Objectives. The aim of the study was to investigate the cause of death of tuberculosis patients infected with the human immunodeficiency virus (HIV). Many researchers and experts note the urgency of the problem of tuberculosis combined with HIV infection in the world and in Russia. One of the main criteria for assessing the effectiveness of medical care for tuberculosis patients infected with the human immunodeficiency virus is the mortality rate.Materials and methods. For a detailed study of the causes of death of patients with tuberculosis in combination with HIV infection, we analyzed the causes of death of this contingent of patients in 5 regions of the Russian Federation.Results. The social characteristics of patients, the forms and course of the disease, the main and immediate causes of death of 223 patients with co-infection with HIV and tuberculosis were studied.Conclusion. Half of the deaths of tuberculosis patients infected with human im­munodeficiency virus were not associated with tuberculosis. Among these cases, there was either the presence of several infections at the same time, equally leading to death, or separate opportunistic infections (candidiasis, Pneumocystis pneumonia, toxoplasmosis), or cancer. In addition, the lifestyle of patients often became the cause of deaths, namely: drug poisoning and accidents, or cirrhosis of the liver, which develops as a result of alcoholism or hepatitis C infection which occurred during intravenous administration of drugs.

Приведено клиническое наблюдение пациента с туберкулезом, развившимся в период транзиторного иммунодефицита ВИЧ-инфекции (2В стадия ВИЧ-инфекции). Основным проявлением туберкулеза был шейный лимфаденит, по поводу которого пришлось провести несколько операций, лучевые методы установили наличие увеличенных лимфатических узлов корня легкого, забрюшинных и паховых групп. На основании наличия туберкулеза пациенту установили позднюю, 4В стадию ВИЧ-инфекции и через 9 дней присоединили АРВТ. Обсуждается вопрос, следует ли рассматривать туберкулез как однозначный критерий последней стадии ВИЧ-инфекции независимо от состояния показателей иммунитета и длительности течения ВИЧ-инфекции.

BACKGROUND: According to official statistics from the Russian Federation in 2021, human immunodeficiency virus (HIV) infection was more often registered in the general population than in vulnerable groups. AIMS: This study aimed to determine the characteristic patient cohorts with tuberculosis (TB) and HIV coinfection in dynamic epidemiological environments and propose additional organizational approaches to reduce TB incidence in patients with HIV. MATERIALS AND METHODS: We investigated the complete medical data of patients with TB and HIV coinfection in three Russian regions. Additionally, we analyzed the cohort of patients with TB and HIV coinfection through sexual transmission. Furthermore, confidential interviews with patients with TB and HIV coinfection were undertaken. Specifically, reasons for refusing clinical examination at a Russian Federal AIDS Center (RFAIDSC) were clarified. RESULTS: Among patients with TB and HIV coinfection, parenteral transmission remains the primary HIV infection route. Moreover, patients who acquired infection through sexual contact are also primarily socially disadvantaged, leading to the refusal of clinical examination and a consequent late detection of TB. On the contrary, patients who are unemployed report that they do not have the financial means to travel to the regional RFAIDSC. Widespread, rapidly progressive MDR TB infections more often occurred in patients with TB and HIV coinfection than in patients with TB but without HIV. Considering that every fourth patient with TB in Russia has been diagnosed with HIV. Moreover, there are specific features regarding the development and course of TB, and the generally accepted criteria for assessing the quality of TB without HIV care often become biased for patients with coinfection. This can lead to unreasonably negative assessments of the antituberculosis system and its work. CONCLUSIONS: In view of the above, it is important to modify regulatory documents regarding informing patients about the importance of seeking timely medical help and solve the issue of travel for patients who are unemployed to medical examinations and in emergency cases. It is also important to introduce adjustments for the criteria in assessing the quality of TB care, thereby accounting for the pathogenesis of TB in patients with HIV coinfection.

