The objective: to evaluate the neuroprotective activity of cytoflavin and combinations of mexidol with vitamin B6 or Magne B6 by changes in behavioral reactions in rats during in-take of a neurotoxic combination of anti-tuberculosis drugs.

Subjects and Methods. Non-linear female rats divided in 4 groups were used in this study. For 14 days, all rats received a combination of Mxf+Lzd+Cs+Pto daily. Additionally, rats of Group 2 were administered cytoflavin before administration of the basic combination; Group 3 – Mexidol + vitamin B6; Group 4 - Mexidol + Magne B6. Doses of anti-tuberculosis drugs, cytoflavin, Mexidol, vitamin B6 and Magne B6 correspond to the recommended doses for humans. The manifestation of neurotoxicity was assessed by changes in behavioral reactions by Open Field Test.

Results. Neurotoxicity caused by the combination Mxf+Lzd+Cs+Pto was manifested by a decrease in motor activity, exploratory activity and grooming. With cytoflavin administration, all parameters of behavioral reactions in rats improved. When using Mexidol with vitamin B6, only a slight decrease in grooming versus the baseline level was observed. There was a less qualitative decrease in neurotoxicity manifestations with administration of Mexidol in combination with Magne B6.

The objective: to evaluate the effect of chronic obstructive pulmonary disease on the severity of silent myocardial ischemia in patients with arterial hypertension.

Subjects and Methods. Examinations and follow-up of 194 COPD patients who were undergoing outpatient follow-up and treatment were analyzed. Those patients suffered from COPD with concurrent arterial hypertension or isolated arterial hypertension.

Results. Holter ECG monitoring should be done in all COPD patients regardless of severity of the disease and presence of comorbid conditions. This is due to the high prevalence of silent myocardial ischemia in such patients.

The objective: to determine the effectiveness of detection of patients with pulmonary tuberculosis and prevention of its spread by sputum microscopy in clinical diagnostic laboratories of general medical services of the Republic of Karelia.

Results. A reduction in the number of sputum microscopy tests in clinical laboratories of GMS and decrease in the positivity rate to 0.66% was revealed. Among new tuberculosis patients with rifampicin resistance, 51% had abundant bacterial excretion (AFB 2+ and 3+); according to sputum microscopy, tuberculous mycobacteria susceptible to rifampicin were isolated in 38%. In the Republic of Karelia, 31.7% of tuberculosis patients were detected in in-patient units of GMS: 60% of them had cavities, and 28.8% had abundant bacterial excretion (AFB 2+ and 3+). The poor quality of sputum microscopy is the cause of late detection of tuberculosis in the Republic of Karelia and promotes the spread of MDR tuberculosis strains among the population, including nosocomial infection.

The objective: to identify changes in effectiveness of treatment of multiple drug resistant tuberculosis among key populations in Dushanbe, including the period of the COVID-19 pandemic.

Subjects and Methods. Retrospective study of medical records of 431 MDR TB patients registered for treatment in Dushanbe was conducted (2017-2019 - Group 1 and 2020-2021 - Group 2 (the COVID-19 pandemic period)).

Results. The duration of treatment was 15.4±6.9 months in Group 1, and 10.8±4.3 months in Group 2, which was due to the introduction of short-course regimens in that group. At the same time, in Group 2 there was an increase in effectiveness of MDR TB treatment to 85% versus 80% in Group 1, which was due to the use of new drugs and regimens containing them. In Group 1, a statistically significant association was found between MDR TB treatment failure and the following parameters: male gender (RR=2.3 (1.36-4.04), p=0.002), positive HIV status (RR=2.35 (1.37-4.05), p=0.011), hepatitis C infection (RR=3.0 (1.87-4.8), p <0.001), alcohol (RR=3.2 (1.96-5.2), p<0.001) and substances abuse (RR=3.99 (2.5-6.2), p<0.001), previous imprisonment (RR=2.6 (1.48-4.6), p<0.001), unemployment (RR=3.5 (1.8-6.7), p <0.001), and homelessness (RR=5.0 (3.9-6.5), p=0.0011). In Group 2, failure of MDR TB treatment was statistically significantly associated with hepatitis C (RR=3.3 (1.5-7.2), p=0.02), alcohol and drug abuse (RR= 4.4 ( 1.95-10.1). p =0.026), as well as (unlike Group 1) labor migration (RR=3.0 (1.45-6.2), p=0.0068), in-patient treatment (RR=3.8 (1.36-10.64), p=0.0056), while there was no association with HIV status.

