Eight hundred and thirty autopsy protocols of died patients with schizophrenia from 1952 to 2007 were studied. Respiratory pathology as a cause of death was noted in 29.8% of cases. There are great changes in the study parameters, which have been particularly evident in the past 2 decades: a reduction in the rate of lobar (croupous) and bronchial pneumonia, an increase in the number of cases of active pulmonary tuberculosis and chronic obstructive pulmonary disease, and lung cancer. The higher incidence of the two latter diseases is associated by the author with the side effects of phenothiazine neuroleptics in the long-term treatment of schizophrenia.

Tuberculosis in children and adolescents is closely associated with the tuberculous infection reservoir existing in the Saratov Region. In this region, the tuberculosis epidemiological situation has improved and stabilized in the past 7 follow-up years, which is undoubtedly associated with the better organization of performed tuberculosis-controlling measures.

The clinical and hematological manifestations and functional state of the immune system were comparatively evaluated in patients with concomitant HIV/tuberculosis (TB) infection (n = 84) and in those with HIV infection without tuberculosis (n = 106). The course of concomitant HIV-TB infection was ascertained to differ from HIV monoinfection in a diversity of additional exposures that aggravated the patients' general condition. These included: the parameters of a long proceeding inflammatory process, which were accompanied by the signs of the infection-toxic syndrome, inflammatory changes in the hemogram, by a sharp stimulation of the nonspecific link of immunity. So the comparative analysis of the trend in HIV infection in combination with active tuberculosis and HIV monoinfection revealed a prompter progression of the disease in the former case.

The authors studied the efficiency of material incentives in the amount of 300 rubles for each case to medical workers of the general health care network for early detection and to those of tuberculosis facilities for effective treatment us in 2001-2007. Due to the tuberculosis-controlling measures made in these years with the mechanism of material incentives to medical workers being introduced, the tuberculosis situation stabilized and the major epidemiological indices, such as morbidity, mortality, and prevalence, decreased by 1.3, 2.2, and 1.7 times, respectively. The higher fluorographic coverage of the population and the introduction of microscopy at the general health care facilities resulted in that the number of new cases of fibrocavernous tuberculosis from 5.6 to 0.7% and, on the contrary, the proportion of bacteria-excreting subjected among the new cases of pulmonary tuberculosis increased from 18.4% in 2000 to 45.2% in 2007 or by 2.5 times (p < 0.001). The results of treatment of the new cases became better. Thus, there were increases in the rate of bacterial discharging cessation from 67% in 2000 to 84.5% in 2007 (p < 0.001), that of cavity closure from 59% in 2000 to 75.2% in 2007 (p < 0.001), and that of transfer to diagnostic registration group III from 23.1% in 2000 to 32.4% in 2007 (p < 0.01). Thus, introduction of the material incentives to the medical workers of the general health care network and tuberculosis facilities had a positive impact on the quality of diagnosis and the efficiency of treatment in patients with tuberculosis.

The state-of-the-art of care given in the inpatient departments of tuberculosis facilities (TF) in the Kemerovo Region is analyzed. Large municipal TFs have been reorganized as interregional ones with their adjacent areas being assigned. Indications for hospitalization have been formulated. Continuous supply with antituberculous drugs (ATDs) is ensured. Strict monitoring of the use of each dose of ATDs has been made. Schools for tuberculosis patients have been set up. The posts of a psychologist and a social worker have been introduced. Compulsory hospitalization of bacteria-excreting patients is used by the decision of the court. As a result of the work done, queue to be admitted to the TFs of the Kemerovo Region has been eliminated; the treatment time has been optimized. The informative value of simple sputum smear microscopy against acid-resistant mycobacteria has significantly increased. The rate of premature treatment discontinuity has reduced. The efficiency of inpatient treatment has enhanced.

The indices of life quality were estimated by the Seattle questionnaire in 140 patients aged 19 to 79 years who had chronic obstructive pulmonary diseases (COPD). The results of the study determined the lower life quality indices in patients with COPD according to a number of social factors: domicile, occupation, number of family members, living conditions, and medical care.

The clinical and pharmacoeconomic effectiveness of the third-generation cephalosporin Ceftriabol versus the original drug Claforan in the treatment of varying community-acquired pneumonia was studied in 60 and 58 patients, respectively. The Russian third-generation cephalosporin Ceftriabol was shown to be as effective as Claforan in treating patients with community-acquired pneumonia. However, in addition to the main--therapeutic effect, Ceftriabol produces a certain economic gain.

By applying the interferon-gamma (IFN-gamma) induction technique in the whole blood samples exposed to short-term (22-24-hour) incubation in the presence of Mycobacterium tuberculosis antigens--PPD tuberculin and specific recombinant ESAT-6 lacking in the cells of vaccine BCG and other non-tuberculous mycobacteria, the authors studied the groups of children and adolescents with a negative Mantoux test (n = 31), with postvaccine BCG allergy (n = 40), as well as patients with primary tuberculous infection (n = 84) and those with pulmonary tuberculosis (n = 44). Patients with primary tuberculous infection and a high sensitivity (94%) and a high specificity (97%) may be differentiated from children and adolescents with postvaccinal allergy when the recombinant ESAT-6 antigen and the critical IFN-gamma level (greater than 70 pg/ml) detectable in the plasma samples after incubation with the antigen. It has been also shown that in adolescents with local forms of pulmonary tuberculosis specific IFN-gamma induction may be suppressed in number of cases, which is ascribed to decreased specific immunity.

Examination of 296 cases of active forms of tuberculosis in children showed various age-dependent antituberculous measures. 14.8% of the children less than 3 years of age had not been vaccinated against tuberculosis; 19.8% had earlier received chemoprophylaxis; and contact with patients with tuberculosis was detected more frequently (70.4%). Against this background, tuberculosis in infancy was more commonly identified from complaints (48.1%) and less frequently at mass tuberculin diagnosis (19.8%); the generalized forms of the disease and complicated tuberculosis of intrathoracic lymph nodes were more frequently found (16% and 24.7%), a fatal outcome was oftener observed (7.4%). The secondary forms of tuberculosis were revealed in 23.8% of schoolchildren. Overall, the mean size of a papule emerging from the Mantoux test was 12.8 +/- 0.37 mm at the detection of tuberculosis.

The paper analyzes the efficiency of vaccination and tuberculin diagnosis in the megapolis on the basis of official reporting forms Nos. 8 and 33 approved by the 11 November, 2005 Resolution of the Russian Statistics Agency and the Moscow tuberculosis monitoring system. It is concluded that refusals to undergo vaccination and tuberculin diagnosis may result in the system crisis of antituberculous care to the pediatric population. For the optimum solution of reducing the rate of refusals to take the drugs prescribed by a physician, the authors propose to use in pediatric antituberculous care the marketing methods that level off the responsibility of the parties in taking a decision whether a medical service is expedient. Under the marketing conditions of medical services, combating the foci of tuberculous infection should be a main line to reduce the prevalence of tuberculosis. Prevention of tuberculosis is most effective with the active interaction of medical services (pediatric phthisiological and primary pediatric care services) and society and with the needs being molded in it (as a market medical service) in the population.