Background: While non-specific pleural empyema in children can be successfully managed with conservative drainage and thoracentesis in 80–84% of cases, tuberculous pleural empyema (TB empyema) exhibits high resistance and frequently requires extensive thoracic surgery. The choice of surgical scope depends directly on disease stage and secondary complications. Methods: We conducted a retrospective cohort study of 85 pediatric patients (aged 4 to 17 years) with confirmed TB empyema treated between 1984 and 2022, and followed until 2025. Disease staging followed a predefined adaptation of the American Association for Thoracic Surgery (AATS) consensus classification. The study adhered strictly to STROBE guidelines, incorporating temporal stratification across three historical eras and standardized Clavien–Dindo complication reporting. This study describes a 38-year surgical experience at a tertiary pediatric phthisiosurgical center; non-operated patients successfully cured with exclusive chemotherapy were excluded. Results: Stage I empyema was identified in three patients, Stage II in seven, and Stage III in 75 patients (79 total procedures). Stage I–II patients underwent video-assisted thoracoscopic (VATS) debridement. In Stage III, advanced reconstructive interventions were required (39 VATS pleurectomies, 21 segmental resections, eight pleuropneumonectomies, six lobectomies, two thoracomyoplasties, two open resections, and one bronchus occlusion). Postoperative complications occurred in two patients (2.35% patient-level; categorized as Clavien–Dindo Grade IIIa and Grade IIIb), presenting as delayed lung re-expansion managed via secondary minor interventions. Overall 30-day postoperative mortality was 0.0%. Over a median follow-up of 48 months (database lock: 31 December 2025; 97.65% 36-month completeness), zero disease recurrences were documented (0.0%). Conclusion: In this tertiary surgical cohort, combined management incorporating stage-dependent surgical intervention achieved durable clinical cure. Early VATS debridement represents an effective option for Stage I–II patients who fail initial drainage, potentially reducing progression to a rigid fibrothorax and the subsequent need for extensive pulmonary resections.

Communicative abilities constitute a crucial element of successful learning and interaction. The psychological impact of the prolonged lack of face-to-face contact with the peer audience and teachers typically remains an unresolved problem, despite the availability of appropriate online learning methodologies and technical tools. This study aims to ascertain a quantitative assessment of social maladjustment and a reduction in the level of communicative competence resulting from prolonged distance learning and the use of mobile devices in communication. The research employs a quantitative approach and is based on a survey of students who participated in eight socio-psychological training sessions (A-trainings). The training sessions are oriented towards refining the personal qualities of individuals and facilitating their adaptation to the fluctuating conditions of learning environments. The analysis of pre-and post-training results was compared with the results of the control group. The research findings indicate a positive impact of socio-psychological training on the enhancement of communicative skills and emotional well-being of students.

Background: While non-specific pleural empyema in children can be successfully managed with minimally invasive drainage and pleural puncture in 85–90% of cases. Tuberculous pleural empyema (TB empyema) exhibits high clinical resistance and frequently requires extensive thoracic surgical interventions. The choice of surgical extent directly depends on the disease stage and the presence of complications. Methods: We conducted a retrospective analysis of diagnostic and surgical outcomes in 85 children and adolescents (aged 4 to 17 years) with tuberculous pleural empyema treated between 1984 and 2022. TB empyema staging was performed using the American Thoracic Society (ATS) classification was adapted for tuberculous etiology. Results: Stage I TB empyema was diagnosed in 3 patients, Stage II in 7 patients, and Stage III in 75 patients. Patients with Stage I and II disease underwent video-assisted thoracoscopic (VATS) debridement of the empyema cavity. In Stage III, 75 patients underwent 79 surgical interventions of varying extents. Postoperative complications occurred in 2 patients (2.5%). This occurred as delayed lung re-expansion, which was successfully managed with repeat thoracentesis in one patient and chest tube drainage in the other. The overall 30-day postoperative mortality rate was 0.0%. No recurrences were reported during the 3-year follow-up period.Conclusion: Comprehensive treatment combined with timely surgical intervention achieves clinical cure in all patients. Early minimally invasive VATS interventions during Stages I–II prevent the need for more traumatic procedures, such as pleurectomy and lung resection, which are often required in Stage III disease.