A systematic analysis of the transformation of the organizational model of tuberculosis (TB) care, taking into account the implementation of modern digital tools, including geographic information systems, within general healthcare institutions is presented. Emphasis is placed on a comprehensive approach to early detection of tuberculosis, patient routing, management of physician workload, and the establishment of effective interagency coordination. The article provides a detailed account of the integration of geographic information systems into the practice of Saint Petersburg State TB Dispensary No. 14 in collaboration with polyclinics of the Nevsky District. The study highlights the potential of geographic information systems for targeted visualization of TB foci, epidemiological surveillance, and healthcare resource management.

The aim was to study the social, medical, radiological and laboratory characteristics of tuberculosis of the central nervous system in patients with HIV infection in the Astrakhan region.
Materials and methods. An open retrospective non-comparative study included 22 HIV-infected patients who received inpatient treatment at the Astrakhan Regional Clinical Anti-tuberculosis Dispensary in the period 2016–2024. The study analyzed patient age and gender distribution, the combination of tuberculosis lesions in various organs and systems, clinical forms of tuberculosis, pathogen identification data and drug resistance testing, duration of HIV infection, neurological status, changes in cerebrospinal fluid parameters, CD4 cell count, and viral load.
Results. The patient’s social profile was determined: unemployed, single, young man of working age, living in the city, with addictions, HIVinfected for more than 3 years (50%), not attending the AIDS center and refusing antiretroviral therapy and tuberculosis chemoprophylaxis, which explains the low CD4 lymphocyte count (< 100 cells/mcl, 63.6% of cases) and high viral load (more than 106 copies / ml in 77.3%) upon admission. A predominance of tuberculosis meningitis (45.6%) and meningoencephalitis (36.4%) was noted, combined with disseminated pulmonary tuberculosis (86.5%) and tuberculosis of the peripheral lymph nodes (50%), with multidrugresistance of M. tuberculosis (50%).

The aim of the study was to analyze the spectrum of clinical forms of respiratory tuberculosis (RTB) in patients with malignant neoplasms (MN), determine the relationship between the oncological course and treatment period, and assess the relative risk of developing RTB within this cohort.
Methods. A single-center cohort study was conducted between 2018 and 2025 at the Central Research Institute of Tuberculosis including 61 patients with verified RTB and MN. A comprehensive diagnostic algorithm was used, including clinical laboratory examination, imaging, TB immunodiagnostics, microbiological, and molecular genetic methods.
Results. In 90.2% of cases, malignant neoplasms had extrathoracic localization; the most common were breast cancer (36.1%), lymphomas (16.5%) and gastrointestinal tumors (14.8%). Among the clinical forms of RTB, infiltrative (29.5%), focal (24.6%) TB and TB of the intrathoracic lymph nodes (13.1%) prevailed. Relapse of TB was registered in 49.2% of patients. In 60.7% of patients, RTB was diagnosed during the period of remission of malignant neoplasms after completion of antitumor therapy. The highest relative risk of developing RTB was associated with combined chemo- and radiation therapy: RR = 2.8 compared with radiation therapy, RR = 2.3 compared with chemotherapy and RR = 2.5 compared with surgical treatment (p< 0.05). Before starting antitumor treatment, not a single patient was consulted by a TB specialist.
Conclusion. Patients with malignant neoplasms, especially that receiving combination anticancer therapy, represent a high-risk group for the development and recurrence of tuberculosis, including during cancer remission. Integration of oncology and phthisiology services, the implementation of mandatory tuberculosis screening before anticancer therapy, and individualized monitoring algorithms are necessary to facilitate early TB diagnosis, timely initiation of treatment and an improved prognosis in patients with comorbidities.

The aim was to analyze chest X-ray changes in patients with severe autoimmune disease undergoing long-term immunosuppressive therapy and positive immunological tests for tuberculosis.
Materials and methods. Chest X-rays were analyzed in 59 patients with severe autoimmune disease referred to the Saratov Regional Clinical Tuberculosis Dispensary for examination due to positive immunological tests for tuberculosis.
Results. The study group showed a high frequency (49.2%) of lung tissue changes based on radiographic examination data, primarily of a nonspecific nature (pneumatization disorders - 11.9%, interstitial lung lesions - 11.9%), as well as post-tuberculous changes (15.3%). The highest frequency of detection of radiographic changes (pathological shadows) in the lungs was found in patients with rheumatoid arthritis and ankylosing spondylitis (44.5% and 31.3%, respectively). The frequency of detection of interstitial lesions and pulmonary tissue pneumatization disorders depended on the duration of the underlying disease and was higher in patients with a disease duration of more than 5 years.

