained by the changes in the epidemic situation: urogenital tuberculosis gave place to bone and joint tuberculosis. The existing health care system is rather inert and it could not change the profile of beds and train the relevant specialists in a prompt way.

The objective of the study: to study markers of carbohydrate metabolism in pulmonary tuberculosis patients with concurrent diabetes during treatment of tuberculosis.

Subjects and methods. 156 pulmonary tuberculosis patients, divided into 2 groups, were examined. Group 1 included 69 (44.2%) pulmonary tuberculosis patients with concurrent type 1 diabetes. Group 2 included 87 (55.8%) pulmonary tuberculosis patients with concurrent type 2 diabetes.

Results. Prior to the start of anti-tuberculosis treatment, disorders of carbohydrate metabolism in type 1 diabetes patients were more expressed: there were the statistically significant higher level of glycated hemoglobin and glucosuria severity during the daytime (within 8-14 hour interval). Analysis of changes in carbohydrate metabolism markers showed that there was a gradual trend for their improvement if the treatment was effective and should treatment be failing, the disorders of carbohydrate metabolism were deteriorating.

Conclusion. Tuberculosis deteriorated the severity of diabetes, especially of type 1, compromising the efficacy of antihyperglycemic therapy. A significant part of treatment failures among type 1 diabetes patients was potentially associated with the negative impact of poorly compensated diabetes.

The objective of the study: to compare psychological features of the patients referring for psychological care during treatment of tuberculosis and of those who did not need it.

Subjects and methods. 78 new pulmonary tuberculosis patients (median age was 31.3 ± 10.6 years old) were included into the study; all of them were diagnosed with psychological disorders of various severity when admitted to Central Tuberculosis Research Institute for in-patient treatment. The main group included 33/78 (42.3%) patients who referred for psychological help during anti-tuberculosis chemotherapy. 45/78 (57.7%) patients didn't receive any psychological support during anti-tuberculosis chemotherapy (comparison group). There was no significant difference between the number of patients in those groups (χ2 = 1.846; p > 0.1). In both groups, women significantly prevailed over men. Women made 89.5% of cases in the main group (χ2 = 18.944; p < 0.001), and 83.3% of cases in the comparison group (χ2 = 18.68; p < 0.001). The psychological status was assessed by the admission and completion of chemotherapy in the hospital using the Symptom Check List (SCL–90–R). In addition to assessing the current psychological status, we studied the forms of destructive responses, interpersonal interaction styles, quality of life, level of subjective control in various life aspects, and also assessed subjective well-being of the individual.

Results. It was found out that the specific psychological features of the patients from the main group were significantly different from the ones of the comparison group (higher level of depressive disorders, less pronounced symptoms of negative affective states, suspicion and negativity towards other people); the difference also included a higher level of internality towards failures and family relations, lower psychological resources needed for positive functioning, and communication and emotional characteristics of the individual. It was demonstrated that patients referred for psychological support not only due to actual problems in the mental sphere, but also due to its specific features, as well as the patient’s personal qualities.

The objective of the study: to assess the potential bactericidal action of UHF on Mycobacterium avium strain104 and Mycobacterium tuberculosis strain H37Rv.

Subjects and methods: M. avium strain 104 and M. tuberculosis strain H37Rv and the microwave generator of Agilent Technologies E82570 1 were used; in order to define the radiation frequency to be set up at the generator, the frequencies of torsion oscillations of mycobacterial DNAhelices were calculated.

Results of the study: it was demonstrated that the nonthermal UHF field was capable of inhibiting the growth of M. avium strain 104 and M. tuberculosis strain H37Rv.

The article describes the clinical case of Langerhans cell histiocytosis with lesions in lungs and flat bones in a 40-year-old smoker. During 4 years, all stages of the disease were followed. The diagnosis was made basing on the results of thoracoscopic lung biopsy. Treatment with a cytostatic drug and smoking cessation resulted in positive X-ray changes.

The article describes a clinical case of invasive adenocarcinoma and fibrous-cavernous pulmonary tuberculosis For timely diagnosis of lung cancer in those suffering from active respiratory tuberculosis, detail analysis of clinical, laboratory and X-ray data is needed as well as the immediate bronchoscopy examination.

The review describes main classes of extracellular microvesicular particles, mechanisms of their biogenesis and their potential role in the development of tuberculosis. Special attention is paid to apoptosis of macrophages infected with tuberculous mycobacteria, generation of apoptotic ectosome and involvement of the latter into the formation of anti-tuberculosis immune response. Conclusion: mechanisms of apoptotic blebbing, ectosomes and clearing of these particles possess the potential to become a new tool within pathogenetic therapy of tuberculosis.