At present the diagnosis of tuberculosis and its treatment features require an individual interdisciplinary approach. The analysis and mentioned clinical examples clearly demonstrate monitoring, supporting and training role of central medial commission. The review of the clinic work prove reduced incidence of hypo- and hyperdiagnosis of tuberculosis after implementation of centralized control, which promote the standardization of diagnostic algorithms.

Government Healthcare Department, Moscow, Russia The article describes case history of two patients with tuberculosis of peripheral lymph nodes, possible pathogenetic mechanisms for this extrapulmonary form of tuberculosis.

The article describes the author’s unifying scheme for identification of micromycetes isolated from culture with rapid differentiation between nine groups of pathogens: ascomycete yeasts; basidiomycete yeasts of the red yeast group; basidiomycete nonpigmented yeasts; ascomycete yeast-like fungi; basidiomycete yeast-like fungi; zygomycosis causative agents; pheogyphomycosis causative agents of the dimorphic black yeast group; pheogyphomycosis causative agents of the mycelial pheoid species; light-coloured mold causative agents of aspergillosis and hyalohyphomycosis. The article also provides the information about species composition and the classification of molds and yeasts, which can persist in the respiratory tract of TB patients. The activity of current antimycotics against different groups of pathogens that cause opportunistic pneumomycoses is characterized.

The aim of the study was to study the effect of the systemic inflammatory response on the body’s homeostasis and its reactivity in patients with respiratory tuberculosis against the background of chronic obstructive pulmonary disease. The study included 90 patients with respiratory tuberculosis with chronic tobacco intoxication and a history of COPD. COPD characterized by varying degrees of impaired airway patency, decreased FEV1 (p< 0.001): COPD I - 58 people (64.4%), COPD II - in 28 people (31.1%), COPD III - in 4 people (4 %). The exclusion criteria from the study were the presence of HIV infection, extra pulmonary pathology in the acute stage, metabolic syndrome, and exogenous intoxication, grade 4 COPD, with reconstructive changes in the lung tissue, previous acute myocardial infarction. The study used the data of the mandatory diagnostic minimum, assessed the biochemical parameters of systemic inflammation, lipid profile, adaptive reactions of the body, homeostatic balance of the body and its reactivity. The procedure for processing the research results was traditional with the use of electronic computers SAS 9.4. The comorbid state characterized by the presence of a systemic inflammatory response, with disorganization of protein metabolism, an increased content of CRP, a change in information redundancy and entropy of protein fractions of blood, and dyslipidemia. Systemic inflammation influenced the state of adaptive reactions, with a high significant predominance of stressed types of AR, deep and pronounced disturbance of the homeostatic balance of the body (p = 0.008) and its pathological reactivity. Thus, patients with a comorbid state characterized by pronounced systemic inflammation and deep disturbance of the adaptive reactions of the body, which largely affects the state of homeostasis and reactivity of the body, determines the course and further outcome of diseases.

A successful tuberculosis control is possible only with active diagnosis and prevention, which should be regularly carried out by doctors of all specialties. The implementation of programs to improve the situation of tuberculosis depends on the teaching of phthisiology as a clinical discipline in medical high schools. The article prepared by leading teachers of specialized departments of phthisiology based on the results of work in the conditions of an unfavorable epidemic situation for coronavirus infection in 2020-2021. The work during the year in the distance format allowed us to find new effective techniques and educational technologies, to highlight the positive and problematic aspects of teaching phthisiology as a clinical discipline, which discussed in detail in the article. The experience gained has shown that phthisiology should still be taught in full-time format, since only in the case of full-time interaction are the most important practical skills in the diagnosis of tuberculosis formed and can be effectively controlled. At the same time, the generated electronic educational content and distance learning technologies should occupy a worthy place in learning, as they provide more options for interaction, clarity, repetition, self-learning and control. Distance learning brings together the most progressive teachers, expands the opportunities for each university and each student to receive the highest quality education.

The review presents the latest information on the mechanisms of development of drug resistance of M. tuberculosis and methods for studying the drug sensitivity of mycobacteria