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The Aim of the Study: Was to improve the quality of treatment in pediatric outpatient dentistry with the effective use of oral sedation., Materials and Methods: The study comprised 60 children aged 3-12 years who were undergoing therapeutic/surgical dental treatment. All children's somatic state was assessed as ASAI-II. All children met a number of psychological, anamnestic and procedural criteria. Midazolam and chloropyramine in a dose calculated for the patient's body weight were used as components of oral sedation. The estimated sedation depth was Ramsay II-III. The study included an analysis of objective (the time of comfortable treatment, the amount of treated or removed teeth per visit, the possibility of treatment without anesthesia during further visits) and subjective (the possibility of contact with the child during treatment, behavioral reactions at home and on further visits) criteria. Negative behavioral reactions and dental effects were also assessed., Results: The treatment features correlated with the age category and gender of the patient. In the older age group of 7-12 years, the amount of comfortable treatment time was higher, the possibility of contact with the child reached 100% (which is twice as much as in the younger one), and also a larger number of patients were treated during further visits without an anesthetic aid. At the same time, in the younger age group of 3-6 years, the volume of treatment per visit was higher, since it takes less time to treat a primary tooth than for a permanent one. Side effects (visual hallucinations, diplopia, hyperactivity, tearfulness and aggressiveness) were more often recorded in the younger age group, but emotional instability was equally manifested in both groups., Conclusion: In order to maximize the effectiveness of using oral sedation as a method, it is necessary to take into account the duration and traumatism of the proposed procedure, the peculiarities of age psychology and the peculiarities of the psychological development of boys and girls.

The article describes a unique clinical case of AL amyloidosis mimicking IgG4-related disease. Plasma cell dyscrasias can mimic clinical and laboratory manifestations of rheumatic diseases, which can lead to a delay in diagnosis and inappropriate therapy.

Background: First-line therapy does not always provide a high level of Helicobacter pylori eradication due to the increase of H. pylori resistance to antibiotics; therefore, it remains necessary to identify the most effective rescue treatments. The purpose of this study was to evaluate the efficacy and safety of empirical H. pylori furazolidone-containing regimens., Materials and Methods: Adult H. pylori infected patients empirically treated with furazolidone-containing eradication regimens were registered in an international, prospective, multicenter non-intervention European registry on H. pylori management (Hp-EuReg). Data were collected at AEG-REDCap e-CRF from 2013 to 2021 and the quality was reviewed. Modified intention-to-treat (mITT) effectiveness analyses were performed., Results: Overall 106 patients received empirical furazolidone-containing therapy in Russia. Furazolidone was prescribed in a sequential scheme along with amoxicillin, clarithromycin and a proton pump inhibitor in 68 (64%) cases, triple regimens were prescribed in 28 (26%) patients and quadruple regimens in 10 (9.4%). Treatment duration of 7 days was assigned to 2 (1.9%) patients, 10-day eradication therapy in case of 80 (75%) and 14 days - in 24 (23%) patients. Furazolidone was mainly used in first- (79%) and second-line (21%) regimens. The methods used to diagnose H. pylori infection were: histology (81%), stool antigen test (64%), 13 C-urea breath test (6.6%), and rapid urease test (1.9%). The mITT effectiveness of sequential therapy was 100%; 93% with the triple therapy and 75.5% with quadruple therapy. Compliance was reported in 98% of cases. Adverse events were revealed in 5.7% of patients, mostly nausea (3.8%). No serious adverse events were reported., Conclusion: Furazolidone containing eradication regimens appear to be an effective and safe empirical therapy in Russia.

The etiology and pathogenesis of schizophrenia remain poorly understood, but it has been established that the contribution of heredity to the development of the disease is about 80-85%. Over the past decade, significant progress has been made in the search for specific genetic variants associated with the development of schizophrenia. The review discusses the results of modern large-scale studies aimed at searching for genetic associations with schizophrenia: genome-wide association studies (GWAS) and the search for rare variants (mutations or copy number variations, CNV), including the use of whole exome sequencing. We synthesize data on currently known genes that are significantly associated with schizophrenia and discuss their biological functions in order to identify the main molecular pathways involved in the pathophysiology of schizophrenia.

There is a worldwide trend towards an increase in the number of people aged over 60, which in turn leads to an increase in the prevalence of vascular dementia and neuropsychiatric disorders, including the accompanying aggressive behavior. The authors analyze the relationship of neuropsychiatric symptoms with aggressive behavior and assess the impact of the evolution of dementia, socio-demographic factors on the development of aggressive behavior in some subtypes of vascular dementia based on literature data retrieved from Scopus, PubMed, eLibrary databases as well as national guidelines. Analyzing the publication was made by the method of the system analysis and generalization. The analysis of the literature suggests that aggressive behavior in patients with vascular dementia changes their lifestyle and worsens its quality, in addition, it increases the burden on caregivers. Also, this psychopathological process is one of the reasons for frequent hospitalizations of patients in psychiatric hospitals and social institutions, which becomes an urgent economic and medical problem at the state level. Of all the psychopathological symptoms in the clinical picture of vascular dementia, aggressive behavior periodically occurs together with apathy, depression, anxiety, abnormal motor activity and hallucinations. The question of the highest frequency of occurrence of aggressive tendencies in one or another subtype of vascular dementia remains debatable. Research on the relationship between dementia severity, gender, and aggressive behavior has been mixed. The question of the influence of the level of education on the manifestation of aggression in patients with vascular dementia remains completely unexplored. Thus, the above facts dictate the need for further study of these issues.

