Combination of Lactate and Base Deficit Levels at Admission to Predict Mortality in Blunt Trauma Patients.

INTRODUCTION: Elevated lactate levels are associated with increased mortality in both trauma and non-trauma patients. The relation between base deficit (BD) and mortality is less clear. Traumatologists debate the utility of elevated lactate (EL) versus BD in predicting mortality. We hypothesized that EL (2mmol/L to 5mmol/L) and BD (≤-2mmol/L) in combination could predict mortality in blunt trauma patients.  Methods: This is a retrospective analysis of the trauma registry from 2012 to 2021 at a level 1 trauma center. Blunt trauma patients with admission lactate and BD values were included in the analysis. Exclusion criteria were age <18, penetrating trauma, unknown mortality, and unknown lactate or BD. Logistics regression of the total 5153 charts showed 93% of the patients presented with lactate levels <5mmol/L, therefore patients with lactate >5mmol/L were excluded as outliers. The primary outcome was mortality. RESULTS: A total of 4794 patients (151 non-survivors) were included in the analysis. Non-survivors had higher rates of EL + BD (35.8% vs. 14.4%, p <0.001). When comparing survivors and non-survivors, EL + BD (OR 5.69), age >65 (5.17), injury severity score (ISS) >25 (8.87), Glasgow coma scale <8 (8.51), systolic blood pressure (SBP) <90 (4.2), and ICU admission (2.61) were significant predictors of mortality. Other than GCS <8 and ISS >25, EL + BD had the highest odds of predicting mortality. CONCLUSION: Elevated lactate + BD on admission in combination represents a 5.6-fold increase in mortality in blunt trauma patients and can be used to predict a patient's outcome on admission. This combination variable provides an additional early data point to identify patients at elevated risk of mortality at the moment of admission.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing for essential food production workers: evolving thinking, pilot testing, and lessons learned.

An essential part of U.S. coronavirus disease 2019 (COVID-19) critical infrastructure is the country's food-production workforce. Keeping food-production workers safe during the COVID-19 pandemic has meant added workplace protections. Protection guidance came early from the Federal Government. Absent from such guidance were strategies to screen for the causative virus. Without viral screening, some food companies had outbreaks; some facilities had to close. Companies interested in viral screening had to devise their own strategies. One company devised a strategy having three main goals: (1) detecting asymptomatic infections, before opportunity for spread; (2) identifying workplace clusters, to indicate potential protection breakdowns; and (3) comparing company results to community infection rates. The company decided on pilot screenings at two U.S. production plants. Screenings involved mandatory viral testing (through reverse transcription polymerase chain reaction) and optional antibody testing (both immunoglobulins G and M). Pilot screenings showed benefits along with limitations: (1) detecting asymptomatic infections, but at questionably relevant time points; (2) identifying infection clusters, but with uncertain sites of transmission; (3) showing relatively low rates of infection, but absent details for meaningful community comparisons. Establishing a worker screening process was an enormous undertaking. Company employees had to stretch job roles and were distracted form usual responsibilities. Whether other companies would find sufficient benefits to justify similar screening is unclear. Moving forward, new Federal leadership could provide greater support for, and assistance with, worker screenings. In addition, new technologies could make future screenings more feasible and valuable. The worker screening experience from this pandemic offers learnings the next.

Declining carbohydrate content of Sitka-spruce treesdying from seawater exposure.

