Цель исследования: определить протективные генотипы по изученным локусам у больных туберкулезом разных групп. Материалы и методы. В исследование включено 568 пациентов. Группу I составили 43 пациента с очаговым туберкулезом легких, группу II-279 пациен

Наиболее выраженным было уменьшение заболеваемости абдоминальным и кожным туберкулезом. При этом заболеваемость урогенитальным туберкулезом сохранялась на высоком уровне, что обусловлено вне

The objective of the study: to analyze treatment outcomes in patients with pulmonary destructive MDR tuberculosis who completed the intensive phase of treatment and had healed or persisting cavities.Subjects and methods. Treatment outcomes were retrospectively analyzed in 191 patients suffering from destructive pulmonary MDR tuberculosis who underwent the intensive phase of chemotherapy in in-patient settings in 2009-2012 and 2013-2015 (treated by different regime ns);  in each of those cohorts, groups were formed depending on persistence/healing of destruction (cavities) during the intensive phase of chemotherapy:  (CV-) ‒ the destruction healed, (CV+) – the destruction persisted.Results. In 24 months, treatment was found to be effective only in 19/68 (27.9%) in the (CV+) group versus 31/40 (77.5%) in the (CV-) group, p < 0.05 (cohort 2009-2012); 17/42 (40.5%) versus 29/41 (70.7%), respectively, p < 0.05 (2013-2015 cohort). Within 48 months, treatment outcomes were as follows: clinical cure in the (CV+) group was 38.2% (26/68 people), and in the (CV-) group – 72.7% (29/40 people), p < 0.05 (2009- 2012) and 23/42 (54.7%) and 33/41 (80.5%), respectively, p < 0.05 (2013-2015 cohort).Conclusion. Considering the above, when assessing treatment in the intensive phase of chemotherapy in destructive pulmonary tuberculosis patients, it is necessary to take into account the rate of cavity healing but not being limited to sputum conversion. Patients with persisting cavities should not be transferred to the continuation phase, the surgery or collapse treatment should be considered for such patients.

Background. In destructive forms of pulmonary tuberculosis, especially in the presence of drug resistance of mycobacteria, one of the ways to increase the effectiveness of therapy is the use of collapse therapeutic techniques in various modifications. Purpose of the study: to develop and substantiate an algorithm for complex treatment of destructive forms of pulmonary tuberculosis, using artificial pneumothorax (AP). Material and methods: A cohort of 84 people with destructive pulmonary tuberculosis was formed. It was divided into two groups: 42 patients in the main group (chemotherapy (ChT) + AP) and 42 in the comparison group (ChT). Results: an algorithm for the treatment of patients with destructive forms of pulmonary tuberculosis was formulated. Within a period of up to 6 months, abacillation was achieved in 61.9% of cases in the main group (MG), and in 18.9% (p <0.05) in the comparison group (CG). By the 10th month of treatment, the closure of decay cavities was achieved in 78.7% of cases in the MG and in 42.8% (p <0.05) in the CG. By 12 months the closure of decay cavities was observed in 92.1 and 52.4% of cases respectively (p <0.05). Conclusions: The use of the algorithm for the complex treatment of destructive forms of pulmonary tuberculosis makes it possible to achieve abacillation at an earlier time (up to 6 months - in 61.9%). It also allows to increase the frequency of cavity closure by 39.6% as well as achieve an increase in clinical cure (according to long-term results of treatment) by 23.8% and a decrease in the amplification of drug resistance and mortality by 14.3% and 11.9% correspondingly.

The latent form - asymptomatic form of arterial hypertension occurs in the general population in 15% to 24% of individuals, is more often associated with men, increased body mass index, smoking, stress, increased systolic blood pressure (BP), hypertrophy and diastolic dysfunction of the left ventricle and is considered the most dangerous a form of the disease that can result in sudden cardiac arrest. Early detection of risk factors for hypertension is of great preventive and economic importance. Objective - to develop a method for early detection of a high risk of developing asymptomatic hypertension with preventive digital X-ray fluorography studies and an interdisciplinary approach. Based on the screening survey conducted in 1411 workers, a method for early detection of high risk factors for asymptomatic hypertension was developed based on statistical significant risk factors. Research was conducted among workers at the workplace of 6 urban enterprises, with the detection of an enlarged left ventricle (ELV) in screening of the subject contingent and measuring BP levels. With elevated BP, 604 (42.8%) workers were identified, and with ELV - 236 (16.7%) cases. The combination of elevated BP and ELV was significantly more frequent (160, 67.8%) than with normal BP (76, 32.2%). Based on the statistical analysis, a logistic regression model with a high residual deviance (about 84%) is constructed, which gives satisfactory forecasts. The diagnostic test of the model, with cutoff threshold equal to pо=0.397, corresponds to: sensitivity - 75.5%, specificity - 64.4%, accuracy - 69.2%. Thus, the use of the screening diagnostic method in the detection of ELV in combination with age in men of 28 years or in women from 39 years of age reveals a high risk of developing asymptomatic forms of hypertension. These patients are taken to the control and sent to the physician by the therapist to perform the pre-examination.