Objective: Of the work is a cross-cultural analysis of the characteristics of student response in a pandemic situation., Material and Methods: The sample consisted of students of NSMU and the Kazakh National University. Al-Farabi in the amount of 37 people aged 20 to 23; The battery of psychological methods was compiled by Spielberger and Khanina; Mississippi Post-Traumatic Stress Disorder Scale (civil version) and PSM-25 Psychological Stress Scale., Results: 52.7% of respondents showed an average level of stress, 47.3% - a low level, which indicates insufficient psychological adaptation to psychological stress. High rates of personal and situational anxiety were diagnosed in 67.57% of cases; the average level of reactive anxiety - in 29.73% of cases and personal - in 27.03% of respondents. The majority of respondents showed average levels of post-traumatic stress reactions (50%, n =37), while a low level of post-traumatic stress reactions occurs in 11 (14.87%) people, a low level - in 17 (22.97%) people and increased - in 9 (12.16%) people. Stress level indicators tend to have significant differences: the frequency of occurrence of average stress indicators in the sample of students from Kazakhstan is higher (75.6%) compared to Russian students (24.32%) ( p <0.05)., Adapting to changing academic workloads in a pandemic situation does not contribute to the psychological well-being of students, as evidenced by the results of diagnosing anxiety and post-traumatic stress reactions. The results obtained emphasize the importance of taking into account cultural factors in stressful situations., Conclusion: Cross-cultural differences in the level of emotional response of students in a pandemic situation were revealed.

The prevalence of affective disorders in patients with Parkinson's disease (PD) is significantly higher than in the general population of people of the same age. It is known that the effectiveness of antidepressants in PD with depressive disorder is lower than in patients with primary depression. For depression resistant to standard treatments, other therapeutic strategies are available. Transcranial magnetic stimulation (TMS) is one of the most popular and safe brain stimulation methods that has been successfully used to treat primary depression. The accumulation of experience in the use of TMS has made it possible to expand the application of the method to other diseases, including PD. The article provides literature data on the use of different TMS protocols for the treatment of depressive disorder in patients with PD.

This review addresses current views on prevention of infectious endocarditis (IE). History of establishing the concept of antibacterial prophylaxis (ABP), major approaches, and substantiation of changes in ABP in recent years are described. Recent international and national guidelines are highlighted, specifically, guidelines of the European Society of Cardiologists, American Heart Association/American College of Cardiology, and the Japanese Circulation Society. The review presents critical evaluation of previously approved international guidelines, including analysis of the effect of partial or complete ABP restriction on IE morbidity and incidence of complications. Special attention is paid to awareness of practitioners, particularly dentists, about ABP issues in their practice. Aspects of validity and key features of preventive approaches in implanting cardiac electronic devices and transcatheter aortic valve implantation are discussed.

Despite the large number of studies devoted to the study of systemic sclerosis (SSc), the high risk of developing lymphomas in this disease, the relationship of their development with certain subtypes of SSc and specific SSc-associated autoantibodies is still debated in the literature., Aim: To study demographic, clinical, laboratory and immunological characteristics of patients with a combination of primary Sjogrens syndrome (pSS) and SSc and diagnosed lymphoproliferative diseases (LPDs); to characterize morphological/immunomorphological variants and course of non-Hodgkins lymphomas (NHL), developing in patients with these rheumatic diseases (RDs)., Materials and Methods: In 19982018 at the Nasonova Research Institute of Rheumatology, 13 patients with clinical and laboratory manifestations of pSS (12) and SSc (13) were diagnosed with various lymphoproliferative diseases (LPDs). In 3 cases, an induced RD was observed: 1 case of a diffuse, rapidly progressive form of SSc, 2 cases of pSS in combination with a limited form of SSc after chemotherapy and radiation therapy of Hodgkins lymphoma (1), B-cell NHL (1) and CR of the breast (1) respectively. The first 2 cases were excluded from the analysis, since the development of lymphomas is not pathogenetically associated with RD., Results: Of 11 patients with LPDs, 10 after a long course of RDs were diagnosed with NHL [MALT lymphoma of the parotid salivary glands 7, disseminated MALT lymphoma 2, disseminated MALT lymphoma with transformation into diffuse large B-cell lymphoma (DLBCL) 1]. RDs debuted with Raynauds phenomenon (RP) in 64.5% and pSS manifestations in 45.5% of patients. Stomatological manifestations of pSS were characterized by recurrent parotitis in 36%, significant parotid gland enlargement with massive infiltration of labial salivary glands (focus score 4) in 100%, severe xerostomia in 70%, extraglandular manifestations and lymphadenopathy in 50% of patients. The course of the SSc was characterized by mild RP with various types of capillaroscopic changes and mild lung changes and non-significant progression during long-term follow-up (median 22 years). The entire spectrum of SSс specific antibodies (anticentromere antibodies 60%, antibodies to ribonucleoprotease III 30%, Pm/Scl 10%), excepting antibodies to topoisomerase I, as well as pSS specific autoantibodies (antiRo/La 70%, RF (rheumatoid factor) 90%), were detected in patients with a combination of these RDs., Conclusion: pSS is often combined with a limited form of SSc regardless of the type of autoantibodies detected. The presence of pSS, rather than SSc, is a high-risk factor for the development of NHL in this group of patients. The patients with pSS and SSc are characterized by a steady progression of pSS with a slow and mild course of SSc throughout the observation period. The development of severe stomatological manifestations and high immunological activity of pSS contribute to the development of localized MALT lymphomas (70%) and disseminated MALT lymphomas (30%) with primary lesions of the salivary glands and transformation into DLBCL in case of their late diagnosis. The optimal method for preventing the development of NHL in this group of patients is the early diagnosis of pSS, the appointment of alkylating cytotoxic agents and/or anti-B-cell therapy in the early stages of pSS. Given the possibility of transformation of localized NHL into DLBCL, for early diagnosis, minimally invasive surgical biopsies of significantly enlarged parotid salivary glands should be performed before glucocorticoids are prescribed. Detection of positive B-cell clonality and lymphoepithelial lesions in the parotid salivary gland is considered a predictor of MALT lymphoma development during follow-up. Localized and disseminated MALT lymphomas in patients with pSS and SSc respond well to therapy, in contrast to MALT lymphomas transformed into DLBCL.