Increasing sea levels associated with climate change threaten the survival of coastal forests, yet the mechanisms by which seawater exposure causes tree death remain poorly understood. Despite the potentially crucial role of nonstructural carbohydrate (NSC) reserves in tree survival, their dynamics in the process of death under seawater exposure are unknown. Here we monitored progressive tree mortality and associated NSC storage in Sitka-spruce (Picea sitchensis) trees dying under ecosystem-scale increases in seawater exposure in western Washington, USA. All trees exposed to seawater, because of monthly tidal intrusion, experienced declining crown foliage during the sampling period, and individuals with a lower percentage of live foliated crown (PLFC) died faster. Tree PLFC was strongly correlated with subsurface salinity and needle ion contents. Total NSC concentrations in trees declined remarkably with crown decline, and reached extremely low levels at tree death (2.4% and 1.6% in leaves and branches, respectively, and 0.4% in stems and roots). Starch in all tissues was almost completely consumed, while sugars remained at a homeostatic level in foliage. The decreasing NSC with closer proximity to death and near zero starch at death are evidences that carbon starvation occurred during Sitka-spruce mortality during seawater exposure. Our results highlight the importance of carbon storage as an indicator of tree mortality risks under seawater exposure.

[Psychoacoustic tests for perceptual assessment of processor fitting in patients with cochlear implants]. / Ispol'zovanie psikhoakusticheskikh testov dlya pertseptivnoi otsenki nastroiki protsessora kokhlearnogo implanta u glukhikh patsientov.

THE AIM OF THE STUDY: Was to study the possibility of using a battery of psychoacoustic tests to assess the tuning of the cochlear implant processor (CI) in deaf patients. METHODOLOGY: The study involved 60 prellingually deaf patients aged 10 to 23 years with oral speech skills. To assess the quality of the CI processor tuning, in addition to traditional methods, a special battery of psychoacoustic tests was used. The first block of tests assessed the perception of the basic characteristics of sound signals (duration, temporal structure, spectrum, timbre) and was used to assess the initial setting. The second block of tests, intended for patients with experience using CI, included tasks to distinguish acoustically similar and dynamically changing signals, etc. RESULTS: At the end of the initial CI setup session, patients with short signal perception problems were identified. Adjusting the frequency of electrical stimulation in patients has increased their ability to distinguish between sounds. During the second tuning session of the CI processor, 6 months later, a group of patients with difficulties in perceiving acoustic information in the low-frequency range was identified - distinguishing melodic intervals, changing the pitch of sounds, highlighting the voice of the target speaker. The «problem¼ patients underwent additional correction of the CI processor setting and the corresponding auditory training, which improved the test performance and subjective perception of sounds. CONCLUSION: The use of psychoacoustic tests expands the possibilities of fine tuning the CI processor, taking into account the individual characteristics of the patient's auditory perception at different stages of CI use, especially in «problem¼ patients.

Low-dose CT angiography of the lower extremities: a comparison study of image quality and radiation dose.

AIM: To investigate the image quality and radiation dose of ultralow-dose (ULD) and low-dose (LD) lower-extremity computed tomography (CT) angiography (LE-CTA) using the advanced modelled iterative reconstruction (ADMIRE) algorithm to detect peripheral arterial disease (PAD) in comparison with standard-dose (SD) CT. MATERIALS AND METHODS: One hundred and seven consecutive patients were examined using LE-CTA at 70 kVp and a dual-source scanner to achieve three image sets using 30% (ULD), 70% (LD), and 100% (SD) tube loads. Qualitative analysis was conducted by examining the three image sets for overall quality. The image quality of arterial segments was analysed by two independent readers. In addition, the CT dose index (CTDIvol) was measured in the three image sets. RESULTS: The mean overall quality scores were 3.4±0.6 for ULD CT, 3.9±0.3 for LD CT, and 3.9±0.2 for SD CT. Both readers scored the arterial segments as 2-4 (adequate-excellent) in the three image sets. In addition, 89.4% (93/104) and 54.8% (57/104) segments of PAD with calcified plaques were scored 4 between SD and LD CT and between SD and ULD CT, respectively, and 45.2% (47/104) segments had a lower score by one point in ULD CT compared with SD CT. The mean CTDIvol was 4.1±1.1 mGy for SD CT, 2.9±0.8 mGy for LD CT, and 1.2±0.3 mGy for ULD CT. CONCLUSIONS: LD/ULD CT at 70 kVp using ADMIRE reconstruction enables a reduction in the radiation dose while enabling adequate evaluation or follow-up of PAD based on LE-CTA.

