The epidemiological survey of the genitourinary tuberculosis (GUTB) in the Stavropol territory during 2001-2012 was done. The effectiveness of risk groups mass screening for early detection of GUTB (introduced in 2006) was evaluated. The I (control) group consisted of 245 patients with newly diagnosed GUTB during 2001-2006, the II (main) group consisted of 348 patients with GUTB registered in 2007-2012. The total TB incidence rate decreased from 56,1 ± 1,3 per 100 thousands of population in the I group to 50,9 ± 2,3 in the II. Significant increase of GUTB incidence in the II group (from 1,51 ± 0,11 to 2,14 ± 0,06, p < 0,05) was detected. Destructive forms of GUTB dominated in the I group. The rate of cavernous renal TB was 16,8 ± 1,3% in the I group vs 9,3 ± 1,3% in the II group (p < 0,05). Consequently, the rates of early forms of GUTB increased: parenchymal TB – from 1,8 ± 0,5% to 6,0 ± 0,4% and TB papillitis – from 17,2 ± 1,8% to 29,0 ± 1,0% (p < 0,05). The increase of male genital TB from 5,0 ± 1,3% up to 13,7 ± 0,3% also was registered (p < 0,05).This testifies about the success of risk groups mass screening for early detection of GUTB.

311 cases of tuberculosis in children at an early age which were on hospitalization during the period from 1985 to 2010 were analyzed. It is established that extra pulmonary localization of specific process was registered rather seldom. In the last studied decade (2001-2010) by 2,5 times more often than during the period from 1985 to 1994, at children of early age the combination of tuberculosis of respiratory organs and extra pulmonary localizations was observed (8,1% and 3,3%, p = 0,177), the isolated extra pulmonary localization of specific process (6,2% and 4,0%, p = 0,588) equally often was registered. Among extra pulmonary forms of tuberculosis at children of early age 50% of cases fell to the share of a tubercular encephalomeningitis.

The article represents dynamics of quality of life in patients with tuberculous small bladder, which developed urinary retention in late postoperative period after ileal cystoplasty. SF-36 scale and specialized scale (IPSS-QOL, UDI-6) data in cases of urinary retention demonstrate significant improvement of pre-surgery parameters only during first 6 months. Patients without chronic urinary retention demonstrate better quality of life than those with urinary retention.

To assess the efficiency of mini-invasive technologies − percutaneous nephrostomy (PNS) and ureteral stenting − in complex treatment of urinary tuberculosis complicated by supravesical obstruction, 75 patients with renal and ureteral tuberculosis were prospectively evaluated. PNS was performed in 40 cases and ureteral stenting – in 35. Adequate drainage of urine was achieved in 96,5% cases after PNS vs 25 (83,3%) after ureteral stenting. 5 (16,7%) patients required conversion into PNS. 5 (16,7%) patients were underwent stenting during ureteral reconstruction or secondary stones removal. So, PNS and ureteral stenting may serve the first step before radical surgery in advanced urinary tuberculosis.

The analysis of metabolic and urodynamic disorders following augmentation ileocystoplasty (ICP) in dependence of the length of the intestinal graft was performed in 65 patients with contracted bladder due to tuberculosis (38 pts) other (27 pts) etiology. ICP with intestinal loop of 30-35 cm length was performed in 30 cases (group I), with 45-60 cm – in 35 cases (group II). Patients were examined after 15-20 days and 6-12 months after ICP. In group I ICP didn’t lead to the hyperchloremia: the mean Cl– concentration was 106,5 ± 0,8 mmol/l vs. 110,2 ± 0,6 mmol/l in group II (p < 0,05) at the early postoperative period and 106,2 ± 0,4 mmol/l vs. 109,7 ± 0,3 mmol/l (p < 0,05) after 6-12 months. After 15-20 days the base excess (BE) was -2,04 ± 0,47 in group I vs. -4,96 ± 0,54 in group II (p < 0,05). During 6-12 months follow up a significant decrease (half the size) of base deficit was registered in group I. The diumal frequency of micturition was 10,1 ± 0,4 in group I vs. 8,2 ± 0,3 in group II (p < 0,05), functional capacity of neobladder – 351,2 ± 44,5 ml and 442,5 ± 35,3 ml respectively (p < 0,05). So bladder replacement with shortened ileal loop prevents hyperchloremic acidosis without of urodynamic characteristics damage.

The choice of management for craniovertebral junction (CVJ) spondylitis should be based both on morphologic and biomechanical changes of this region. Utilizing biomechanical concept of F. Denis, the “three column”–model of CVJ was elaborated, that explain biomechanical changes in spondylitis caused by the forces of the tonic muscles and cantilever location of the head. Proposed biomechanical model determines the kind of surgical treatment based on restoration of the affected CVJ columns. The good results of surgery, based on this model, were obtained in 85% patients: regression of neurological symptoms and osseous block in spondylodesis region formation.

Efficacy of total hip arthroplasty in 24 patients with active progressive tuberculosis of the hip and in 27 patients – about its consequences. The results of this operation in progressive hip joint disease on the background of prolonged anti-tuberculosis therapy and consequences of tuberculosis of the hip comparable, and the inclusion of this method in the complex treatment of advanced tuberculosis coxitis of 8,6 months reduces recovery time of joint function and improves the quality of life of the patient.

