Search

This work is a comparative analysis of the experience of the legal regulation of public relations in counteracting the development of epidemics (pandemics) in the USSR and the Russian Federation. It is considered in the context of the legal formulation of a model of socially useful behavior of an individual. The model of socially useful behavior of an individual under conditions of the threat of epidemics in the USSR was normatively formed by the 70s80s and included the traditional law-abiding and active components. The first was based on the populations knowledge of the normatively fixed rules of action in the event of foci of the spread of specific diseases. The second was associated with the involvement of the public in the direct implementation of anti-epidemic measures. It is revealed that the current Russian legislation does not create sufficient legal prerequisites for forming of a legal model of socially useful behavior of an individual. The circumstances that led to such a situation are indicated. It was concluded that it is necessary to accumulate its inherent restrictions and prohibitions in the uniform federal Rules of conduct for citizens and activities of organizations under the threat of epidemics of dangerous diseases with the provision of the states of the Russian Federation with the right to authorize their application to create legal prerequisites for the formation of a traditional law-abiding model of socially useful behavior of an individual. Forming a legal model of socially active behavior of an individual requires the definition of legal forms and the permissible degree of public participation in preventive work by analogy with the extensive Soviet experience. In contrast, the incentives for useful behavior should be a ramified system of legal guarantees in the fields of labor, social security, education, and related areas, and their interrelationships.

The wide prevalence of inflammatory vaginal diseases in women of different ages, a significant deterioration in the quality of life due to their presence, as well as an adverse effect on conception and the course of pregnancy make the search for more efficient and safe therapy of vaginitis an urgent issue. The article presents the results of experimental staphylococcal vaginitis treatment with probiotics and autoprobiotics in rat models, including hormonized animals after ovariectomy. The effectiveness of topical application of the probiotic strain E. faecium L3 in rats has been confirmed. The probiotic proved to be effective both in rats with a hormonized cycle and in rats with preserved ovaries. Among the tested autoprobiotic and homologous (rat) strains, the elimination of staphylococci occurred faster after the introduction of bifidobacterial. However, lactobacilli are more reliable in protection against the recurrence of infection. At the same time, homologous strains of both lactobacilli and bifidobacteria contribute to faster elimination of the pathogen compared to autostamps.

The withdrawal of lands from active agricultural use and their overgrowth with woody vegetation have a steady trend in Russia, especially in the boreal zone. Studying the plantations developed on fallow lands of agricultural territories enables estimation of their resource potential for further use. The aboveground phytomass of vegetation is the most reliable indicator of habitat productivity. It is possible to determine the volume of carbon storage by assessing the phytomass of tree and shrub vegetation, which is relevant in the context of global climate change. The study object was a field out of active agricultural use in the Gatchina district of the Leningrad region. A trial area was laid out on the test site, where a complete enumeration of native hardwoods (birch, aspen, tree and shrub willows) with the determination of the basic inventory indicators was carried out. In order to find out the volume of phytomass, from 6 to 8 model trees of each species were cut down. Allometric equations for calculating the fractional composition of phytomass with a high determination coefficient were derived based on the data obtained on the values of individual fractions of the trunk ground part. The accuracy of the derived equations is reduced due to the high variability of crown characteristics in dense deciduous young growth. The highest phytomass is in the trunk part, and the lowest in the assimilation apparatus for all species of woody vegetation. Calculation of aboveground phytomass on the test site according to the obtained equations showed that the highest value per 1 ha at this successional stage is typical for downy birch. Currently, the participation of woody vegetation growing on post-agrogenic lands in carbon sequestration has no reliable full assessment for the study region. Wood that was grown on lands out of active agricultural use can serve as a biofuel source and be harvested in the form of technological chips.

The results of a complex interpretation of seismic and gravity data along a part (500 km long) of the 3DV profile located in the transition zone from the Siberian Platform to the Verkhoyano-Kolyma fold system are considered. It crosses the Priverkhoyansk advanced trough, the Sette-Daban tectonic zone with access to the folded region [Tectonics…, 2001; Kashubin et al., 2016]. The structure of the crust of the eastern margin of the Siberian craton is interest, which, according to structural and tectonic criteria, belongs to the Mesozoic passive continental margin [Parfenov, 1991; Sokolov, 1991; Tectonics..., 2001] in order to find signs of superimposed folding in the structure of the Earth's crust according to seismic and gravitational data. The depth of the crystalline basement in the Priverkhoyansk trough is also debatable, depending on the nature of the rocks at a depth of 18–23 km at a velocity of 6.2–6.3 km/s, possibly belonging to the Proterozoic.