Multi-criteria decision analysis to evaluate foot and mouth disease control strategies with the perspectives of Chief Veterinary Officers in the Asia-Oceania region.

The objective of this study was to evaluate the effectiveness of foot and mouth disease (FMD) control strategies using multi-criteria decision analysis (MCDA). The FMD control strategies were evaluated for epidemiological, economic and social-environmental criteria, accounting for the preferences of Chief Veterinary Officers (CVOs) from the Asia-Oceania region, with the preferences quantified using a questionnaire study. Previously reported simulation results of an FMD epidemic were used to measure the epidemiological effectiveness of FMD control strategies. The simulated FMD epidemic results, such as the number of infected farms, the duration of the epidemic and the outbreak area, were compared for a number of FMD control strategies. Based on previous simulation and economic modelling results and incorporating a literature search to quantify the social and environmental outcomes of an FMD outbreak, MCDA analysis was conducted to evaluate control strategies. According to the overall score in the MCDA results, an FMD control strategy which consisted of a 3-km radius of pre-emptive slaughter, 100 days of movement restriction and vaccinating all FMD-susceptible animals (baseline strategy) was the preferred strategy, with the highest overall score of 62.99. In contrast, the same duration of movement restriction and vaccination strategy with a 0.5-km radius of pre-emptive slaughter was least preferred, with the lowest overall score of 37.05. The evaluation of the FMD control strategies presented here using MCDA has provided scientific evidence for selecting an appropriate baseline FMD control strategy, based on the preferences of CVOs.

Les auteurs présentent les résultats d'une étude qui visait à évaluer l'efficacité d'un certain nombre de stratégies de lutte contre la fièvre aphteuse en recourant à une analyse décisionnelle multicritères (ADMC). Diverses stratégies de lutte contre la fièvre aphteuse ont été évaluées au regard de critères épidémiologiques, économiques et socio-environnementaux, en prenant en compte les préférences exprimées par les chefs des Services vétérinaires de la région Asie-Océanie, recueillies et quantifiées lors d'une étude par questionnaire. L'efficacité des stratégies de lutte contre la fièvre aphteuse au plan épidémiologique a été évaluée à partir des résultats d'une simulation d'épidémie de fièvre aphteuse effectuée au préalable. Les résultats de la simulation, notamment le nombre d'exploitations infectées, la durée de l'épidémie et l'extension de la zone focale, ont été comparés au regard de chacune des stratégies de lutte pouvant être appliquées contre la fièvre aphteuse. Une ADMC a été réalisée pour évaluer les stratégies de lutte en s'appuyant sur les résultats de simulations antérieures et de modélisations économiques, ainsi que sur les données réunies lors d'une recherche documentaire visant à quantifier les répercussions sociales et environnementales d'un foyer de fièvre aphteuse. Il ressort du classement des notes globales attribuées par l'ADMC que la stratégie préférée de lutte contre la fièvre aphteuse (note globale de 62,99) était celle associant l'abattage préventif dans un rayon de 3 km à une restriction des déplacements d'animaux pendant une période de 100 jours et à la vaccination de toutes les espèces sensibles au virus de fièvre aphteuse (stratégie de référence). En revanche, la stratégie associant une restriction des déplacements d'animaux de même durée, la vaccination et l'abattage préventif dans un rayon de 0,5 km recueillait le score le plus bas dans l'ordre de préférence (note globale de 37,05). Les évaluations des stratégies de lutte contre la fièvre aphteuse présentées par les auteurs à partir des résultats de l'ADMC fournissent des éléments scientifiques probants pour choisir une stratégie de référence appropriée afin de lutter contre la fièvre aphteuse, fondée sur les préférences des chefs des Services vétérinaires.