The objective: to develop a method for assessing the probability of progression of pulmonary fibrosis in patients with interstitial lung diseases in order to determine further treatment tactics.

Subjects and Methods. 80 patients with interstitial lung diseases underwent lung biopsies with consequent morphological and immunohistochemical tests. The group with progressive fibrosis consisted of 42 patients. The prognostic model was built using the binary logistic regression method.

Results. A statistical model was developed in the form of a regression equation consisting of 3 parameters: the presence of a morphological pattern of interstitial fibrosis; intensity of CTGF expression; and intensity of TGF-β expression. This mathematical model makes it possible to predict the progression of pulmonary fibrosis in patients with interstitial lung diseases with 83.3% sensitivity and 84.2% specificity.

The objective: selection of optimal timing for chest CT to identify respiratory tuberculosis treatment failures in children and adolescents through clinical and radiological comparison.

Subjects and Methods. A retrospective comparative study was conducted. Totally 70 patients aged from 2 to 17 years with various clinical forms of respiratory tuberculosis were examined. Retrospectively, patients were divided into 3 groups: Group 1 (35 people) – CT was performed before the treatment start and, as the first control, after 2-3 months of chemotherapy; Group 2 (17 people) had a CT before the chemotherapy start and after 2-3 months – plain X-ray (or in combination with linear tomography), CT control – after 6-9 months after the chemotherapy start; Group 3 (18 people) included patients who had only plain X-ray (or in combination with linear tomography) before and during chemotherapy, CT was first performed after treatment failure

Results. In all groups, in more than 40% of cases, radiological changes were the only informative criterion of treatment failure. CT performed in the early stages was optimal for timely detection of treatment failure: before the chemotherapy start and in 2-3 months (Group 1). In patients of Groups 2 and 3, opportunities for timely correction of chemotherapy were missed due to inadequate assessment of pathological changes. CT performed after 6-9 months of treatment reliably revealed irreversible changes in 53% and 78% (Groups 2 and 3), respectively.

The objective: to assess possibilities for timely diagnosis of drug resistance of M. tuberculosis in the regions of the Siberian Federal District (SFD) with a high burden of drug resistant tuberculosis.

Subjects and Methods. The retrospective analysis included federal and sectorial statistical reporting data (Form no. 33, Form no. 8, Form no. 30, Form no. 7-TB, Form no. 8-TB), forms of non-recurrent statistical surveillance VR-5MLU, Form no. 68, data from Visit Reports by specialists of Novosibirsk Tuberculosis Research Institute by the Russian Ministry of Health for 2021 – 9 months of 2023.

Results. All laboratories of TB units in the regions of the Siberian Federal District are equipped with equipment for rapid molecular genetic diagnosis of M. tuberculosis, however, the majority of laboratories have no possibility to conduct rapid molecular genetic DST to fluoroquinolones. In a number of regions no DST to levofloxacin and moxifloxacin is performed. Susceptibility testing to linezolid and bedaquiline is conducted extremely rarely. Susceptibility testing to delamanid is performed in single cases and only in one region. To achieve treatment effectiveness rates defined in Edict no. 19 by Russian Ministry of Health dated February 07, 2023, it is necessary to equip TB units with modern equipment for rapid DST, organize an uninterrupted supply of consumables, as well as train laboratory personnel in the shortest possible time.

The objective: to evaluate postponed results of lung resection for disseminated fibrous cavernous tuberculosis.

Subjects and Methods. Postponed treatment results were evaluated 3–5 years after surgery, it was the time when patients were taken off the register at TB dispensary (TBD). Inpatient medical records (Form no. 003/u) and outpatient records (Form no. 025/u-04) were used as the source of information.