The purpose of this article is to analyze the domestic and foreign experience of forming a cluster structure and determine the possibilities and prospects of its use as a tool for increasing energy efficiency and establishing energy independence. Submission of proposals for the formation of an energy cluster in the Luhansk region under the name "Luhansk Energy Center". Determination of the features of the energy cluster, substantiation of its advantages and disadvantages, the structure and participants are proposed, the main types of activities are indicated, and proposals for the way of strategic development are provided. Methodology. Today, the formation of a cluster structure in Ukraine is a necessary condition for the activation of domestic production, increasing the efficiency of innovative development, achieving high indicators of economic growth, energy efficiency, energy security and energy independence. Information about the specifics of the development of countries and regions can help to understand the role of clusters, thereby creating a competitive advantage. Results. Clusters are the basis of an innovative economy and a form of economic activity, and their importance is growing, an example of which is the application of the concept of clusters in the development of renewable energy. Their multi-level structure makes it possible to conduct constant research, implement the most complex projects, including international ones, maintain business competitiveness and protect its interests. One of the main reasons for the urgency of the Ukrainian cluster is the globalization and restructuring of the economy, increasing competitiveness, access to foreign markets, partnership with investors and funds, investment attraction, etc. Cluster activity can depend on individual fields or a combination of several fields. Practical implications. As research shows, a big role in the activation of innovation belongs to renewable energy. Formation of new innovative centers of social economic development of the region should be carried out on the basis of cluster development of energy infrastructure tours according to the target function, namely energy recovery type provision. Most often, regional division in countries forms has existed historically for a long time, but it is not always takes into account all economic, technological, geographical physical features. Today there are new theoretical ones and practical knowledge, management mechanisms, with the help of with the help of which different fields are directed and combined technical and technological, economic and social overall progress Value/originality. The main goal of the selected research is to determine the role of various institutions in the formation of the Luhansk energy cluster for the effective development of the region in the energy sector, as well as to confirm the possibility of using cluster systems in the context of ensuring an energy-efficient Ukrainian economy based on energy independence.

The study aims to analyze the representation of the Soviet Union in two Arab novels, “Ice” (2011) by Egyptian Sun‘allah Ibrahim and “Time of the Red Reed Pipe” (2012) by Kuwaiti Thurayya al-Baqsami. Within the vast expanse of the Arab “emigrant” literature one can find relatively few works of fiction that have to do with the USSR despite the fact that in the 1960-1980s thousands of Arab students studied in the country. Among a couple dozen Arab writers who wrote some fiction about the USSR very few spent more than a couple of months in the country, and their works, as a rule, present idealized and rather superficial images of the Soviet Union. Unlike these authors, Sun‘allah Ibrahim and Thurayya al-Baqsami spent in the 1970s quite a long time in Moscow in the status of ordinary students, and for this reason their novels present a much more realistic picture of the Soviet Union. Without any noticeable warmth towards their Soviet hosts, the writers consider many negative features of Soviet social and economic life as commodity shortage, low quality of Soviet goods and services, illegal currency operations, etc. The two authors’ representations of the Soviet Union stand in contrast to the Soviet’s own idea of how the people from the developing countries perceived the “country of victorious socialism.”

This document was produced with the support of the National Medical Association for the Study of Comorbidities (NASС). In 2021 the first multidisciplinary National Consensus on the pathophysiological and clinical aspects of Increased Epithelial Permeability Syndrome was published. The proposed guidelines are developed on the basis of this Consensus, by the same team of experts. Twenty-eight Practical Guidelines for Physicians statements were adopted by the Expert Council using the "delphic" method. Such main groups of epithelial protective drugs as proton pump inhibitors, bismuth drugs and probiotics are discussed in these Guidelines from the positions of evidence-based medicine. The clinical and pharmacological characteristics of such a universal epithelial protector as rebamipide, acting at the preepithelial, epithelial and subepithelial levels, throughout gastrointestinal tract, are presented in detail.Документ создан при поддержке Национальной медицинской Ассоциации по изучению Сочетанных Заболеваний (НАСЗ). В 2021 г. опубликован первый национальный междисциплинарный консенсус, посвященный патофизиологическим и клиническим аспектам синдрома повышенной эпителиальной проницаемости. Предлагаемые рекомендации разработаны на базе этого консенсуса, тем же коллективом экспертов. Двадцать восемь положений практических рекомендаций для врачей приняты экспертным советом дельфийским методом. В рекомендациях с позиций медицины, основанной на доказательствах, рассмотрены такие основные группы эпителий-протективных лекарственных средств, как ингибиторы протонной помпы, препараты висмута, пробиотики. Детально представлены клинико-фармакологические характеристики такого универсального эпителиопротектора, как ребамипид, действующего на преэпителиальном, эпителиальном и субэпителиальном уровнях на всем протяжении желудочно-кишечного тракта.