Los autores describen un estudio encaminado a evaluar la eficacia de distintas estrategias de control de la fiebre aftosa, para lo cual se siguió un proceso de análisis de decisiones con empleo de múltiples criterios de tipo epidemiológico, económico y socioambiental que recogían las preferencias de los jefes de los Servicios Veterinarios de la región Asia-Oceanía (preferencias cuantificadas con empleo de un cuestionario). Para medir la eficacia epidemiológica de las estrategias de lucha se utilizaron los resultados previamente descritos de simulaciones de una epidemia de fiebre aftosa. Después se compararon entre sí los resultados (por ejemplo, número de explotaciones infectadas, duración de la epidemia o territorio afectado por el brote) que deparaban distintas estrategias de lucha en una epidemia simulada de fiebre aftosa. A partir de los resultados de simulaciones y modelizaciones económicas anteriores e incorporando una búsqueda bibliográfica para cuantificar los efectos sociales y ambientales de un brote de fiebre aftosa, se procedió a evaluar las estrategias de lucha empleando el análisis de decisiones por criterios múltiples. A tenor de la puntuación global que arrojaban los resultados de este análisis, se determinó que la estrategia preferible de lucha contra la fiebre aftosa era la consistente en sacrificios sanitarios preventivos en un radio de 3 kilómetros, restricciones de desplazamientos durante 100 días y vacunación de todos los animales sensibles a la enfermedad (estrategia básica), pues era la que deparaba la puntuación global más elevada (62,99). La menos eficaz, es decir, la que deparaba la puntuación global más baja (37,05), preveía la aplicación de restricciones de desplazamientos durante el mismo período e idéntica estrategia de vacunación, pero con sacrificios sanitarios preventivos en un radio de solo 0,5 kilómetros. La evaluación de estrategias de lucha mediante un análisis de decisiones por criterios múltiples que aquí se presenta ha aportado sólidos datos científicos con los que seleccionar, partiendo de las preferencias de los jefes de los Servicios Veterinarios, una estrategia básica adecuada para combatir la fiebre aftosa.

Data analysis algorithm for the development of extracellular miRNA-based diagnostic systems for prostate cancer.

Urine of prostate cancer (PCa) carries miRNAs originated from prostate cancer cells as a part of both nucleoprotein complexes and cell-secreted extracellular vesicles. The analysis of such miRNA-markers in urine can be a convenient option for PCa screening. The aims of this study were to reveal miRNA-markers of PCa in urine and design a robust and precise diagnostic test, based on miRNA expression analysis. The expression analysis of the 84 miRNAs in paired urine extracellular vesicles (EVs) and cell free urine supernatant samples from healthy donors, patients with benign and malignant prostate tumours was done using miRCURY LNA miRNA qPCR Panels (Exiqon, Denmark). Sets of miRNAs differentially expressed between the donor groups were found in urine EVs and urine supernatant. Diagnostically significant miRNAs were selected and algorithm of data analysis, based on expression data on 24-miRNA in urine and obtained using 17 analytical systems, was designed. The developed algorithm of data analysis describes a series of steps necessary to define cut-off values and sequentially analyze miRNA expression data according to the cut-offs to facilitate classification of subjects in case/control groups and allows to detect PCa patients with 97.5% accuracy.

[Antimycotic therapy impact on oral mucosa Candida species composition in HIV-infected patients]. / Vliianie antimikoticheskoi terapii na vidovoi i shtammovyi sostav gribov roda Candida polosti rta bol'nykh VICh-infektsiei.

RESEARCH OBJECTIVES: the analysis of a specific and strains drift of Candida in HIV/AIDS patients with oropharyngeal candidiasis and the analysis of Candida sensitivity dynamics to reference antimycotic drugs. The study comprised 49 HIV-infected patients aged 20-69 years. The study revealed candidiasis treatment provides specific and strains drift of Candida. Eradication of fluconazole sensitive C. albicans leads to growth of more resistant strains (C. glabratae, krusei, tropicalis) thus lowering antimycotic therapy efficacy. The efficacy improvement requires selective approach to candidiasis treatment with azol agents.