76 patients with perforative tuberculous intestinal ulcers and HIVinfection were underwent surgical treatment. Resection of intestine without primary anastomosis performed in 40 patients (group I). Adducent and abducent parts were sutured tightly, nasointestinal tube was inserted. Sanifying relaparotomies, antibacterial therapy, parenteral nutrition were done. Intestinal anastomosis was performed after regression of peritonitis. In group II (n = 36) intestinal resection was finished by primary anastomosis with nasointestinal intubation
and following program sanitations of the abdominal cavity. The results of the surgery were better in group I: there were no cases of anastomosis insufficiency, new ulcer perforations arise in 8 (20,0%) patients, 22 (55,0%) patients died. In group II 28 (77,8%) patients died, new ulcer perforations (including anastomosis zone) and peritonitis progression developed in 18 (50,0%) which required re-operation.

Since 2010 till 2012 76 colonoscopies were performed in 63 patients (22-77 years old, 63,5% males and 36,5% females), suspected as abdominal tuberculosis (AT). Pulmonary tuberculosis was diagnosed in 49 (77,7%) patients, AT without pulmonary tuberculosis was suspected in 5 (7,9%). 49,2% patients were HIVinfected. Visual evidence of intestinal tuberculosis were observed in 74,6% patients, histological findings (epithelioid cell granuloma, acid-fast mycobacteria) – in 38,1%, adenocarcinoma of the colon – in 3,2%, CMV-colitis – in 6,4%, nonspecific colitis – in other 58,7% cases. Luminescent microscopy of intestinal specimen removed from ulcers revealed M.tuberculosis (MBT) in 27,0%. Bacteriologic verification on solid media was obtained in 33,3% including 4 patients with negative result of luminescent microscopy. DNA of MBT was detected by polymerase chain reaction in 44,4% cases. So, colonoscopy is fast, cheap and reliable method of intestinal tuberculosis diagnostics allowing prove the origin of the disease in over 75% patients.

For optimization of identification and diagnostics of genital tuberculosis the assessment of medico-social and clinical features of a course of the genital tuberculosis (GT) at 170 women with infertility (IF) is carried out. The I group patients (GT and IF) include 64, the II group (IF only) – 106 patients. In patients with GT persons of mature reproductive age (40,6%), with the higher education (70,3%) and a stable social status prevailed. In the I group complaints on subfebril temperature (79,2%), intoxication symptoms (60,1%) and a pain syndrome (87,5%) as well as late age the menarche (13,36 ± 0,2 years) and TB-burdened anamnesis (45,4%) are more often. Among the transferred diseases in the I group dominated the inflammatory diseases of pelvic organs (65,6%), without the proper effect from treatment more than at a half of patients (65,5%). 43,8% of patients with GT underwent operations on pelvic cavity contrary to 16% of the II group (p < 0,001).

129 patients underwent surgical treatment of cataract in 2008-2013: 78 men (60,5%) and 51 women (39,5%), mean age 68,0 ± 10,1 years. Group I include 43 patients (33,3%) cured from tuberculosis; group II – 28 (21,7%) patients with post tuberculosis cataract, group III – 58 (45,0%) patients with active pulmonary tuberculosis. Two surgical methods were performed: extracapsular cataract extraction (EEC) (87 – 67,4%) and cataract phacoemulsification (FEC) (42 – 32,6%). Intraocular lens (IOL) were implanted in all cases. In group I post-FEC complications weren’t registered, after EEC two cases of keratopathy were observed (resolved by conservative treatment). In group II after EEC one case of keratopathy was obtained, complicated subsequently by epithelial-endothelial dystrophy of the cornea, and one case of intra-operative complication – expulsive bleeding. In group III after EEC two cases of keratopathy were noted, one case of IOL dislocation (anchoring was successfully performed) and one postoperative uveitis (resolved by conservative treatment).
The active tuberculosis isn’t the contraindication for surgical treatment of cataract. The difference in intraocular pressure after FEC and EEC wasn’t significant. The FEC efficacy by visus improvement was significantly higher than EEC (the mean parameter after operation 0,45 ± 0,04 vs 0,29 ± 0,02, respectively, р < 0,001). So, FEC is most preferable in tuberculosis patients.

The study is based on the analysis of tuberculosis care problems, associated with the competence of medical personnel, and Russian and foreign experience in providing education in a system of continuous additional professional medical education. Educational process organization for postgraduate and professional education of physicians should be based on the unsolved issues in tuberculosis care in each corresponding specialty. It is important to keep Russian traditional approaches to organizing learning Phthisiology with
developed individual-centered education system of step-by-step process of building up professional skills and implement foreign experience of continuing postgraduate medical education. Parttime modular system with a remote part of the educational program is an optimal form of education during the transition period of postgraduate education.

The treatment of 0,2-12,0% TB patients is complicated by druginduced peripheral neuropathy. The review contains some recent data about anti-tuberculosis drugs responded to peripheral neuropathy, its pathways and main diagnostic features. Strategy of antituberculous treatment, recommendations for non-drug means and pharmacology treatment, preventive measures including schemes of pyridoxine prescription are reviewed.