Objective: to analyze the effectiveness of rehabilitation of high-class athletes under the influence of a complex of physical factors. Material and methods: the data of the dynamic state of 75 high-class athletes who train mainly for the development of the qualities of dexterity, speed and strength during rehabilitation and rehabilitation measures were analyzed. To control the complex impact of physical factors, along with functional research methods, a digital pain rating scale (NRS) was used. Results. After the influence of physical factors, a significant improvement in the physical and psycho-emotional state of patients was noted. The athletes were able to return to full-fledged training. Conclusion. The rehabilitation effect of physical factors under the objective control of subjective assessments of individual pain sensitivity makes it possible to effectively control the functional state of athletes. Цель: анализ эффективности реабилитационных мероприятий в спорте высших достижений при комплексном подходе в условиях специализированных физиотерапевтических воздействий. Материал и методы: анализировались данные динамического состояния 75 спортсменов высокого класса, тренирующихся преимущественно на развитие качеств ловкости, быстроты и силы, в ходе реабилитационно-восстановительных мероприятий. Для контроля комплексного воздействия физических факторов наряду с функциональными методами исследования использовалась цифровая рейтинговая шкала боли (Numeric rating scale for pain - NRS). Результаты. В результате воздействия физических факторов отмечено значительное улучшение физического и психоэмоционального состояния пациентов. Спортсмены смогли вернуться к полноценным тренировкам. Заключение. Реабилитационное воздействие физических факторов под объективным контролем субъективных оценок индивидуальной болевой чувствительности позволяет эффективно контролировать функциональное состояние спортсменов.

INTRODUCTION. The heterogeneity of the population of patients with perforated ulcers determines the need for a targeted research of the results of their treatment, including taking into account the level of comorbidity.OBJECTIVE. To study the results and develop a predictive model of surgical treatment of perforated ulcers, taking into account the comorbid status of patients.METHODS AND MATERIALS. The results of treatment of 194 patients with perforated ulcers of the stomach and duodenum were studied. Stratification of patients was carried out taking into account the Charlson-Deyo comorbidity index. The construction of prognostic models was carried out using binary logistic regression.RESULTS. Depending on the level of comorbidity, during a posteriori comparisons, the incidence of postoperative complications in the third group (46.7%, 28/60) was statistically significantly higher compared to the first (22.8%, 13/57) and second groups (16.9%, 13/77) (χ2 = 15.908, pIn a comparative analysis, a prognostic model taking into account the comorbid status of the patient predicted the development of postoperative complications and mortality with the greatest accuracy.CONCLUSION. Taking into account the comorbid status of patients with perforated ulcer makes it possible to predict with greater accuracy the development of postoperative complications of III-V degree according to Clavien-Dindo.

BACKGROUND: Bacteria in the gastrointestinal tract regulate eating behavior and metabolic processes. A number of probiotic strains have a positive effect on glucose and insulin metabolism. A series of studies have demonstrated the effectiveness of autoprobiotic therapy in the treatment of patients with gastrointestinal diseases. The efficacy and safety of an indigenous strain of Enterococcus faecium in overweight patients with type 2 diabetes has not been studied in the past. AIM: To evaluate the effectiveness of products containing the probiotic strain Enterococcus faecium L3 or the indigenous strain Enterococcus faecium in patients with diabetes mellitus (DM) type 2. MATERIALS AND METHODS: Patients with diabetes mellitus type 2 were randomized into two groups: group of probiotic therapy with an industrial strain of Enterococcus faecium L3 (11 patients); group of autoprobiotic therapy based on an indigenous strain of Enterococcus faecium (9 patients). Therapy was for 14 days. Before and 10-14 days after the end of therapy, anthropometric parameters were assessed; psychometric testing was carried out; biochemical parameters of blood serum were studied. The intestinal microbiota was studied by real-time polymerase chain reaction. RESULTS: Probiotic therapy based on Enterococcus faecium L3 and autoprobiotic therapy based on indigenous Enterococcus faecium had no significant effect on glucose metabolism in patients with type 2 DM. In the Enterococcus faecium L3 group and the group of indigenous Enterococcus faecium there was a significant decrease in gastroenterological complaints on scales of the GSRS questionnaire. Patients in both groups showed a statistically significant decrease in the total bacterial mass, an increase in the quantitative content of Lactobacillus spp., a decrease in the population of Bifidobacterium spp. and Bacteroides thetaiotaomicron. CONCLUSIONS: The probiotic strain Enterococcus faecium L3 and the indigenous Enterococcus faecium do not have a significant effect on the metabolism of glucose and insulin, while they contribute to a similar change in the component composition of the microbiota and a decrease in the severity of gastroenterological complaints.