Idiopathic multicentric Castlemans disease is a rare lymphoproliferative disorder that has many similar laboratory, radiological, clinical and pathological manifestations with various conditions, including IgG4-related disease. Increased activity of cytokines, especially interleukin-6, leads to systemic inflammatory symptoms with the development of lymphadenopathy and rarely extranodal lesions. Histological changes in the lymph nodesin hyaline vascular and plasma cell variants of Castlemans disease are hardly distinguishable from the pattern of reactive, tumor and IgG4-related lymphadenopathy. Idiopathic multicentric Castlemans disease can be diagnosed only when infection with human herpesvirus-8 type and human immunodeficiency virus is excluded. In the article, the authors describe two cases of idiopathic multicentric Castlemans disease, including the first world literature description of extranodal damage of the hip muscle in this disorder. In addition, the authors gave a review of the literature on the main clinical, laboratory and morphological manifestations, which allow confirming the diagnosis of Castlemans disease.

Objective: To designate the targets for medical and psychotherapeutic effects in patients with comorbid recurrent affective and panic disorders based on the study of cognitive functions., Material and Methods: A battery of pathopsychological tests («Schulte Table», «Corrective Test», «Ten Words test», «Cube Drawing Technique», Binet and Berstein Tests) has been used to assess the neuro-cognitive status of 60 patients with symptoms of recurrent affective (depressive) and panic disorders. According to ICD-10, 27 patients have been diagnosed with recurrent affective disorder with a mild or moderate depressive episode (RAD, F33.0, F33.1) in combination with panic disorder (PD, F41.0). The control group included 33 patients with recurrent affective disorder with a mild to moderate depressive episode (RAD, F33.0, F33.1) without panic disorder., Results: All the patients showed the changes in the cognitive sphere. In patients with recurrent affective disorder in combination with panic disorder, cognitive impairment was more pronounced than that in patients from the control group. Cognitive functions in patients with recurrent affective and comorbid panic disorder were distinguished by their peculiarity, which manifested itself in «left hemisphere» disorders in the form of paroxysmal emotional disorders with the predominance of fear and anxiety affect, work dysfunction in a number of neuropsychological factors: successiveness, spatial, inertness-mobility, for which mediobasal and subcortical parts of the brain are responsible. The targets for medical and psychotherapeutic effects in patients with comorbid panic and recurrent depressive disorder are: attention, auditory and verbal memory, thinking components (logical and spatial)., Conclusion: It is reasonable to use neuropsychological correction of cognitive impairment in this group of patients.

The furan or pyran related hetero cycles play basic role in structural units of nucleic acids (NA) and polysaccharides (PS), significantly predetermining their functional specifics. Some of such properties, in great relevancy for medicine, can be imitated through mimicry of polymers synthetic. Particularly, a formation of similar cycloisomeric chains is possible in process of free-radical cyclocopolymerization of divinyl ether (DVE) and maleic anhydride (MA). The products yielded (DVEMA) of general formula [DVE(MA)-alt-MA]n become precursors for a broad family of water-soluble derivatives capable of wide spectrum of bioactivity, including induction of interferon, immune-stimulated and direct antiviral protection. In this connection, the knowledge: what is content of different heterocyclic isomers in backbone of the preparations and what their partial contributions in promotion of the certain bioactivities observed, are in great importance. Available experimental data (NMR, IR, etc.), controversial for interpretations, didn't elucidate a required estimation of the DVEMA isomerism. The current work represents an independent exploration of the problem via quantum chemistry-based analysis of kinetic (activation barriers) and thermodynamic (enthalpies) priorities in competition between variable isomerism within the chain synthesis. The system is considered in maximal range of hypothetically allowable variations of two levels for double regioselective bifurcations: there are four competitive ways, each of which involves a sequence of four type elementary reactions for a diverse-isomeric formation of chain units. A genesis of six chiral centers (62 stereoisomers permitted) per every of the four part ways was accounted in view for up to 256 isomeric variations in total. The required time-minimized but precisely accurate computations were conducted via B3LYP/6-31G(d), M06-2X/6-311+G(d), M06-2X/6-31+G(2df,p) techniques, which were preselected through model test-systems. As a result, the mechanisms, crucial points and factors for the process-permitted regulation of isomeric content of DVEMA were studied in details. The narrow enough set of most probable enantiomers within highly competitive 5-exo- and 6-endo- ring closing sub-ways was revealed. The results obtained are very actual for an adequate modeling (docking / molecular dynamics) of DVEMA derivatives in their interactions with biopolymer targets, in search for purposed advancement of current background in design and synthesis of highly effective agents for combined antiviral protection (against HIV, flu, herpes, and other infections).

