Purpose — To study the reasons influencing the treatment of patients. Material and Methods — Anonymous questioning of patients with tuberculosis in number of 584 people being on treatment in antituberculosis hospitals, 92 phthisiopulmonologists and 144 therapists of Volgograd was performed. Results — The conducted research testifies that patients with tuberculosis consider that they observe medical recommendations completely in 76.5% of cases, and the opinion of medical workers was completely opposite, only 4.3% of phthisiopulmonologists and 2.8% of therapists. Most doctors were sure that medical recommendations were carried out by only a half of tuberculosis patients that was told by 54.4% of phthisiopulmonologists and 31.3% of therapists. Conclusion — Commitment formation to treatment at patients with tuberculosis should be carried out taking into account those difficulties and problems which are specified by patients, and also critical evaluation of performance by patients of the medical recommendations influencing the result of treatment. At the solution of medical problems phthisiopulmonologists did not pay enough attention to influence of psychological factors, taking into account available gender, age and educational level of the patient that compels to look for new ways of interaction of phthisiopulmonologists and psychotherapists in development of the individual plan of treatment and rehabilitation of every patient with tuberculosis.
Sergey A. Yudin, A.S. Borzenko, V.V. Delaryu, A.A. Kaluzhenina Difficulties of treatment of patients with tuberculosis and medical recommendations performed by them // Russian Open Medical Journal, Vol. 3, Issue 3, 2014, pp. 307-0

Objective; analysis of the dynamics of the main indicators of the ТВ epidemic in the Saratov region during the 5-year period. Material and Methods. The analysis of major indicators of epidemic (morbidity and mortality) in the Saratov region during the five years of observation. In the work a comparative evaluation of the parameters studied with analogical indicators in the Russian Federation was carried out. Results. During the period from 2009 to 2013 situation of tuberculosis epidemic in the Saratov region has positively stabilized. Over the past five years, the mortality rate in the region has decreased, while in the Russian Federation as a whole only on 25%, the incidence of the population in the region fell by 20%. It has been established that the later detection of a tuberculosis process leads to an increase in mortality and maintains reservoir of ТВ infection. Conclusion. In the Saratov region ТВ infection is thoroughly controlled. There is a well-established system for the detection, diagnosis, treatment and prevention of this specific process.
Danilov A.N., Morozova T.l., Doktorova N.P. Dynamics of the main epidemic indicators of tuberculosis in the Saratov region // Saratov Journal of Medical Scientific Research, Vol. 10, Issue 2, 2014, pp. 289-293

Purpose: To study the reasons influencing the treatment of patients. Material and methods: Anonymous questioning of patients with tuberculosis in number of 584 people being on treatment in antituberculosis hospitals, 92 phthisiopul-monologists and 144 therapists of Volgograd was performed. Results: The conducted research testifies that patients with tuberculosis consider that they observe medical recommendations completely in 76,5% of cases, and the opinion of medical workers was completely opposite, only 4,3% of phthisiopulmonologists and 2,8% of therapists. Most doctors were sure that medical recommendations were carried out by only a half of tuberculosis patients, that was told by 54,4% of phthisiopulmonologists and 31,3% of therapists. Conclusion: Commitment formation to treatment at patients with tuberculosis should be carried out taking into account those difficulties and problems which are specified by patients, and also critical evaluation of performance by patients of the medical recommendations influencing the result of treatment. At the solution of medical problems phthisiopulmonologists did not pay enough attention to influence of psychological factors, taking into account available gender, age and educational level of the patient that compels to look for new ways of interaction of phthisiopulmonologists and psychotherapists in development of the individual plan of treatment and rehabilitation of every patient with tuberculosis.
Yudin S.A., Borzenko A.S., Delaryu V.V., Kaluzhenina А.А. Difficulties of treatment of patients with tuberculosis and medical recommendations performed by them // Saratov Journal of Medical Scientific Research, Vol. 9, Issue 4, 2013, pp. 741-743