Despite the significant prevalence of shoulder-scapular periarthrosis, methods of its early diagnosis remain insufficiently developed. The study aims to clarify the possibility of using osteodensitometry for early diagnosis of shoulder-scapular periarthrosis. We examined 70 men (the main group) with a diagnosis of shoulder-scapular periarthrosis without disorders of the function of the shoulder joints, which corresponded to the initial stage of the disease. The comparison group consisted of 78 patients with diagnosed osteoarthritis of the shoulder joints with moderate recurrent algic syndrome without limitation of the volume of movements; the control group consisted of 112 practically healthy men. The age of all examined men were 30-50 years. In addition to clinical and functional examination with neuro-orthopedic examination and radiography of the shoulder joints, the researchers conducted the mineral density of the bone tissue of the head of the humerus according to the results of digital radiography with a wedge-standard density. This method has a high accuracy in determining the mineral density of bone tissue, does not have an additional load and allows you to get the desired information. In the examined main group, in the absence of bone changes on the shoulder joint radiographs, experts have identified a significant decrease in the mineral density index in all zones of the upper sector, maximally expressed in the lateral zone of the humerus head in relation to the results of the control group. Patients in the comparison group also showed a significant decrease in this indicator in relation to the indicator of the control group. The decrease in bone mineral density in patients with osteoarthritis exceeded the decrease in similar indicators in individuals with shoulder-scapular periarthritis, however, there was no significant difference in these cases. The obtained results of the study allow us to conclude that the applied osteodensitometry makes it possible to detect a local decrease in bone mineral density in articular structures at the early stages of their formation, resulting from damage to the soft tissues of paraarticular structures, due to the unity of the response of the ligamentous-articular apparatus. Ethics. This study did not require the conclusion of the Ethics Committee.

Significant differences in the layered-block structure of the earth's crust and the upper mantle, expressed in the distribution of localized seismic inhomogeneities of the Aldan and Stanovoi blocks and the zone of their junction, are revealed. A laterally inhomogeneous near-surface two-layer structure with a velocity of 3.8-4.5 and 5.0-5.9 km/s at thicknesses of 0.3-1.0 and up to 2-4 km has been established, which overlaps the Early Precambrian basement of the shield with a velocity of 6.0-6.3 km/s. The crust in the Stanovoi block and the adjacent Central Aldan folded belt is represented by a two-layer, and in the Aldan block by a three-layer models. The zone of the Stanovoi Ridge separating them is characterized by exceptionally contrasting velocity inhomogeneities, which correlate with a step-like increase in the depth of the Moho from 40 to 50 km.

Background. Gastric cancer is the world 5th top malignancy, with treatment success largely conditioned by comorbidity. Patients with end-stage renal failure developed with chronic kidney disease could not expect a specialty cancer treatment before the advent of long-term haemodialysis.Aim. A case description of successful perioperative therapy and surgery in a long-term haemodialysis patient performed by a multi-specialty team of oncologists and transplantologists.Materials and methods. We case-illustrate surgical treatment options in a gastric cancer patient with long-term haemodialysis.Results and discussion. A specialty oncological treatment of end-stage renal failure patients requiring long-term haemodialysis is a complex multidisciplinary task feasible in hospitals equipped for different haemodialysis regimens. The treatment plan should be laid out by a multi-specialty team, as chronic kidney disease influences the choice of the drug class, dosage and administration mode. Moreover, such patients need laboratory (control of acid-base balance, haemoglobin, electrolytes, creatinine and urea) and clinical (body weight, liquid balance, etc.) monitoring.Conclusion. Perioperative management studies in gastric cancer and chronic kidney disease-comorbid patients under long-term haemodialysis is a promising area of combining eff ort in oncology and transplantation science. Further research is needed in this topic for data enrichment and analysis in complex comorbidity patients.

