The problem of community-acquired pneumonia continues to be urgent due to high incidence, hospital admission rates, and mortality.

The objective of the study is to characterize epidemiological parameters of incidence and mortality of community-acquired pneumonia, influenza, and ARVI in Moscow.

Subjects and methods. The incidence and mortality of community-acquired pneumonia, influenza, and ARVI among different population groups in Moscow were analyzed. The Pearson correlation coefficient (rxy) was calculated to assess the relationship between incidence of pneumonia, influenza, and ARVI. Data were analyzed using IBM SPSS Statistics IBM statistics, version 23.0.

Results. Over the studied period of long-term changes in the incidence of community-acquired pneumonia among all population groups, a pronounced upward trend is observed. The highest incidence rates of community-acquired pneumonia in Moscow are registered among under in infants one year, 1-2 years old and 3-6 years old pediatric patients. The months of the maximum incidence of community-acquired pneumonia in adults coincide with the months of the maximum incidence of influenza (January - February). The maximum incidence of community-acquired pneumonia among children 15-17 years old and 0-14 years old is registered 2 months earlier than with influenza. The highest mortality of pneumonia is observed after 1-2 months after the maximum incidence of ARVI and influenza, which is due to delayed mortality as a result of the exacerbation of chronic diseases. The authors suggest considering simultaneous vaccinations against influenza and pneumococcal infection among people over 65 years old and high-risk groups during the pre-season vaccination against influenza.

Objective: to analyze the species and genetic families of tuberculous mycobacteria isolated from humans and cattle by spoligotyping.

Subjects and methods. Biological materials collected in the cattle, livestock farmers (who underwent annual fluorographic examinations) and tuberculosis patients were studied. To identify mycobacteria, the spoligotyping method was used.

Results. The article assesses the variability of sites within direct repeats (spacers), which are used in laboratory diagnostics for spoligotyping of mycobacteria and identification of tuberculosis pathogens. The frequency of combinations of different spacers in the analyzed mycobacteria in the specimens identified as Mycobacterium tuberculosis complex is compared with the spoligotyping profile of known mycobacteria thus establishing their belonging to a specific genetic family The studied isolates were tested by microscopic, bacteriological, and molecular genetic (PCR) methods. Based on the results of spoligotyping, it was found out that they belonged to genetic families of M. tuberculosis of Beijing, LAM, and Haarlem.

The article describes a new in vitro dormancy model of M. tuberculosis based on cultivation with deprivation of four components of the standard medium of Mediumbrook 7H9. The modeling method and characteristics of the obtained dormant phenotype of M. tuberculosis are described in detail, and fields for potential application of the model are proposed.

Objective: to study the prevalence of latent tuberculosis infection (LTBI) among university students, to evaluate the effectiveness of preventive treatment in students with LTBI.

Subjects and methods. In 2016-2019, the three-stage study was conducted that enrolled all university students in the city of Stavropol.

In 2016-2017 during the first stage of the study, 4,139 students had tests with tuberculous recombinant allergen (TRA).

At the second stage of the study, 141 medical files of students with positive results of TRA tests were retrospectively analyzed, all students were followed up and 133 of them underwent preventive treatment.

In 2018-2019 at the third stage of the study, the long-term results of preventive treatment were evaluated.

Results. Tests with TRA allowed detecting LTBI and defining indications for preventive treatment with anti-tuberculosis drugs. Among 133 students with LTBI who had preventive treatment, there were no cases of tuberculosis; sensitivity to TRA decreased, which manifested by a decreased induration size during the control test. Thus, in 36 months of follow-up over 83 patients with hyperergic reaction, it persisted only in 4 of them.

The objective: to study the influence of certain social factors on treatment results of suppurative diseases of the lungs and pleura in HIV positive patients.

Subjects and methods: 232 HIV positive patients with suppurative diseases of the lungs and pleura (the mean age made 36.9 ± 7.2 years) who were admitted to the clinic to have treatment. Various surgical interventions were performed in 171 (74%) patients, 10 (5.8%) had postoperative complications. Based on the outcome of suppurative disease, 232 patients were divided as follows: 42 (18.1%) - clinical cure with no X-ray signs in the lungs, 100 (43.1%) - clinical cure with residual changes in the lungs, 55 (23.7%) - improvement, 9 (3.9% ) - no changes. 26 (11.2%) patients died, of them 24 (10.3%) died due to systemic complications, 2 (0.9%) - due to pulmonary/intrapleural hemorrhage.