Standardized protocols and procedures can precisely and accurately quantify non-structural carbohydrates.

Non-structural carbohydrates (NSCs), the stored products of photosynthesis, building blocks for growth and fuel for respiration, are central to plant metabolism, but their measurement is challenging. Differences in methods and procedures among laboratories can cause results to vary widely, limiting our ability to integrate and generalize patterns in plant carbon balance among studies. A recent assessment found that NSC concentrations measured for a common set of samples can vary by an order of magnitude, but sources for this variability were unclear. We measured a common set of nine plant material types, and two synthetic samples with known NSC concentrations, using a common protocol for sugar extraction and starch digestion, and three different sugar quantification methods (ion chromatography, enzyme, acid) in six laboratories. We also tested how sample handling, extraction solvent and centralizing parts of the procedure in one laboratory affected results. Non-structural carbohydrate concentrations measured for synthetic samples were within about 11.5% of known values for all three methods. However, differences among quantification methods were the largest source of variation in NSC measurements for natural plant samples because the three methods quantify different NSCs. The enzyme method quantified only glucose, fructose and sucrose, with ion chromatography we additionally quantified galactose, while the acid method quantified a large range of mono- and oligosaccharides. For some natural samples, sugars quantified with the acid method were two to five times higher than with other methods, demonstrating that trees allocate carbon to a range of sugar molecules. Sample handling had little effect on measurements, while ethanol sugar extraction improved accuracy over water extraction. Our results demonstrate that reasonable accuracy of NSC measurements can be achieved when different methods are used, as long as protocols are robust and standardized. Thus, we provide detailed protocols for the extraction, digestion and quantification of NSCs in plant samples, which should improve the comparability of NSC measurements among laboratories.

Paravertebral blocks reduce the risk of postoperative urinary retention in inguinal hernia repair.

PURPOSE: Inguinal hernia repair and general anesthesia (GA) are known risk factors for urinary retention. Paravertebral blocks (PVBs) have been utilized to facilitate enhanced recovery after surgery. We evaluate the benefit of incorporating PVBs into our anesthetic technique in a large cohort of ambulatory patients undergoing inguinal hernia repair. METHODS: Records of 619 adults scheduled for ambulatory inguinal hernia repair between 2010 and 2015 were reviewed and categorized based on anesthetic and surgical approach [GA and open (GAO), GA and laparoscopic (GAL), PVB and open (PVBO), and GA/PVB and open (GA/PVBO)]. Patients were excluded for missing data, self-catheterization, chronic opioid tolerance, and additional surgical procedures coinciding with hernia repair. Risk factors associated with the primary outcome of urinary retention were examined using logistic regression. RESULTS: PVBO (n = 136) had significantly lower odds than GAO of experiencing urinary retention (odds ratio 0.16; 95% CI 0.05-0.51); overall (P < .01), with 4.4% (n = 6) of the patients in the PVBO group having urinary retention versus 22.6% (n = 7) with GAO. Expressed as intravenous morphine equivalences, the PVBO group had the lowest median opioid use (5 mg), followed by GA, PVB, and open (7.5 mg); GAO 25 mg; and GAL 25 mg. Also, 30% (n = 41) of the PVBO group required no opioid analgesia in the postanesthesia care unit. CONCLUSIONS: PVBs as the primary anesthetic or an adjunct to GA is the preferred anesthetic technique for open inguinal hernia repair as it facilitates enhanced recovery after surgery by decreasing risk of urinary retention, opioid requirements, and length of stay.

[Prevalence of DNA viruses in maxillofacial area of HIV-infected]. / Porazhennost' DNK-virusami cheliustno-litsevoi oblasti bol'nykh s VICh-infektsiei.