Aim: To determine clinical and psychopathological features of anxiety-depressive disorders in patients with cerebral residual organic insufficiency., Material and Methods: One hundred and fourteen patients with anxiety-depressive disorders and cerebral residual-organic insufficiency were studied. Psychopathological, psychometric, statistical methods were used., Results and Conclusion: Asthenia was identified as a core syndrome in anxiety-depressive disorders developed in patients with cerebral residual-organic insufficiency. Severe anxiety and depression with somatization of symptoms were characteristic of the structure of affective pathology. The somatization of affect, interpersonal sensitivity, marked asthenic and autonomic disorders as well as negative attitudes about their own condition, abilities and activity were main features of affective disorders in patients with cerebral residual-organic insufficiency. Clinical characteristics of cerebral residual-organic insufficiency and the diversity of its manifestations, including the combination with mental disorders, determine the relevance of further research.

Aim: To conduct a comprehensive examination of patients with controlled hypertension, including assessment of the functional state of the cardiovascular system, vegetative and psycho-emotional status., Material and Methods: The study involved 80 patients (51 men, 29 women) divided into 2 groups: 60 patients with essential hypertension (EH) without concomitant severe pathology and normal blood pressure during the preceding 3 months (group 1) and 20 healthy patients without EH (group 2). Anthropometric parameters (height, weight, body mass index), parameters of central hemodynamic (heart rate, systolic and diastolic blood pressure), vegetative status (vegetative Kerdo index), mental and emotional status (SCL-90R, Leonhard questionnaire, HADS, SF-36, MPQ) were assessed., Results and Conclusion: There were significant differences in the psycho-emotional status between patients with hypertension and patients with normal blood pressure. Significant correlations between anthropometric indicators, the state of the autonomic nervous system and psycho-emotional status of patients with hypertension were shown.

Aim: To study the clinical and neurological manifestations of hemorrhagic stroke (HI) in infants., Material and Methods: The retrospective analysis of case histories of 140 infants with MI hospitalized in the children emergency department is carried out., Results and Conclusion: Clinical manifestations of HI in infants are accompanied by signs of cerebral edema, general cerebral symptoms, meningeal, focal symptoms.

Objective: To analyze surgical treatment of tuberculous pleural empyema in children depending on the stage of the process., Material and Methods: There were 82 patients aged 4-17 years with tuberculous pleural empyema. Clinical and X-ray features of different stages of disease are described. Certain types of surgical interventions at each stage of the process are analyzed., Results: In 72 children with empyema stage III 76 surgeries were performed. Postoperative complications occurred in 2 (2.6%) cases (delayed lung inflation) that required thoracocentesis with pleural drainage. There was no postoperative mortality., Conclusion: Complex treatment of tuberculous pleural empyema in children and adolescents with the use of modern surgical methods is followed by satisfactory outcomes in all patients. However, surgical technique, postoperative morbidity and hospital-stay depend on the stage of the process. Unfortunately, almost 90% of patients had empyema stage III. Therefore, minimally invasive surgery was not advisable and extensive, traumatic surgeries were required.

Programmed cell death is governed by a set of gene networks, which define a variety of distinct molecular mechanisms essential for the maintenance of multicellular organisms. The most studied modality of programmed cell death is known as apoptosis. Caspase-2, as a member of the family of the cysteine-dependent protease, demonstrates both proapoptotic and tumor suppressive functions. This protease plays an essential role in the maintenance of genomic stability and induces apoptotic cell death in response to geno-toxic stress. Here we discuss the molecular mechanisms of caspase-2 regulation and its physiological role as a tumor suppressor and metabolic regulator.

Aim: To identify a role of infection in the development of hemorrhagic stroke (HS) in infants., Material and Methods: A retrospective analysis of case histories of 145 infants hospitalized with hemorrhagic stroke was performed., Results and Conclusion: The analysis of HS risk factors shows the importance of infectious-inflammatory factor both for local and generalized forms of inflammation of the organs associated with disseminated intravascular coagulation, hypocoagulation and an increase in anticoagulant and fibrinolytic potentials.

