The objective: development of the best vaccination regimen against pneumococcal infection in patients with chronic obstructive pulmonary disease (COPD) with consideration of changes in microbiological and clinical parameters.

Subjects and Methods. 115 patients with COPD were randomized into 4 pneumococcal vaccination groups, they were examined and followed up for 4 years; 112 patients completed the study complying with the protocol. Detail medical history of all subjects was collected. To verify the diagnosis of COPD, all subjects underwent external respiratory function test and bronchodilator test (salbutamol, 400 μg) according to the standard method. The classic microbiological assessment was used in this study. The clinical effectiveness of vaccination was assessed. Statistical processing of the results was performed using StatPlus Pro 6.2.0.0 software (license number 2883).

Results. Сonsecutive vaccination with pneumococcal conjugate and polysaccharide vaccines leads to decreased isolation rate of pneuniococcus from the sputum of CODP patients. The frequency of exacerbations, the need for antibiotic chemotherapy and hospitalizations also goes down.

The objective: to identify factors of a higher risk to develop tuberculosis in children exposed to tuberculosis cases resistant or sensitive to rifampicin.

Subjects 161 children under 6 years old exposed to tuberculosis in their families were enrolled in the retrospective study. The children were divided into 2 groups: Group 1 (n = 92) – children free of TB; Group 2 (n = 69) – children ill with TB. In each group, two subgroups were identified: those with index cases susceptible to rifampicin (RS) 1A (n = 40) and 2A (n = 43) and those with index cases resistant to rifampicin (RR) 1Б (n = 52) and 2Б (n = 26).

Results. Exposure to isoniazid resistant tuberculosis increases the risk of TB in the child by 12 times, on the opposite, drug resistance to rifampicin provides no impact on the risk to develop tuberculosis. If the child is exposed to 2 cases of tuberculosis and more, the risk to develop tuberculosis increases by 2-14 times. BCG vaccination of the child exposed to tuberculosis reduces the risk to develop tuberculosis by 2-13 times.

The objective: to assess the severity of symptoms of urinary dysfunction in tuberculosis patients with benign prostatic hyperplasia (BPH) and determine the effectiveness of comprehensive therapeutic and preventive measures aimed at their elimination as well as the possibility of their combination with anti-tuberculosis therapy.

Subjects and Methods. 447 men with various localizations of tuberculosis at the age from 20 to 96 years old were examined. The questionnaire we used included questions regarding lower urinary tract symptoms, urinary tract infection, involuntary urination, and male genital disorders. The assessment involved comprehensive clinical and laboratory evaluation, including objective examination, laboratory and echographic tests of genitourinary organs.

Results. According to assessment results, among 447 male tuberculosis patients, 88 (19.7%) were diagnosed with benign prostatic hyperplasia which indicated a large proportion of older men with various forms of tuberculosis. Analysis of the structure of tuberculosis clinical forms showed the highest frequency of benign prostatic hyperplasia in patients with infiltrative pulmonary tuberculosis (51.1%) and bone and joint tuberculosis (26.1%). Medical treatment (tamsulosin 0.4 mg once a day for 3 months) in 66 patients was highly effective – up to 80.3%.

The objective: to assess the effect of active finding of tuberculosis cases on the frequency of bacterial excretion, lung tissue destruction, and treatment outcomes.

Subjects and Methods. The characteristics of adult patients (newly detected - new cases and those with relapsed pulmonary tuberculosis) were studied in 2 phases: a) 1,404 cases, including 814 actively found, at detection; b) the outcomes of the completed first course of chemotherapy in 946 patients, including 565 actively detected, registered for treatment in 2017 and 2018. Adjusted relative risk (aOR) and statistical significance of differences were calculated.

Results. Patients detected actively versus those detected by self presentation to a medical unit had a lower level of positive results of smear microscopy (aOR = 2.7; p < 0.01) and lung tissue destruction (aOR = 1.4; p = 0.01), but the level of positive culture was equal (aOR = 0.9; p = 0.6).  Active case finding had no effect on treatment failure rate but if a patient is HIV negative and young, it reduced the risk of death in tuberculosis patients during treatment (aOR = 0.3; p < 0.01). Active case finding, along with no history of previous treatment, negative HIV status, and older age were inversely associated with treatment interruption (aOR = 0.3; p < 0.01).

The objective: to compare liver function of respiratory tuberculosis patients during the intensive phase of treatment with first line drugs (chemotherapy regimen 1) and reserve drugs (chemotherapy regimens 4 and 5).

Subjects and Methods: Data of 144 respiratory tuberculosis patients were analyzed, those patients were divided into 2 groups. Group 1 included 67 patients receiving chemotherapy regimen 1 and Group 2 included 77 patients treated with chemotherapy regimens 4 or 5. During the first 3 months of treatment, the frequency and severity of changes in the liver function were assessed.

Conclusion: in patients with chronic viral hepatitis, parenchymal liver damage is more frequent and it improves slower. Transaminase levels returned to normal levels more frequently and rapidly with chemotherapy regimen 1, whereas with chemotherapy regimens 4 and 5, reduction of alanine aminotransferase level was observed only from the 2nd month of treatment.

A clinical case of HIV-associated multiple drug resistant tuberculosis in a pregnant woman is presented. The clinical situation was complicated since during the main course of treatment this patient had two pregnancies and delivery with an interval of less than 2 years, and the onset of the disease occurred during the early period in the first pregnancy. This case demonstrates effective treatment of the specific disease and favorable perinatal outcomes. The article assesses medical tactics, analyzes the time of diagnosis, complex therapy, the choice of the way of delivery, considers the need for interdisciplinary interaction at all stages of observation to improve the quality of care.

57 publications on pneumotoxicity of antitumor drugs were analyzed. It was found that the development of pneumotoxic effects could be influenced by risk factors such as gender, age, tobacco smoking, comorbidities, and duration of therapy. Symptoms of lung injury induced by antitumor drugs are nonspecific thus it is difficult to diagnose them promptly. For prevention, early diagnosis and timely management of drug-induced lung injury during antineoplastic therapy, it is necessary to raise awareness of such a condition in practitioners of different specialties, primarily general practitioners, pulmonologists, phthisiologists, and oncologists.