One of the reasons of growing incidence of tuberculosis (TB) is spread of AIDS, drug dependence, and alcoholism. To investigate their mutual influence the authors examined 185 lung TB patients (of them, 124 males) admitted to TB hospitals of St-Petersburg in 2003-2005. Inclusive criteria were age of 18 to 79 yrs, recent admission to the hospital, the patient's consent to participate the study. Patients were excluded if they were severely ill or had psychiatric disorders. The lung TB was evaluated using medical history, physical, clinic, laboratory, radiologic, and bacteriologic data. Alcohol and drug abuse was assessed with Addiction Severity Index (ASI), retrospective analysis of alcohol and substance use for previous 90 days, Michigan Alcohol Screening Test (MAST), measurement of alcohol in exhaled air and detection of substances in urine. Somatic and psychic health was evaluated using ASI, Beck Depression Inventory, and Spielberger Trait Anxiety Inventory. Risk of HIV-infection was determined in a test of HIV risk assessment and with HIV risk questionnaire developed at Johns Hopkins University. The average age of the participants was 40.5 yrs. More than 60 % of them had abuse-related disorders: alcohol abuse in 51.9 %, alcoholism plus drug dependence in 8.6 %, and drug dependence in 3.8 %. Alcohol dependence facilitated development of TB multiple drug resistance (21 % vs 7.6 % in patients without alcohol dependence, p < 0.05), extensive (73.9 % and 40.9 %, respectively, p < 0.001) and chronic (28.6 % and 16.7 %, respectively) forms of TB. Most of TB patients with abuse-related disorders tended to have psychiatric disorders (depression, anxiety). The risk of HIV-infection was significantly higher in TB patients with drug abuse (3.51 vs 0.07). Thus, it is necessary to consider co-morbidity in TB patients for more effective treatment of lung tuberculosis.

The nature and frequency of mutations in the rpoB gene of M. tuberculosis (MBT) vary considerably in various geographical locations. There is no information on the prevalence of specific mutations in the rpoB gene of MBT isolated from patients in Kyrgyz Republic. In this work, we analyzed a distribution of the rpoB gene mutations in Kyrgyz Republic. A total of 380 rifampicin-sensitive and 225 rifampicin-resistant MBT cultures were analyzed to identify and to characterize mutations in the rpoB gene using a biological microchip assay. The biochip test determined 18 different mutation types in 8 codons of the rifampicin-resistant samples. The majority of mutations (180 of 225, or 80 %) were in the codons 531 and 526, mainly in the codon 531 (137 of 225, 60.8 %). The Ser531>Leu mutation (134 of 225, 59.4 %) was by far the most common. Another group of mutations were in the codon 526 (43 of 225, 19.1 %). Five different types of mutations were found in the codon 526 which were: His526®Tyr (4.9 %), His 526®Asp (4.9 %), His526®Arg (4.0 %), His526®Leu (3.5 %), and His526®Pro (1.8 %). The third group of common mutations were Leu511®Pro (6.3 %) and Asp516®Tyr (4.4 %). Other mutations found in the codons 533, 522, 513, and 512 were less frequent and had a very low rate comprising about 1.8 % of the total mutation number among 225 rifampicinresistant samples.

The problem of lowering adherence to therapy in lung tuberculosis patients and abilities to enhance motivation to for treatment has not been highlighted in literature. The aim of this study was to investigate factors influencing the adherence to treatment in tuberculosis patients and abilities to enhance their motivation for treatment. A total sample of 72 inpatients with infiltrative and firbocavernous lung tuberculosis were involved. They were residents of Samara region aged 22 to 56 yrs. To investigate factors reducing adherence to therapy a special questionnaire consisting of 34 points has been created proposed by Samara military medical university. Statistic analysis was performed using SPSS programme, version 12.0. As a result, the most common factors reducing adherence to therapy in lung tuberculosis patients were adverse effects of antituberculosis drugs, financial problems, complications of the disease and fear of their appearance, painfulness of treatment procedures, tiredness of long treatment period and of hospital environment. To overcome the fear education of the patients is necessary. To reduce the emotional component and painfulness of some treatment procedures, manual and audiomethods could be helpful. Effective therapy, confidence in the attendant physician and full information of the disease could enhance motivation to treatment.