The aim was to analyze newly diagnosed post-tuberculosis changes in children aged 7–14 years; to examine the nature, location, and extent of lesions based on computed tomography data, taking into account contact with a patient with tuberculosis (TB) and preventive chemotherapy courses.
Methods. A retrospective analysis of the medical records of 71 children aged 7–14 years (36 girls and 35 boys) with newly diagnosed post-TB changes in the lungs based on computed tomography data was conducted. The characteristics of detection, skin test results, history of contact with TB patient and test results after preventive chemotherapy course were examined.
Results. In 95.8% of cases, post-TB changes (calcifications in lung tissue and intrathoracic lymph nodes, Ghon foci) were detected during examination by skin immunology tests. The majority of patients (74.6%) showed hyperergic skin tests; 42.3% had a contact with a TB patient (in 73.3% with a case with bacteriologically confirmed TB). In exposed children Ghon foci were 1.5 times more common, and calcification in the bifurcation group of lymph nodes was 7 times more common. After three months of preventive anti-TB treatment, the proportion of children with a positive skin test decreased to 55%, and the papule size decreased to 5–6 mm.

The activity of 10 antifungal drugs (fluconazole, itraconazole, voriconazole, posaconazole, ketoconazole; anidulafungin, caspofungin, micafungin; amphotericin B; flucytosine) was tested against 33 species of yeast and mycelial fungi (genus Acremonium, Alternaria, Aspergillus, Candida, Cryptococcus, Fusarium, Geotrichum, Paecilomyces, Penicillium, Rhizopus, Rhodotorula, Trichoderma, Trichosporon) using the MIC Test Strip (gradient diffusion method) and Sensititre (microdilution method) test systems. A comparative study of two commercial standardized test systems for determining fungal susceptibility to antifungal drugs demonstrated a high level of agreement between the results (identical and highly similar MIC values for the antifungals totaled approximately 86%). The 10 drugs tested differed significantly in their spectrum of activity against pathogens causing candidiasis, cryptococcosis, rare yeast mycoses, aspergillosis, mucormycosis, hyalohyphomycosis, and phaeohyphomycosis. A group of drugs with a broad spectrum of activity (itraconazole, voriconazole, posaconazole, ketoconazole, amphotericin B) and a group of drugs active against individual groups of fungi (fluconazole, anidulafungin, caspofungin, micafungin, flucytosine) were identified.

The aim was to evaluate the impact of information and educational work with patients with multidrug-resistant tuberculosis (TB) in a tuberculosis hospital on adherence to anti-TB therapy.
Methods. The study included 95 patients, divided into groups based on their participation in the «Tuberculosis Patient School»: 45 patients (who were receiving treatment before the school’s implementation) were not trained; 50 patients (who were trained). The groups were compared based on length of hospital stay, reasons for early discharge, and level of treatment adherence.
Results. High treatment adherence during the inpatient stage was noted in both study groups (p=0.08). Non-participants of the «School of Tuberculosis Patients» (group 1, treated before the school’s implementation) were more often discharged from the hospital early (OR=2.7, 95% CI 1.1-6.7). The frequency of missing 6-11% of doses of anti-tuberculosis drugs was higher in the first group (OR = 4.1, 95% CI 1.5-11.1), and 5% or less doses – in the second (OR=0.3, 95% CI 0.1-0.8).
Conclusion. The lack of informational work led to an increase in early discharge, which was more often associated with unauthorized withdrawal from the department. The findings indicate an increase in patient adherence to treatment during informational and educational work, which was reflected in a decrease in the frequency of short-term interruptions in treatment (OR = 4.1).

Two clinical cases of suspected measles in patients undergoing inpatient treatment at a tuberculosis facility are presented. Analysis of the disease course and clinical manifestations demonstrated difficulties in diagnosing measles in tuberculosis patients, necessitating the implementation of additional anti-epidemic measures to prevent nosocomial spread of the infection.