The aim of the study– to evaluate the parameters of left atrial myocardial strain in patients with atrial fibrillation who underwent electrical and drug cardioversion.Materials and methods.The study included 118 patients of the University Clinical Hospital No 1 of the First Sechenov Moscow State Medical University. The analysis was carried out in three groups of patients: group 1 (n=54) – patients with atrial fibrillation who underwent electrical cardioversion; group 2 (n=31) – patients with atrial fibrillation who underwent drug cardioversion; group 3 (n=43) – patients without a history of atrial fibrillation. The clinical and anamnestic data of the medical history of each patient, as well as ultrasound indicators were evaluated: global strain of the left atrial, the values of negative peaks as a reflection of the left atrial systole and the values of positive peaks as a reflection of the filling of the left atrium, LASI – the left atrial stiffness index.Results.The analysis showed that left atrial strain in patients with atrial fibrillation were reduced in all analyzed parameters: negative strain peaks (-9.00 vs. -12.6 in the control group, pConclusions.The indicators of left atrial strain were significantly reduced, and the left atrial stiffness index was significantly increased both in the group with electrical cardioversion and in the group with drug-induced cardioversion, compared with patients with similar cardiovascular pathologies, but without a history of atrial fibrillation episodes.

The legal and ethical regulation of medical activity in Russia vs. European countries has common features and a number of specific differences. The regulation of medical activity in the Old Russian state and European medieval states was carried out within the framework of legal norms and Christian worldview, the main principle of which was service to one’s neighbor. For instance, these were ethical issues that came to the fore. The secular state form, began its historical path with the emergence of the first secular doctors at the courts of ancient Russian princes. From the 16th century on, it became part of the state apparatus extending its influence to the social estate of the military servicemen. In the middle of the 19th century, during the period of the Zemstvo Reform, it became the main form of servicing rural population. The specificity of zemstvo medicine was the organization of medical activities based on of local self-government bodies and medical societies. At the beginning of the 19th century, with the increasing complexity of scientific knowledge and organization of medical services, European medical codes of ethics aimed at developing the rules of conduct to be followed by the members of newly emerging national medical associations. Despite regulating medical activity, the issues of healthcare were not given due attention, and there were no specific legislative acts affecting the health care regulation in prerevolutionary Russia. In Europe, too, for a long time, the responsibility of a medical professional for mistakes was considered from the standpoint of private relationships based on contractual and commercial principles.

The efficacy of a new photosensitizer of chlorin E6 conjugated with a prostate-specific membrane antigen (PSMA) in photodynamic therapy of murine melanoma B16 was studied in in vivo experiments. The dynamics of photosensitizer accumulation in the tumor and surrounding tissues was evaluated and antitumor efficacy of photodynamic therapy was assessed by parameters of regression and morphological characteristics of experimental transplanted melanoma B16. The inhibitory effect of photodynamic therapy on melanoma was evaluated by complete regression of the tumor, absolute tumor growth coefficient in animals with continuation of tumor growth, and the increase in life span in comparison with the control; the criterion of cure was the absence of signs of tumor recurrence in mice within 90 days after therapy. The therapeutic potential of photodynamic therapy was determined by devitalization of tumor cells (histological examination of the zones of laser exposure on day 21 after treatment). The photosensitizer with PSMA-ligand exhibited high antitumor activity in photodynamic therapy for melanoma B16. Photodynamic therapy carried out at the optimum time after photosensitizer injection with experimentally determined parameters of laser exposure allows achieving the maximum inhibitory effect on melanoma. Pathomorphological study in the zones of exposure detected no survived tumor cells.

Polybrominated diphenyl ethers (PBDE) are a group of flame retardants used in a variety of artificial materials. Despite being phased out in most industrial countries, they remain in the environment and human tissues due to their persistence, lipophilicity, and bioaccumulation. Populational and experimental studies demonstrate the male reproductive toxicity of PBDEs including increased incidence of genital malformations (hypospadias and cryptorchidism), altered weight of testes and other reproductive tissues, altered testes histology and transcriptome, decreased sperm production and sperm quality, altered epigenetic regulation of developmental genes in spermatozoa, and altered secretion of reproductive hormones. A broad range of mechanistic hypotheses of PBDE reproductive toxicity has been suggested. Among these hypotheses, oxidative stress, the disruption of estrogenic signaling, and mitochondria disruption are affected by PBDE concentrations much higher than concentrations found in human tissues, making them unlikely links between exposures and adverse reproductive outcomes in the general population. Robust evidence suggests that at environmentally relevant doses, PBDEs and their metabolites may affect male reproductive health via mechanisms including AR antagonism and the disruption of a complex network of metabolic signaling.