OBJECTIVE AND METHODS: A long-term observational study was conducted in Samara, Russia to assess the survival and risk factors for death of a cohort of non-multidrug resistant tuberculosis (non-MDRTB) and multidrug resistant tuberculosis (MDRTB) civilian and prison patients and a civilian extensive drug-resistant tuberculosis (XDRTB) cohort. RESULTS: MDRTB and XDRTB rates of 54.8% and 11.1% were identified in the region. Half (50%) of MDRTB patients and the majority of non-MDRTB patients (71%) were still alive at 5 years. Over half (58%) of the patients died within two years of establishing a diagnosis of XDRTB. In the multivariate analysis, retreatment (HR = 1.61, 95%CI 1.04, 2.49) and MDRTB (HR = 1.67, 95%CI 1.17, 2.39) were significantly associated with death within the non-MDR/MDRTB cohort. The effect of age on survival was relatively small (HR = 1.01, 95%CI 1.00, 1.02). No specific factor affected survival of XDRTB patients although median survival time for HIV-infected versus HIV-negative patients from this group was shorter (185 versus 496 days). The majority of MDRTB and XDRTB strains (84% and 92% respectively) strains belonged to the Beijing family. Mutations in the rpoB (codon 531 in 81/92; 88.8%), katG (mutation S315T in 91/92, 98.9%) and inhA genes accounted for most rifampin and isoniazid resistance respectively, mutations in the QRDR region of gyrA for most fluroquinolone resistance (68/92; 73.5%). CONCLUSIONS: Alarmingly high rates of XDRTB exist. Previous TB treatment cycles and MDR were significant risk factors for mortality. XDRTB patients' survival is short especially for HIV-infected patients. Beijing family strains comprise the majority of drug-resistant strains.
Balabanova Y, Nikolayevskyy V, Ignatyeva O, Kontsevaya I, Rutterford CM, Shakhmistova A, Malomanova N, Chinkova Y, Mironova S, Fedorin I, Drobniewski FA. Survival of civilian and prisoner drug-sensitive, multi- and extensive drug- resistant tuberculosis cohorts prospectively followed in Russia. PLoS One. 2011;6(6):e20531. Epub 2011 Jun 10.

Former Soviet Union countries including the Baltic States (Latvia, Lithuania, and Estonia) are hot spots for an emerging epidemic of drug resistant tuberculosis (TB). As a part of the development of a co-ordinated network of centers for diagnostic trials across Eastern Europe we conducted a retrospective multicenter analysis of the performance of the GenoType® MTBDRPlus assay for TB identification and susceptibility to isoniazid (INH) and rifampicin (RIF) in routine settings. A total of 1,045 primary samples, 1045 TB cultures derived from these specimens and 306 separate M. tuberculosis isolates tested in 2007-2010 at four participating sites (Tartu, Estonia; Riga, Latvia; Vilnius, Lithuania; and Samara, Russian Federation) were included in the analysis. The pooled sensitivity and specificity values for RIF and INH were 95.3% and 95.5%, 89.9 and 87.1%, respectively; there were no statistically significant variations in performance across sites. The proportion of multidrug resistant (MDR) strains in the collections ranged from 21.8% (in Estonia) to 55.9% (in Russia). In a routine non-trial context, the assay reliably detected both rifampicin and isoniazid resistance. The absence of statistically significant differences between sites suggested that the comparable performance obtained using these assays has helped demonstrate the formation of a successful diagnostic trial network.
Mironova S, Pimkina E, Kontsevaya I, Nikolayevskyy V, Balabanova Y, Skenders G, Kummik T, Drobniewski F. Performance of the GenoType® MTBDRPlus assay in routine settings: a multicenter study. Eur J Clin Microbiol Infect Dis. 2012 Jul;31(7):1381-7. Epub 2011 Oct 25.

