The article describes the methodology for monitoring the mortality of patients with tuberculosis in the city of Moscow, which includes the collection of data from several sources to clarify information on deaths, the determination of the lifetime status of patients’ registration as a TB patients and the status of their residence in the city.
The monitoring system examines deaths in terms of identifying a «TB death as a TB infection nidus» in the city for appropriate antiepidemic measures. This determines specific approaches to the processing and analysis of data that include all deaths occurring in the city area during the reporting period, regardless of the Russian regions in which they were registered and at what time interval the death was registered. The monitoring system made it possible to assess not only the very fact of a significant decrease in the mortality rate observed in recent years in the city, but also to study its components, which will allow us to determine the possibilities and ways of influencing its on the indicator level in the future.
It is shown that the TB mortality rate in the city has a fivefold decrease from 2001 to 2016 – from 12.4 to 2.5 per 100K. Only in 2012–2016 there was a 25% decrease in the TB mortality rate. In 2016 the proportion of permanent residents among those who died from tuberculosis became less than 50%, reaching 47.2%. 66.5% of died TB patients were not associated with tuberculosis and included, primarily, those who died of HIV infection – 49.1% of all deaths.

Pregnant women and women after childbirth are at risk to catch tuberculosis. In the study included 267 pregnants and puerperants: 48 – with active progressive tuberculosis (TB) (1st group), 131 – with TB, resolving on treatment (2nd group) and 69 – cured after completed TBtreatment with residual changes in lung (3rd group). In all patients the skin test with allergen tuberculosis recombinant (ATR was performed (АТР, recombinant protein ESAT6-CFP10, registered as Diaskintest®). The positive results were obtained in 93.7% in 1st group, 94.7% – in 2nd group and 72.5% – in 3rd group. The test with ATR was well tolerated in all women and embryo toxicity was not registered. Sensitivity of the skin test with Recombinant protein ESAT6-CFP10 in cases of active Tuberculosis and latent Tuberculosis in such patients is high. The skin test with Recombinant protein ESAT6-CFP10 (Diaskintest®) is specific, sensitive and effective for screening in pregnant women with high risk of TB due to social and medical factors.

To evaluate the effect of silymarin for the prevention of antituberculosis drug-induced liver injury 307 new tuberculosis patients were enrolled to the retrospective cohort study. The patients of silymarin group (n = 204) received silymarin in a dose of 105 mg per day from the start of anti-tuberculosis treatment; patients of control group (n = 103) received only anti-tuberculosis drugs. The follow-up period were equal to the duration of intensive phase of anti-tuberculosis treatment. Drug-induced liver injury was registered in 20.1% (41/204) and 33.0% (34/103) in silymarin and control groups, respectively (р = 0.017, RR 1.64, 95%CI 1.11–2.42). The effect of silymarin was different in groups of high and low individual risk of drug-induced liver injury defined by validated risk assessment scale. Only in patients with high individual risk the rate of drug-induced injury in silymarin group was significantly low: 23.2% (13/56) vs 65.8% (25/38) in control group (р < 0.001, RR = 2.83, 95%CI 1.67–4.81). In patients with low individual risk silymarin had no protective effect (19.2% and 12.8% cases of druginduced injury in silymarin and control groups, p = 0,320). So, silymarin preventive use indicated only for TB patients with high individual risk of drug-induced liver injury.

In this research it was investigated a possibility of using immunological tests in the diagnosis of TB infection in people living with HIV. It was analyzed the results of medical examination of 345 patients with HIV-infection. In addition to standard clinical and laboratory examination there were made an immunological tests T-SPOT®.TB and skin test with recombinant tuberculosis antigen. Using a lab test T-SPOT®.TB on patients with HIV infection with established subsequently diagnosed with TB results were positive at 115 (54%) patients (95%CI 47,0–60,6%), the application of skin test with recombinant tuberculosis antigen 51 (23,9%, 95% CI of 18.7–30.1 %).
In the group of HIV-infected patients without active TB, positive results of a laboratory test was obtained in 13 (9,9%) patients (95%CI of 5.9 to 16.1%), using skin tests with recombinant tuberculosis antigen at 14 (10,6%, 95% CI 6,4–17,0%); tests demonstrated good consistency (κ = 0,6, p < 0,001), indicating their equal opportunities to identify tuberculosis infection in people with HIV.

252 patients underwent surgical treatment due to renal TB during two periods (1985-1987 and 2014-2016). It was established that the moiety of elderly (over 60 y.o.) increased to almost 11 percent from 3.5 percent to 38.1 percent. Clinical and radiological features of kidney tuberculosis in dependence of age studied in 144 patients. It has been shown that aged patients have a prevalence of late destructive stages of the disease, 1.5-fold increase of extrarenal TB cases compared to younger patients. All (100.0%) of them suffer from cardio-vascular pathology and renal insufficiency. The nephrectomy is the most common procedure in the elderly (86.0%) which is twice as high as the middle age. A high degree of anesthetic and operational risk limits the opportunities of surgical treatment which requires widespread introduction of gentle approach to the kidney for it’s removal.

Inflammation damage of vertebral column (spondylitis) often leads to neurologic disturbances. There are no accurate data on epidemiology of neurogenic lower urinary tract dysfunction (NLUTD) in these patients.
Objective. To evaluate urodynamic disturbances in spondylitis.
Materials and methods. 23 patients with spondylitis and symptoms of micturition’s impairment underwent complex urodynamic investigation. Neurologic status was assessed according to the ASIA impairment scale.
Results. All patients were diagnosed with urodynamic dysfunction. There were no correlation between urodynamic pattern and ASIA grade.
Conclusion. Patients with spondylitis have variable lower urinary tract dysfunction. In our study approximately a half of patients had detrusor hyporeflexia. Detrusor overactivity in combination with detrusor-sphincter dyssinergya was diagnosed only in 13,1%.

This article is based of literature reviews on the use of combined fixed-dose combinations (FDCs) in the treatment pulmonary tuberculosis. Some of the WHO guidance documents on the use of FDCs in children are provided. The assortment of permitted combined preparations in the Russian Federation and the possibility of their use in the regimens of chemotherapy for the treatment of children with tuberculosis are presented.