Features of tuberculosis (TB) in HIV-infected patients were studied in a large industrial center. Data from outpatient and inpatient medical charts and yearly TB reports in Samara during 2004-2005 have been analyzed. During the study period tuberculosis was diagnosed in 199 HIV-infected patients in Samara. Morbidity for tuberculosis among the HIV-infected patients was 1438.3 per 100,000 of HIV-infected persons compared to that of 61.2 per 100,000 of total population in Samara. Clinical TB types in HIV-infected patients were the following: infiltrative TB in 124 patients (62.3 %), disseminated TB in 6 patients (3 %), caseating pneumonia in 7 patients (3.5 %), focal TB in 8 patients (4 %), pleural TB in 10 patients (5 %), tuberculoma in 7 patients (3.5 %), fibrocavitary TB in 25 patients (12.6 %), and other forms in 12 patients (6.1 %). Majority of patients were males (M/F 6.5/1). The average age was 27 years ranged from 18 to 58 yrs. AFB smear or culturing for M. tuberculosis was positive in 161 patients (80.9 %), 90 patients (45.2 %) had positive AFB smear. Thirty eight patients (19.1 %) were negative for M. tuberculosis. Therefore, the morbidity for tuberculosis in HIV-infected patients was 23 times higher than that in the whole population of the region. Infiltrative tuberculosis with lung tissue destruction was the most common. M. tuberculosis was found in 80.9 % of the patients. HIV-infected patients with TB represent epidemiological risk for other population. Further increase in TB and HIV co-infections could be expected.

The main cause of seeking for medical aid of COPD patients is exacerbations of the disease which have viral etiology in 30 % [3]. The aim of this study was to investigate efficacy of Amixin, which is an oral inductor of endogenous interferon, to prevent exacerbations of COPD. The study was performed at a large industrial works and involved 58 workers with COPD stage I or II aged 40 to 60. Of them, 38 workers received Amixin 0.125 weekly during 6 wks in winter outbreak of acute respiratory viral infections; 20 workers were as controls. Number and severity of exacerbations of COPD and changes in FEV₁ during 4 months were analyzed. During the follow-up, 42.86 % of the Amixin group participants had no exacerbations of COPD, 57.14 % experienced mild exacerbations. There were no moderate and severe exacerbations in this group. Dyspnea severity was 0.7 according to the MRC scale, number of days off-work was 2.4 per a patient for the follow-up period. In the control group, 15 % of workers did not have exacerbations, the others had 1 or 2 moderate to severe exacerbations. Dyspnea severity was 2.5, number of days off-work was 7.25 per 1 patient. FEV₁ has grown by 92 ml for 12 months in Amixin group patients. The administration of Amixin led to increase in secretory IgA level in saliva and reduction in total IgG level. Tolerability and safety of Amixin were good. Therefore, clinical efficacy of preventive administration of Amixin in COPD patients during an outbreak of acute respiratory viral infections was shown.

Two hundred and ninety seven young medical students were divided in the study group (93 smokers) and the control group (204 non-smokers). Depending on smoking history and risk factors of COPD (GOLD, 2005), the smokers were divided into the risk-positive (32 % of the smokers) and risk-negative (68 % of the smokers) subgroups. Spirometry parameters, blood oxygenation and desaturation during a voluntary hold of breathing at the full inspiration were analyzed. As a result of mathematical modeling, we have proposed the respiratory gas index (RGI) that is an integral index of early cardiorespiratory dysfunction at the early-stage COPD. The lowest RGI was in the study group especially in smokers with risk factors of COPD.

The purpose of this research was to evaluate asthma control in Krasnoyarsk patients using E.Bateman's criteria, GOAL and ACTTM . We examined 480 patients (both genders; 18 to 70 years old) with asthma of different severity. The patients were divided into 2 groups: the 1st group (n = 1250) was examined by primary care practitioners using the ACT™ alone and received different basic medications, the 2nd group patients (n = 230) had been taught at asthma-schools; they were treated with fixed combination of fluticasone and salmeterol (Seretide) and were tested with E. Bateman's criteria, GOAL and ACTTM . According to the ACTTM , 16 % of the 1st group patients had asthma controlled and 86 % had < 19 points. In the 2nd group, asthma control was achieved in 87 % of the patients. When compared ACT TM with E.Bateman's criteria and GOAL, results were equal. Basic therapy adequate to asthma severity, regular follow-up, continuous education of patients allowed achievement of asthma control. The ACT TM use led to objective results with similar interpretation in various patients which allows assessing asthma control and efficacy of treatment.

This one-year open randomized comparative trial was designed to evaluate efficacy of tiotropium bromide (TB) in disabled patients with mild to moderate chronic obstructive pulmonary disease (COPD). The patients were Ј 60 years old. The TB group patients (n = 46) received Spiriva (Boehringer Ingelheim, Germany) 18 mg daily, the F group patients (n = 29) received Foradil (Novartis Pharma AG, Switzerland) 12 mg b.i.d. for a year. The active control group (AC, n = 14) were given inhaled steroids and short-acting b2-agonists as before entering the trial. We assessed lung function using spirometry, the annual decline of FEV₁, severity of dyspnea using Baseline and Transitional Dyspnea Indexes, rate and length of exacerbations, and quality of life (QoL) using the St.George's Respiratory Questionnaire. The trial was close to real-life practice. Results demonstrated efficacy of both TB and F in therapy of disabled COPD patients compared with the AC group. Criteria of efficacy of long-term TB administration were slowing of the annual FEV₁ decline, improvement of dyspnea, reduction in number of exacerbations, and improvement of QoL in TB and F patients compared with the baseline.