The Russian Federation is a high-tuberculosis (TB)-burden country with high rates of drug resistance, including multidrug and extensive drug resistance to TB (M/XDRTB). Rapid diagnosis of resistance to fluoroquinolones (FQs) using molecular assays is essential for the implementation of appropriate drug regimens and prevention of the transmission of XDR strains. A total of 51 individual MDRTB strains were tested by pyrosequencing of the quinolone resistance determining region of the gyrA gene and the GenoType MTBDRsl assay (Hain Lifescience, GmbH, Nehren, Germany), and the results were evaluated against those obtained by phenotypic drug susceptibility testing (DST). Mutations were detected in 25 (78.1%) FQ-resistant strains, with the majority of mutations (n = 19 [73.0%]) found in codon 94 of the gyrA gene; the novel mutation 1457 C→Τ was found in the gyrB gene. Three mixed allelic variants were detected, which is a well-known phenomenon in areas with high TB and drug-resistant TB rates. The sensitivity and specificity of pyrosequencing (86.2 and 100%, respectively) and MTBDRsl (86.2 and 100%, respectively) were high; however, the results for 5.9% of the analyzed strains were unreadable when MTBDRsl was used. The MTBDRsl and pyrosequencing assays offer a rapid and accurate means for diagnosing resistance to FQs in high-TB-burden areas.
Kontsevaya I, Mironova S, Nikolayevskyy V, Balabanova Y, Mitchell S, Drobniewski F. Evaluation of two molecular assays for rapid detection of mycobacterium tuberculosis resistance to fluoroquinolones in high-tuberculosis and -multidrug-resistance Settings. J Clin Microbiol. 2011 Aug;49(8):2832-7. Epub 2011 Jun 1.

The purpose of the study is to determine clinical and pathogenetic efficacy of cycloferon liniment in the combined therapy of periodontitis of patients with focal tuberculosis. It is proved, that use of liniment Cycloferon in the combined treatment of patients with focal tuberculosis allows to accelerate process of normalization of parameters of lipid per-oxidation and antioxidant potential of blood, to decrease infection (herpes symplex virus I, Candida albicans, staphylo-coccus aureus) in parodontal pockets and local inflammation with reduction of activity of factor tumours necrosis and interleukin 1b. It leads to soon recovery and decrease of frequency of parodontitis recurrences
Lepilin A.M., Alexandrova Е.А., Kazimirova N.E., Shuldyakov А.А. Improvement of therapy of inflammatory dieseases of parodentium in patients with focal tuberculosis // Saratov Journal of Medical Scientific Research, Vol. 7, Issue 1, 2011, pp. 132-135

The research work has been carried out on the basis of official statistics data and results of curator departures. The purpose is to study the basic tendencies of tuberculosis epidemic situation among children for the period from 2004 till 2008 in the region of the North-west of Russia for working out priority antitubercular scheme. The disease morbidity has been investigated. Tendencies of situation development in each region with application of an estimation of morbidity rate have been defined. The nonparametric factor of correlation of Spirmen (c) has been taken into account. It is established that in case of normal epidemic situation, the basic indicators of tuberculosis in children from the Northwest of Russia are higher than all over the country. Epidemic situation in Kaliningrad is marked by accumulation of MBT+ in contingents. St.-Petersburg and Kaliningrad epidemic statistics accounts 52% from total number of ill children that influences a district indicator. In Kaliningrad and Arkhangelsk regions children from contact as a result of accumulation of adult MBT+ in contingents fall ill more often. The main method to reveal the pathology among children in St.-Petersburg is prevention, however children morbidity from contact with MBT+ in 2008 in 1,8 times lower than in the North-west Russia. The received data have found out that in Kaliningrad and Arkhangelsk regions the main direction in the antitubercular scheme is an increase in efficiency of treatment of tuberculosis in contingents of adults MBT+; in Murmansk, Pskov and Leningrad region it includes the modern preventive measures. For St.-Petersburg all directions of antitubercular work will be equally significant
Isaeva N.Yu., Mayorova О.A., Galkin V.B., Archakova L.I. Modern patterns of tuberculosis epidemiologic situation among children in the North-West of Russia // Saratov Journal of Medical Scientific Research, Vol. 7, Issue 2, 2011, pp. 518-522

The research goal is to investigate the mechanisms of formation and peculiarities of periodontitis in patients with focal tuberculosis. Patients with periodontitis and focal tuberculosis are proved to develop local inflammatory reaction with increased infection and activation of proinflammatory cytokines in parodontal pockets fluid. The main risk factor of frequent and durable recurrence of parodontal pathology in case of focal tuberculosis was the development of pathologic process as a cause of disbalance of lipid peroxidation and antioxidant system, endotoxicosis syndrome
Alexandrova Е.А., Lepilin A.V., Kazimirova N.E., Shuldyakov А.А. Periodontitis in patients with focal tuberculosis // Saratov Journal of Medical Scientific Research, Vol. 6, Issue 4, 2010, pp. 815-817