The authors have described the world's first case of necrotizing sarcoid granulomatosis (NSG) in a 22-year-old woman with the clinical presentations of acute abdomen, which are associated with abdominal lymph nodal infiltration and necrosis, obvious constitutional disturbances (fever, nocturnal sweats, and significant weight loss), high inflammatory activity (anemia, leukocytosis, high erythrocyte sedimentation rates and C-reactive protein levels), the gradual appearance of splenic and hepatic necrotic foci, and infiltration into the lung and lacrimal glands with the development of unilateral uveitis. The patient underwent five surgical interventions, several needle biopsies for recurrent abdominal syndrome, and long-term antibiotic treatment for presumed sepsis, which had caused drug-induced hepatitis. Bacteriological examination of blood, puncture samples, and removed abdominal cavity tissues, serological tests, and immunomorphogical study of biopsy samples and removed tissues yielded negative results for the presence of bacterial, fungal, and tuberculosis infections. NSG was diagnosed on the basis of the systemic nature of the lesion, the presence of granulomas with severe abdominal lymph nodal necrosis and necrotizing granulomatous/lymphocytic vasculitis in the mesentery and removed spleen, as well as the absence of granulomas in the spleen, appendix, and biopsy materials of the liver, colonic mucosa, and parotid gland. Fludarabine therapy was first used in world practice due to the inefficient treatment with high-dose glucocorticoids and cyclophosphamide and to a disease relapse when reducing their doses. The paper gives a detailed review of the literature on the clinical, laboratory, radiological, and morphological manifestations of the disease, which allow the differential diagnosis of NSG with different variants of granulomatous lesions. Based on the 5-year follow-up of the patient and on the analysis of clinical, laboratory, radiological, and morphological changes, the authors uphold the concept that the disease is an independent nosological entity: necrotizing angiitis with sarcoid reactions, rather than the entity of nodular or classic sarcoidosis.

Objective: to give computed tomography (CT)- and magnetic resonance imaging (MRI)-based new anatomic-topographic relationships in patients after combined pancreas and kidney transplantation and to describe main visualization tasks and the types and frequency of various complications occurring in different periods after transplantation. Material and methods. Spiral CT and MRI images were analyzed in 45 patients after pancreas and kidney transplantation. A total of 51 studies (35 CTs and 16 MRIs) using intravenous contrast enhancement (n=34 (66%)) were performed. Results. A total of 55 complications, among which pancreatitis after pancreas transplantation was most common (55%), were found. Necrotizing pancreatitis following pancreas transplantation, which required open operative or percutaneous intervention, was diagnosed in 6.6%. Vascular complications were detected in 22%. Conclusion. The current capabilities of CT and MRI enable us to quickly obtain objective information on the status of transplanted organs, their vascular architectonics, as well as on the presence and type of occurred complications. Timely correction of identified complications positively affects the survival of transplanted organs and quality of life in a recipient.

It has been demonstrated that electroacoustic analysis with polyclonal antibodies can be used for bacteriophage detection. The frequency dependences of the real and imaginary parts of electrical impedance of a resonator with a viral suspension with antibodies were shown to be essentially different from the dependences of a resonator with control viral suspension without antibodies. It was shown that ΦAl-Sp59b bacteriophages were detected with the use of antibodies in the presence of foreign virus particles. The ΦAl-Sp59b bacteriophage content in the analyzed suspension was ~1010–106 phages/mL; the time of analysis was no more than 5 min. The optimally informative parameter for obtaining reliable information was the change in the real or imaginary part of electrical impedance at a fixed frequency near the resonance upon the addition of specific antibodies to the analyzed suspension. It was demonstrated that the interaction between bacteriophages and antibodies can be recorded, offering good prospects for the development of a biological sensor for liquid-phase identification and virus detection.

The main objective of anticancer treatment is the elimination of degenerated cells by the induction of programmed cell death. Various chemotherapy drugs and radiation are able to activate cell death mechanisms in tumors. However, unfortunately, monotherapy will always be insufficiently effective because of the variety and virulence of tumors, as well as their ability to develop resistance to drugs. Moreover, monotherapy might constrain many negative side effects. Therefore, the combination of different approaches and/or drugs will increase the efficiency of treatment. One such promising approach is the combination of nutrient restriction (NR) and various chemotherapeutic drugs. This approach may not only affect the autophagy but also influence apoptotic cell death. This review is focused on the potential of NR use in anticancer therapy, as well as the molecular mechanisms underlying this approach.

Mitochondria participate in various vital cellular processes. Violation of their functions can lead to the development of cardiovascular and neurodegenerative diseases and malignancies. One of the key events responsible for mitochondrial damage-induction of Ca^(2+)-dependent mitochondrial permeability transition, due to the opening of a nonspecific pore in the inner mitochondrial membrane. Despite active studies of pore components, its detailed structure has not yet been established. This review analyzes possible constituents and regulators of the pore, the role of the pore in various pathologies, and hypotheses that explain the organization of the pores. Elucidation of these questions can help developing strategies for the treatment of a wide range of pathologies-from Alzheimer and Parkinson's disease to cancer.

