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Introduction: The number of tuberculosis cases in Finland has decreased. Cases among immigrants have, however, increased, and the disease may not be recognized early enough., Methods: We describe four group exposures to tuberculosis that occurred in Finland, the index patient coming from a country with a high incidence rate of tuberculosis., Results: Over 900 persons were exposed to tuberculosis. Coordination of the surveys was hampered by the fact that several healthcare operators participated in the study. Three index patients had drug-resistant tuberculosis, one of which was multidrug resistant., Conclusions: Extensive operations of tracking and prevention could have been avoided, if the symptoms would have been recognized earlier.

Obesity and non-communicable diseases and related costs increase with physical inactivity. In addition to the lack of recreational exercise, a sedentary lifestyle also seems to have a negative effect of health, independently of other lifestyle and risks. New means, as well as multidisciplinary and multiprofessional collaboration, are required in order to improve health and well-being on the population level and to reduce health-related costs. New, more effective operational models are also needed in health communication in order to achieve the desired and more permanent results.

The causative agent of MDR tuberculosis is resistant to at least isoniazid and rifampin, and in the case of XDR tuberculosis, also to fluoroquinolones and aminoglycoside. In 2012, 450000 people had MDR tuberculosis and 170000 people died of it. The majority of the cases were reported in South Africa, India, and Russia. In North West Russia nearly one third of the new tuberculosis cases are MDR. In Finland 2-5 new cases of MDR tuberculosis are notified annually, and this far only one case of XDR tuberculosis has been reported. Treatment of MDR tuberculosis lasts longer and costs more than treatment of drug-susceptible tuberculosis. Moreover, the second line drugs used are less effective and have more side effects than the first line drugs.

Most cases of hemoptysis are due to lung infections, bronchiectasis, lung cancer and pulmonary vascular disorders. Apart from the respiratory passages, the blood coming up with a cough may also originate from elsewhere, and its amount may vary from minor streaks of blood to a massive pulmonary hemorrhage. The extent of hemorrhage is decisive for the choice of investigational and therapeutic measures. Massive hemoptysis is always life-threatening and requires immediate action. Accurate determination of the cause of the hemorrhage is possible only after the acute situation has settled. In the hospital, bronchoscopy is the most important means of investigation and treatment.