Results. Out of 702 patients for whom postpones results were available, 571/702 (81.3%) were taken off the register 5 years after the surgery due to cure. Relapse with a chronic course of tuberculosis developed in 49/702 (7.0%) patients, and lethal outcome occurred in 82/702 (11.7%) patients (relapse and progression of tuberculosis were the cause in 51 patients, while surgical complications in 31 patients). Over all period of follow-up, 132 tuberculosis relapses were detected, but a significant limitation of this part of the study was the loss of patients for follow-up every year. By the period of “10 years or more”, there were only 139 people available for follow-up and among them 15 (10.8% ) relapses were registered.

It was also found that the chances of an unfavorable outcome of tuberculosis treatment were more than 32 times higher in patients with an unfavorable immediate result of the surgery (including not resolved postoperative complications) versus the patients who achieved a favorable result after the surgery (OR = 32.14, 95 % CI 17.57 – 58.78, p<0.001, χ2 =218.8)

The objective: to compare treatment effectiveness of drug resistant tuberculosis (MDR, pre-XDR, XDR) depending on the HIV status of patients in Stavropol Region from 2019 to 2022.

Subjects and Methods. In a retrospective study, chemotherapy outcomes for pulmonary tuberculosis (TB) were evaluated with distribution by treatment regimens for MDR, pre-XDR, and XDR in 100 patients with drug resistant tuberculosis (MDR, pre-XDR, XDR and HIV infection (DR TB/HIV Group ) and 707 patients with drug resistant tuberculosis (MDR, pre-XDR, and XDR) (and negative HIV status (DR TB Group). The immune status of patients in DR TB/HIV Group and its impact on the effectiveness of tuberculosis treatment were analyzed.

Results. Effective treatment (definitions are given according to the Guidelines) was statistically significantly more frequently registered in DR TB Group versus DR TB/HIV Group (59% and 48%, respectively, p<0.05). Treatment failure was statistically significantly more frequently registered in patients in DR TB/HIV Group versus DR TB Group (42% and 26%, respectively, p<0.05). In DR TB/HIV Group, the lowest effectiveness (33%) of tuberculosis treatment was noted in the patients with CD4 count below 200 cells/µL. Among those died, the median time to death from the start of tuberculosis treatment was 12 months in DR TB Group, 8 months in DR TB/HIV Group, and 4 months in the subgroup of patients with CD4 count below 100 cells/µL.

The objective: to assess impact of the COVID-19 restrictive measures on tuberculosis detection among children and adolescents.

Subjects and Methods. For the analysis, materials from statistical collections and state statistics forms (Form No. 33) were used. Changes of the main epidemiological tuberculosis rates were assessed for two observation periods: before the pandemic (2017-2019) and during the pandemic (2020-2022). Statistical analysis methods were used.

Results. The COVID-19 pandemic and related restrictive measures generally provided no significant impact on the coverage with preventive screening for tuberculosis of population in the Republic of Sakha (Yakutia). At the same time, during the pandemic, a slight reduction of the main epidemiological tuberculosis rates was noted both among adults and children. Despite this decrease, a deterioration in the structure of new tuberculosis patients was revealed, which indicated that the disease was not detected in a timely manner.

The review presents modern ideas about X-ray examination for diagnosis of lung diseases including tuberculosis in the pregnant. The use of X-ray diagnostic tools in the pregnant is limited due to the lack of information about modern capabilities of equipment and special protection, and often by X-ray phobia among patients and physicians. The article presents data on the physical parameters of modern X-ray methods (digital radiography, low-dose CT) and highlights methods free of ionizing radiation, which are gradually entering phthisiologic practice.

The review analyzes publications devoted to the formation of phenotypes in sarcoidosis patients. It has been noted that there is a certain difficulty in phenotyping the disease that can affect all human organs and systems. The article demonstrates the trend to shift from Scadding radiographic stages of intrathoracic sarcoidosis, based on radiography, to phenotypes based on high-resolution computed tomography. It presents phenotypes based on such parameters as organ damage, respiratory dysfunction, laboratory and genetic data, and treatment effects. The authors note that phenotypes should be applicable to clinical practice and clearly reflect differences between patients and the likelihood of clinically significant outcomes.