Aim: To find out the factors of satisfaction with psychiatric help in inpatients with neurotic and depressive disorders depending on the moment of satisfaction evaluation and patients' treatment experience., Material and Methods: The sample included 266 first-time admission inpatients (satisfaction was evaluated at the moment of discharge) and 134 rehospitalized inpatients (satisfaction with previous treatment was evaluated at the moment of discharge; satisfaction with current treatment was evaluated at the moment of rehospitalization). The survey was performed using a questionnaire designed for this study. Statistical analysis was performed using multiple regression., Results and Conclusion: Satisfaction with nursing care was the key factor of satisfaction at the moment of discharge among both groups of inpatients (first-time admission and rehospitalization). Psychiatrist's empathy was the 2nd factor by importance. The structure of factors of medical service satisfaction of these 2 groups was different. General satisfaction with psychiatrist's work was the key factor of satisfaction with medical service during previous hospitalization while nursing care was twice less important. In whole, there were major differences in the structure of factors of medical service satisfaction during previous and current hospitalizations. The shift of importance from nursing care to psychiatrist's work and other differences in the structure of factors of satisfaction of rehospitalized patients with medical services can be explained by belonging of medical services to credible goods - patient is able to evaluate results of treatment only some period after discharge.

The authors discussed a methodology of the study of medical service satisfaction and it's factors: moment of assessment, methodology of data collection, format of data, bench-marking, principles of inclusion of questions into a questionnaire, organizing and frequency of conducting studies.

The review gives the current views of the etiology and risk factors of infective endocarditis (IE) in the elderly. It reports the specific clinical picture of the disease at this age, including clinically apparent syndromes, comorbidity, and various clinical signs and peculiarities of IE. Particular emphasis is placed on the diagnosis of an endocardial infectious lesion, which is based on the use of the modified Duke criteria. The methods of IE diagnosis, particularly microbiological examination, imaging techniques, among which echocardiography in different modes plays a particular role, are listed. The treatment of the disease is based on the latest recommendations for antibiotic therapy with and without regard to a specific etiological factor. The issues of surgical intervention, as well as approaches to preventing IE in elderly people are discussed.

The aim of the research is to determine the reasons of post operative nausea and vomiting and to compare the efficiency of taken PONVprophylaxis after adenotonsillectomy with general anesthesia in children. 155 patients took part in the research work at the age from 3 to 10 years, of ASAI-II physical status, who were operated on in planned order because of adenotonsillectomy. The patients were divided into 5 groups according to the type of holding PONV prophylaxis. The 1-st group consisted of 30 patients who were given antiemetic--Metoclopramidum (0.15 mg/kg); the 2-nd group (30 patients) was given ondansetronum (0.1 mg/kg); the 3-d group also consisted of 30 patients who were given Dexamethasone (0.2 mg/kg, but not more than 8 mg); the 4-th included 30 patients who were given Dexamethasone (0.2 mg/kg, but not more than 8 mg) and Metoclopramidum (0,15 mg/kg) as the antiemetic; the 5-th group the test one, included 35 patients who were not given PONVprophylaxis. During the first day after the operation the amount of nausea and vomiting have been estimated, the time of occurrence and the character of vomiting. According to the results of the research the PONV in postoperative period consisted 22.6% in which in 13.6% vomiting with blood was pointed out during coming out from general anesthesia, and in early post operative period (p < 0.01), which is connected with blood swallowing on the phase of awaking or possible postoperative bleeding. According to given prophylaxis the least number of PONV is revealed in the group which was given ondansetronum, and the high frequency of post operative nausea and vomiting was pointed out in the group which wasn't given prophylaxis of PONV.

Objective: To evaluate the damaging effects of cisplatin on MMSCs from adipose tissue in a phase of active proliferation and the state of the monolayer, this was exposed at standard (20%) and reduced to 1% and 5% level of oxygen., Methods: The effect of cisplatin was detected on monolayer cultures in the active growth phase after 2 passages. Profile surface markers of MMSC was determined by flow cytometry. MMSCs viability after incubation with cisplatin was detected by the number of apoptotic and necrotic cells using ANNEXIN V-FITC--PI Kit (Immunotech, France). Standard culture conditions (~20% O₂) were created in a CO₂ incubator (Sanyo, Japan), 5% O₂--using multigas incubator (Sanyo, Japan), 1% O₂--using an airtight chamber (Stemcell Technologies, USA)., Results: Incubation of MMSC monolayer with cisplatin at a concentration of 10 ug/ml for 72 hours leads to death of half of the cells in the culture. Cisplatin increased thefracture of PI⁺-cell, and PI⁺/Ann⁺-cells under all culture conditions. The short-term exposure with cisplatin (24 and 48 hours) did not cause the damaging effect. Effects of cisplatin on the MMSC in the growth phase for 48 hours led to accumulation of Ann⁺-cells and PI⁺/Ann⁺-cells under all culture conditions. However, minimal noci-influence of cisplatin was observed in a culture under hypoxic conditions (1% O₂)., Conclusion: These data suggest that MMSC monolayer dies primarily through necrosis, whereas MMSCs in the growth phase in response to cisplatin treatment dies by apoptosis, regardless the oxygen tension.