DNA viruses have high oncogenic risk viruses; they cause emergence of Kaposi sarcoma, Lymphoma, Squamous cell carcinoma. HIV immunodeficiency promotes increase in frequency of such tumors. Etiotropic therapy of HIV patients considerably reduces prevalence of DNA viruses and a viral malignization.

RF photonic downconversion of vector modulated signals based on a millimeter-wave coupled electrooptic nonlinear polymer phase-modulator.

We report the RF photonic reception and downconversion of vector modulated RF signals using a millimeter-wave coupled electrooptic phase modulator with in-plane slotted patch antennas based on SEO125 nonlinear polymer. We demonstrate experimental results with QPSK, 8-PSK, 16-QAM, 32-QAM, and 64-QAM millimeter-wave signals centered at 36 GHz. After downconversion to intermediate frequencies between 0.5 GHz and 2 GHz, the vector encoded signals are demodulated using an electrical signal analyzer and found to have measured error vector magnitudes below 8%. Design, simulation, fabrication, and experimental results are presented and discussed.

VUV spectroscopy in impurity injection experiments at KSTAR using prototype ITER VUV spectrometer.

The ITER vacuum ultra-violet (VUV) core survey spectrometer has been designed as a 5-channel spectral system so that the high spectral resolving power of 200-500 could be achieved in the wavelength range of 2.4-160 nm. To verify the design of the ITER VUV core survey spectrometer, a two-channel prototype spectrometer was developed. As a subsequent step of the prototype test, the prototype VUV spectrometer has been operated at KSTAR since the 2012 experimental campaign. From impurity injection experiments in the years 2015 and 2016, strong emission lines, such as Kr xxv 15.8 nm, Kr xxvi 17.9 nm, Ne vii 46.5 nm, Ne vi 40.2 nm, and an array of largely unresolved tungsten lines (14-32 nm) could be measured successfully, showing the typical photon number of 1013-1015 photons/cm2 s.

Ruptured Dissecting Intramural Duodenal Hematoma Following Endoscopic Retrograde Cholangiopancreatography.

A 34-year-old woman with schizophrenia developed abdominal pain. Ultrasound demonstrated cholelithiasis and a dilated biliary tree. The patient underwent endoscopic retrograde cholangiopancreatography (ERCP), sphincterotomy, and extraction of gallstones from the common bile duct. She developed post-procedure fever, tachycardia, and abdominal pain and was taken to the operating room for urgent cholecystectomy with intraoperative cholangiogram. At laparotomy, an intramural dissecting duodenal hematoma was discovered, which extended the length of the duodenum and ruptured. She underwent gastric pyloric exclusion, gastrojejunostomy, and healed uneventfully. ERCP is not without risks, and a degree of vigilance should be maintained in patients who develop new symptomatology following the procedure.

Non-structural carbohydrates in woody plants compared among laboratories.

Non-structural carbohydrates (NSC) in plant tissue are frequently quantified to make inferences about plant responses to environmental conditions. Laboratories publishing estimates of NSC of woody plants use many different methods to evaluate NSC. We asked whether NSC estimates in the recent literature could be quantitatively compared among studies. We also asked whether any differences among laboratories were related to the extraction and quantification methods used to determine starch and sugar concentrations. These questions were addressed by sending sub-samples collected from five woody plant tissues, which varied in NSC content and chemical composition, to 29 laboratories. Each laboratory analyzed the samples with their laboratory-specific protocols, based on recent publications, to determine concentrations of soluble sugars, starch and their sum, total NSC. Laboratory estimates differed substantially for all samples. For example, estimates for Eucalyptus globulus leaves (EGL) varied from 23 to 116 (mean = 56) mg g(-1) for soluble sugars, 6-533 (mean = 94) mg g(-1) for starch and 53-649 (mean = 153) mg g(-1) for total NSC. Mixed model analysis of variance showed that much of the variability among laboratories was unrelated to the categories we used for extraction and quantification methods (method category R(2) = 0.05-0.12 for soluble sugars, 0.10-0.33 for starch and 0.01-0.09 for total NSC). For EGL, the difference between the highest and lowest least squares means for categories in the mixed model analysis was 33 mg g(-1) for total NSC, compared with the range of laboratory estimates of 596 mg g(-1). Laboratories were reasonably consistent in their ranks of estimates among tissues for starch (r = 0.41-0.91), but less so for total NSC (r = 0.45-0.84) and soluble sugars (r = 0.11-0.83). Our results show that NSC estimates for woody plant tissues cannot be compared among laboratories. The relative changes in NSC between treatments measured within a laboratory may be comparable within and between laboratories, especially for starch. To obtain comparable NSC estimates, we suggest that users can either adopt the reference method given in this publication, or report estimates for a portion of samples using the reference method, and report estimates for a standard reference material. Researchers interested in NSC estimates should work to identify and adopt standard methods.