In the patients, relationships between the manifestations and outcomes of the suppurative disease (pulmonary suppuration, pleural empyema, development of complications, fatal outcome) were studied considering each of 9 factors and using Spearman's rank correlation: age, education, employment status, marital status, tobacco smoking, drug abuse, alcohol addiction, the way of infecting with HIV, and in-take of ART. Only the inverse weak correlation was revealed between the level of education and fatal outcome (patients with higher education died less often), as well as employment and development of pleural empyema (in those employed, pleural empyema was less common).

The objective: to assess functional disorders in various models of clinical situations in patients with the severe course of tuberculosis.

Subjects and methods. Functional disorders were assessed in 154 tuberculosis patients (HIV positive or HIV negative) with a severe course of the disease, distributing them according to clinical situation models. 4 models of clinical situations for such patients were proposed: M₁ - patients with chronic forms of tuberculosis (after 2 or more treatment failures), with complications, but no severe immunodeficiency; patients with acute progressive tuberculosis without lesions of the central nervous system (CNS); M₂ - HIV positive and HIV negative patients with acute progressive tuberculosis without lesions of the central nervous system; M₃ - patients with tuberculosis and meningitis (meningoencephalitis) of various etiologies; M4 - patients with tuberculosis and chronic progressing diseases of a therapeutic profile.

Results. The scale for assessing functional deficits in tuberculosis patients allows determining the type and severity of functional disorders as well as mobility, the ability to self-service and communication in patients with a severe course of the disease. The severity of functional disorders differs in patients from different models, it is the smallest with M₁ model - a chronic course of tuberculosis, and it is the biggest in M₃ model - tuberculosis with central nervous system lesions.

The proposed models can be the basis for development of differentiated management regimens for such patients and provision of care in TB units, estimation of the demand for auxiliary care products, analgesic and symptomatic therapy, as well as compilation of algorithms for medical personnel actions.

The objective: to evaluate relationships between the oxidative-antioxidative system (OAS) and the force indicators of respiratory muscles (RM) in patients with community-acquired pneumonia (CAP).

Subjects and methods. 78 men from 18 to 26 years old admitted to an in-patient unit with non-severe (NSCAP) and severe community-acquired pneumonia (SCAP) were examined. Force of expiratory (MEP, MRPD) and inspiratory (MIP, MRPD, SNIP) respiration muscles was registered by MicroRPM (CareFusion, UK). The state of OAS was assessed by the level of malondialdehyde (MDA), total antioxidative activity, superoxide dismutase (SOD), catalase, glutathione reductase (GR), glutathione peroxidase (GP), and reduced glutathione. Cluster and correlation analysis methods were used for data processing.

Results. CAP patients were divided into 3 clusters based on typical combinations of respiratory muscle force indicators and OAS. The first cluster included NSCAP, the second one included NSCAP and SCAP, and the third cluster included SCAP In patients of the 1st cluster, the dysfunction of expiratory respiration muscles prevailed, while in patients of the 2nd and 3rd cluster, it was inspiratory respiration muscle dysfunction. Significant negative correlations of MDA with MEP, MRPD during expiration, SNIP, and MIP were found, as well as positive correlations with GP, GR, catalase, and SOD. In convalescents of the 1st cluster, dysfunction of expiratory respiration muscles was improving, and in the 2nd and 3rd clusters, the dysfunction of expiratory and inspiratory respiration muscles was going down. In CAP patients, respiratory muscle dysfunction is associated with imbalanced OAS and the effect of these factors on respiratory muscle contractive activity.

The article describes a clinical case of a patient with tuberculosis that developed during the period of transient immunodeficiency of HIV infection (stage 2B of HIV infection). The main manifestation of tuberculosis was cervical lymphadenitis, for which several operations had to be performed; enlarged lymph nodes of the lung root, retroperitoneal and inguinal groups were visualized by X-ray. Based on the presence of tuberculosis, the patient was diagnosed with an advanced, 4B stage of HIV infection and, after 9 days, ART was started.

The article speculates on whether tuberculosis should be considered as an unambiguous criterion for the last stage of HIV infection regardless of immunity indicators and duration of the course of HIV infection.

To solve the problems of tuberculosis (TB) in penitentiary institutions, it is advisable to conduct a retrospective analysis, to find the most successful ways to prevent the spread of the infection in this system.

Objective: to study the historical aspects of tuberculosis control in the penitentiary system of the Russian Federation.

Methods. Information analysis methods were used. Data from 61 sources were studied.

Results. The most significant attention was given to tuberculosis control in the penitentiary units at the beginning of the XXI century, which resulted in the significant improvement of the situation. In recent years, less attention has been paid to this problem, which is capable of stagnating positive changes. It is proposed, along with the continued implementation of proven measures, to intensify research activities, the interaction between civil and penitentiary health care and social communication.