The changes in the electro-acoustic parameters of cell suspension due to the interaction of cells with bacteriophages both in a pure. culture and in the presence of extraneous microflora were investigated. It has been found that the specific changes in the electroacoustic parameters of cell suspension under the action of bacteriophage occur only in microbial cells which are sensitive to the bacteriophage studied. It has been established that a sensor unit allows of distinguishing a situation when the bacterial cells are infected with specific bacteriophages of the control experiments and a situation with no introduction of infection. An approximate criterion of the presence of specific interactions of bacteriophages and cells in suspension was developed. In accordance with this criterion the change in electrical impedance of the sensor unit must not be less than - 1%. In control experiments a standard microbiological technique, plating the cells infected with bacteriophages on solid nutrient medium, was used. For the first time the possibility of using the method of electroacoustic analysis for determination of a spectrum of lytic activity of bacteriophages was shown. The results obtained may be used for development of a new express method for determining the sensitivity to bacteriophages of the microbial cells.

Experts of the medical service of the Armed Forces carried out an analysis of capabilities of modern Russian enterprises and their innovative projects regarding creation of unified means of evacuation of wounded and providing to them necessary types of emergency care with the use of existing and future special and regular means of transport for medical evacuation. As a result of the work of industrial enterprises of the OAO Kazan "Vertoletniy Zavod", "Zarechie", "Vysota" was created a device for the medical evacuation of severe wounded patients. The device is designed for medical evacuation of severe wounded patients from the military medical unit to the site providing comprehensive medical care with maintenance of vital functions and monitoring of his condition. Testing was conducted on the products of regular vehicles medical company of one of the brigades of the Western Military District. The device was presented at the special tactical exercises the Armed Forces Medical Service "Frontier-2014", "Innovation Day" of the Defence Ministry in 2014.

Sedation is a controllable level of medication depression of consciousness during which protective reflexes, adequate breathing, and responsiveness to physical stimuli and verbal commands are retained A number of physical and psychological factors affect the psyche of patients in the intensive care unit. Central nervous system (CNS) is a primary target of action of anesthetics and analgesics, and the bi-spectral index reflects the level of sedation of CNS, regardless of what drug caused sedation. The aim of this study was to use volatile anesthetics sevoflurane and isoflurane in children for sedation in the intensive care unit. Constant use of the inhalation route of administration helps to maintain the desired level of sedation depth for the required period of time in patients who are on long-term sedation and is practical for correction.

Materials and Methods: We conducted a comparative evaluation of anesthesia used during tracheal intubation with and without the application of muscle relaxants in cases of adenotonsillectomy in children. Intubation parameters were evaluated according to Cormack-Lehane scale; the presence of cough reflex, limb movement, laryngospasm and desaturation during intubation was also taken into account. The presence of cough, husky voice, and complaints of pain in the throat were recorded in the monitoring report after extubation. We used the MOPS scale to evaluate postoperative pain and discomfort in children., Results: Tracheal intubation in children with adenotonsillectomy without the use of muscle relaxants was successfid in 100% of the cases, despite the fact that, according to the Cormack-Lehane classification, first degree of visualisation of the glottis during direct laryngoscopy was observed in 79.3% of the cases and the second degree was observed in 20.7% of the cases. No significant reactions in the cardiovascular system to the endotracheal tube were noted. The group without the use of muscle relaxants (p < 0.05) experienced earlier extubation and a shorter duration of anesthesia, which in turn contributed to a more rapid activation of the patients. According to the number of post-intubation complications, no significant differences in the two groups were observed. According to the MOPS scale, higher scores (p < 0.05), indicating discomfort in the early postoperative (within the first 15 minutes after the operation) period were observed in the group with the use of muscle relaxants., Conclusions: Thus, the method of tracheal intubation without the use of muscle relaxants can be used for adenotonsillectomy in children.

An interfaced analysis of change of forage vegetation, nutrition of saigas (Saiga tatarica), and their state in tne steppe regions of Russia is performed. It is noted that the percent of graminoids has increased considerably and the proportion of forbs has decreased in the vegetation of current pastures, which has had a negative impact on the nutrition and state of saigas. It is shown that the lower nutritional value of graminoids has caused a decrease in the digestibility of forage used by saigas and does not provide the physiological requirements of the animals. It is established that modern steppe pastures, where gramineous communities prevail, are of little use or absolutely unsuitable for the stable existence of saiga populations. Only separate dwelling places with an abundance of forbs continue to provide adequate nutrition for saigas and well-being for their local groupings.

Objective: Factors of patients' satisfaction with medical care vary depending on the level of care and medical specialty. Patient's satisfaction with psychiatric care is understudied. An aim of the present study is to find out the factors of satisfaction with psychiatric care in inpatients with neurotic and depressive disorders., Material and Methods: The sample included 356 inpatients suffering from neurotic or depressive disorders. The patients were questioned using PAPI questionnaire designed for this study. Statistical analysis was performed using multiple regression., Results and Conclusion: Key factors of satisfaction with medical care included quality of work of nurses and psychiatrists, hospital ward comfort, the number and quality of psychotherapeutic sessions, psychiatrists' empathy and aptitude to provide the patient with information about the disease and treatment. Multiple regression equation explained 81% of the variance of patients' satisfaction.

The satisfaction of patients with medical care determines their consumer behavior. The factors of satisfaction with medical care vary depending on level of its provision and profile of medical specialty. At that, there are only sporadic studies dedicated to factors of satisfaction with psychiatric care. The study was carried out to examine factors of satisfaction with hospital psychiatric care by patients suffering from depressive and neurotic disorders. The sampling consisted of 356 hospital patients suffering from depressive and neurotic disorders. The survey in written form was carried out using originally developed questionnaire. The statistical analysis was implemented by compiling equation of multiple regression. It is established that key factors of satisfaction include functioning of medical nurses of department, functioning of attending physician, comfort of wards, proportions and quality of psychiatric care capability of physician to empathic listening. The developed mathematical model explains 81% of variation of satisfaction with treatment.