[EFFECT OF HYPOXIA ON THE CHARACTERISTICS OF HUMAN AUDITORY PERCEPTION].

The effect of normobaric hypoxic hypoxia (single and interval training) on the characteristics of human hearing was investigated. The hearing thresholds (tonal audiograms), reaction time of subjects in psychophysical experiments (pause detection, perception of rhythm and target words), and short-term auditory memory were measured before and after hypoxia. The obtained data revealed improvement of the auditory sensitivity and characteristics of working memory, and increasing of response speed. It was demonstrated that interval hypoxic training had positive effect on the processes of auditory perception.

Test of prototype ITER vacuum ultraviolet spectrometer and its application to impurity study in KSTAR plasmas.

To optimize the design of ITER vacuum ultraviolet (VUV) spectrometer, a prototype VUV spectrometer was developed. The sensitivity calibration curve of the spectrometer was calculated from the mirror reflectivity, the grating efficiency, and the detector efficiency. The calibration curve was consistent with the calibration points derived in the experiment using the calibrated hollow cathode lamp. For the application of the prototype ITER VUV spectrometer, the prototype spectrometer was installed at KSTAR, and various impurity emission lines could be measured. By analyzing about 100 shots, strong positive correlation between the O VI and the C IV emission intensities could be found.

Converging risk factors but no association between HIV infection and multidrug-resistant tuberculosis in Kazakhstan.

SETTING: Kazakhstan is a country with a low HIV/AIDS (human immunodeficiency virus/acquired immune-deficiency syndrome) burden, but a high prevalence of multidrug-resistant tuberculosis (MDR-TB). METHODS: We describe the epidemiology of multidrug resistance and HIV among TB patients, using the 2007-2011 national electronic TB register. RESULTS: HIV test results were available for 97.2% of TB patients. HIV prevalence among TB patients increased from 0.6% in 2007 to 1.5% in 2011. Overall, 41.6% of patients had a positive smear at diagnosis, 38.6% a positive culture and 51.7% either a positive smear or culture. Drug susceptibility testing (DST) results were available for 92.7% of culture-positive cases. Socio-economic factors independently associated with both HIV and MDR-TB were urban residency, drug use, homelessness and a history of incarceration. In adjusted analysis, HIV positivity was not associated with MDR-TB (OR 1.0, 95%CI 0.86-1.2). Overall, among TB patients with DST and HIV test results available, 65.0% were positive for neither HIV nor MDR-TB, 33.5% only for MDR-TB, 0.9% only for HIV and 0.6% for both HIV and MDR-TB. Among injection drug users, 12.5% were positive for HIV and MDR-TB. CONCLUSION: We showed increasing HIV prevalence among TB patients in Kazakhstan. HIV was not an independent risk factor for MDR-TB, but risk factors were largely overlapping and we did identify subgroups at particular risk of HIV-MDR-TB co-infection, notably drug users. Enhanced efforts are necessary to provide care to these socially vulnerable populations.