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The effectiveness of tuberculosis control is associated with efficacy of treatment of TB patients and above all patients with multiple and extensive drug resistance (MDR/XDR MTB). Patients with TB/HIV co-infection providethe significant impact on the situation.The objective of the study is to assess outcomes of chemotherapy regimens containing bedaquiline in patients with MDR/XDR TB including those with concurrent HIV infection.Subjects and methods. The efficacy and safety of the regimes containing bedaquiline were assessed in the intensive phase of chemotherapy in 80 patients with MDR/XDR TB: Group1 consisted of 46 patients with negative HIV status (ICD10 code A15-A19); Group 2 – 34 HIV positive patients at the advanced stage with manifestations of a mycobacterial infection (ICD10 code B20.0).Results. Treatment outcomes in the groups were as follows: the effective treatment was statistically significantly more frequent in Group 1 versus Group 2 (80.4 and 52.9%, respectively, p = 0.0088). Treatment failure was registered in 3 patients from each group; treatment defaults were statistically significantly more frequent in Group 2 compared to Group 1: in 8/34 versus 2/46 (p = 0.011). 3 patients were transferred out in both Group 1 and Group 2 (3/46 and 3/34, p = 0.69). During treatment, only 1 patient from Group 2 developed an adverse event, most likely associated with the in-take of bedaquiline, a heart rhythm disorder (ventricular arrhythmia) and prolongation of QTcF > 450 ms.

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To manage autonomic disorders in adolescents with tuberculosis, 100 people from 12 to 15 years old were examined and randomly divided into two groups: Group 1 received standard anti-tuberculosis therapy, and in Group 2, additionally to standard therapy, comprehensive treatment with Magne B6 was used for 2 months, and then Valerian extract was used for another 2 months. For comparison, 50 healthy adolescents were examined. Before treatment, all adolescents with tuberculosis experienced a decrease in heart rate variability, a pronounced autonomic imbalance with the prevalence of sympathicotonia and overexertion of compensatory mechanisms. In Group 1, during the comprehensive treatment there were an increase in SDNN and Mo and decrease in AMo and tension index at rest. Active orthostatic test (AOT) was accompanied by a significant increase in SDNN, Mo and a decrease in AMo, which indicated an increase in the activity of the parasympathetic autonomic nervous system and decreased activity of the sympathetic autonomic nervous system. In the group receiving standard therapy, hypersympathycotonia persisted and manifested through significant (p < 0.05) reduction in such parameters as SDNN, increased heart rate, AMo, and Mo shift to short intervals. Medication management resulted in the vegetative balance by increasing heart rate variability, reducing hypersympathicotonia, improving the autonomic support of the cardiovascular system at rest and during AOT.

Ocular tuberculosis is a serious disease with a long recurrent course, often leading to a significant decrease in the visual functions and quality of life of patients as well as disability. In recent years, the incidence rate of the ocular tuberculosis in the Russian Federation has been declining: in 2016, according to a number of authors, its incidence amounted to 5.2%.Purpose. To systematize literature data on the topic of ocular tuberculosis.Materials and methods. We reviewed literature available on elibrary.ru, cyberleninka.ru websites and in “Clinical Ophthalmology” journal. Results. We suggested classification of the ocular tuberculosis lesions, analyzed modern diagnostic methods and treatment regimens and evaluated their effectiveness.Conclusions. Literature review revealed that in order to improve the quality of detection, diagnosis and treatment of ocular tuberculosis, joint efforts of ophthalmologists and phthisiologists as well as use of modern methods of tuberculinodiagnosis are essential.