The cuticular structure of the horsehair worm Gordionus alpestris (Villot, 1885) was studied under scanning and transmission electron microscopes. Adult worms were collected in the Syuk River near Nickel' Village in the Republic of Adygea (Russia) in June 2013. In the sampling area, the G. alpestris juveniles parasitize diplopods Pachyiulus krivolutskyi Golovatch, 1977. Similarities with other Nematomorpha species with the known cuticle ultrastucture are discussed.

The publications review analyzes factors impacting satisfaction with medical care. The principles of development of questionnaire are substantiated. The sociological instrument is targeted to detect such factors impacting satisfaction with medical care as flexibility in selection of patients, carrying out of focus-groups of in-depth interviews with patients and literature analysis, possibility to combine qualitative and ordinal attributes as well as open questions, comfortability of respondent at the choice of ordinal scale and analysis of inner validity of questionnaire.

The article reviews the process of migration of nociogenic zones and principles of their integrative switching - off from the point of systematic approach and the informational-structural theory of pain. The phenomenon of migration of nociogenic zones underlies the development of clinical manifestations of pain.

The effect of antipsychotic drugs, typical and atypical neuroleptics, is described in the following sections of this paper: antipsychotic drugs and carbohydrate metabolism, prevention and risk factors, pharmacoepidemiology, treatment. It is concluded that neuroleptic treatment increases the risk of metabolic impairment. Mechanisms of this effect are not clear so far. Ethnicity, sex, age and features of the therapy may play a role. Clozapine, olanzapine, ziprasidone, sertindole and some typical neuroleptics are risk factors as well. Common glucose-reducing drugs as well as prevention of metabolic impairment and special behavioral training,including the control over the level of glycemia, are used in treatment of diabetes mellitus induced by neuroleptics.

Apoptosis (programmed cell death) is essential machinery for multicellular organisms. Apoptosis plays an important role in cell differentiation, damaged cell elimination and immune system homeostasis. This review is focused on various mechanisms of signal transduction through caspase-2 which believed to be one of the most enigmatical protease involved in apoptosis. Caspase-2 is activated upon stimulation by such agents as genotoxic stress, death receptors ligation, ER stress, metabolic changes, etc. In addition, caspase-2 may act as a tumor suppressor and has been implicated in cell response to oxidative stress and neurodegenerative progression during ischemic brain damage. Thus, variety of signal pathways triggered by caspase-2 place this protease apart from other members of the family and suggests a prominent role in apoptosis. Here, we analyse different functions of this unique caspase and discuss possible applications of accumulated knowledge in advanced oncology and medicine.

To study changes in attention and executive functions during psychopharmacotherapy in patients with paranoid schizophrenia, we have examined 120 patients with a first episode of paranoid schizophrenia treated with typical and atypical neuroleptics. Clinical and statistical analyses have revealed the heterogeneity within treatment groups that allowed to define two subgroups. These subgroups were characterized by a differed disease course (favorable or poor type). Before remission was achieved, the effect of atypical neuroleptics on cognitive performance was higher compared to typical neuroleptics. After remission, when doses of neuroleptics were decreased, a type of disease course played a main role. At 6 months after remission, attention and executive functions have improved in subgroups with favorable course of disease regardless of treatment.

The article deals with skills improving problem of epidural anaesthesia with ultrasound control. Methods of gelatin spinal column model making, use and its economical side are discussed in the article.

Objective: to optimize the diagnosis of different stages of Paget's disease, by determining the extent of bone structural lesions in the cerebral and visceral cranium on the basis of computed tomography data., Material and Methods: Computed tomographic data were assessed by keeping in mind the structure, density, outlines, shadow shapes of the described tumor-like disease and the state of involved bone structures. Twelve patients with histologically verified Paget's disease were examined., Results: The findings allowed the high informative value of computed tomography in diagnosing different stages of Paget's disease to be estimated in bone structural lesions in the cerebral and visceral cranium and skull base. Also, the obtained computed tomography data permitted the tracing of the extent of the lesion in the area under study.

The phage mini-antibodies to bacterial cells of strain Azospirillum brasilense Sp245 were obtained and the possibility of using them for detection of microbial cells by means of a lateral field excited piezoelectric resonator was studied. It has been found that the frequency dependencies of the real and imaginary parts of the electrical impedance of the resonator loaded by the cell suspension A. brasilense Sp245 with the mini-antibodies, significantly differ from those of the resonator with the control cell suspension without mini-antibodies. The concentration limit of possible determination of the microbial cells in their interaction with the mini-antibodies is equal to 10(3) cells/ml. It has been ascertained that detection of A. brasilense Sp245 cells using the mini-antibodies is possible even in the presence of other cultures, for example, E. coli BL-Ril and A. brasilense Sp7 cells. Therefore, it has been shown for the first time that detection of microbial cells by an electro-acoustic sensor is feasible.