The surface of cellulose acetate (CA) films has been modified by gas–liquid fluorination. The treatment has been carried out with a fluorinating mixture (10 vol % F2 + N2) in a perfluorodecalin medium in a flow reactor for 30, 60, and 120 min. Film samples have been studied using X-ray diffraction and IR spectroscopy. It has been shown that the general appearance and position of peaks in the diffraction patterns of the initial and fluorinated CA samples are almost the same, indicating the absence of a significant effect of treatment on the phase composition of the film samples. On the contrary, according to IR data, there is an increase in the concentration of fluorine-containing and hydroxyl groups in the fluorinated CA layer. SEM images of cross sections of fluorinated films have confirmed their layered structure. The transport parameters of the films with respect to He, H2, O2, CO2, and CH4 have been also determined experimentally. The gas permeability has been found to monotonically decrease with an increase in the fluorination time and to increase with an increase in the size of the penetrant molecule. Direct fluorination also leads to an increase in O2/N2, CO2/CH4, N2/CH4, He/CH4, H2/CH4, and He/H2 ideal permselectivities compared to those of the unmodified cellulose acetate film. The data points for fluorinated CA films on the Robeson plots for these gas pairs approach the 1991 upper bound, whereas those for the virgin polymer are located in the middle of the plots.

The article provides data from studies conducted on the basis of the Saratov State Medical University on the prevention of respiratory diseases using physiotherapy and exercise therapy. In the course of the measures taken, a decrease in the incidence rate among children of this group was noted.

The article selects and analyzes scientific literature sources and regulatory documents on the reconstruction of public spaces within the boundaries of coastal territories. It analyzes global experience in the reconstruction of embankments and the modern specifics of urban development of coastal areas in terms of the relationship of coastal areas with urban development. It investigates the architectural and planning problems of embankment spaces and the problems of their reconstruction. It formulates the principles of reconstruction of public spaces of the coastal territories of the locality. It provides practical recommendations for their use. It analyzes the history of the development and current state of the embankment of the urban-type settlement of Chernomorskoye in the Republic of Crimea. It provides proposals and recommendations for the reconstruction of the specified embankment urban-type settlement of Chernomorskoye. On the basis of the conducted research, an experimental design model for the reconstruction of the embankment of urban-type settlement of Chernomorskoye is proposed.

Evidence from patients in the intensive care department of a multifield hospital treated for COVID-19 associated pneumonia with or without the use of a heated heliox mixture points to the beneficial effect of the mixture in the complex therapy of the disease. Comparative analysis of the clinical symptoms and laboratory data of the patients who received the heliox therapy and who did not (controls) testifies that heliox improves blood oxygenation, returns acid-base balance to normal, maintains dynamics of key pamaters positive and, therefore, increases effectiveness and shortens time of treatment. © 2021 Slovo Ltd. All rights reserved.

Recently collated scientific data on the management of C1 clinical class of chronic venous disorders; wide prevalence of the disease and high variability amongst medical practitioners in relation to managing this category of patients and absence of any regulatory documents has prompted the development of clinical guidelines for the treatment of patients with reticular varicose veins and telangiectasias of the lower extremities and various parts of the body. These guidelines have been developed by a self-regulated organization Association “The National College of Phlebology”. The purpose of the de novo guidelines is to systematize the existing evidence and offer minimal standards of care for chronic venous disorders in C1 patients.

Hemodynamics was studied in essentially healthy resting 8 male subjects exposed to an experimental hypomagnetic environment (HME). The cardio-respiratory system functioning was evaluated by 8-hour continuous monitoring of heart rate (HR), blood pressure (BP) fluctuations during every cardiac cycle, Kerdo autonomic index (KAI) and blood oxygenation (SpO2) in the Earth's natural magnetic field and a field attenuated in approximately 1,000 times. Comparative analysis of the measurements made in the control and HME tests elicited different trends. Thus, the HR average reduction amounted to 4 bpm; BP dropped significantly, i.e. diastolic BP by 11 mmHg and systolic BP, 16 mmHg on average. In HME, KAI rose commonly 20 %. Hemoglobin saturation did not change. The paper contains graphic interpretations of the KAI dependence on duration of the HME exposure. Mathematical modeling suggests a physiological interpretation of these results. More often than not sitting at rest in HME reduced substantially the modulating effect of parasympathetic regulation on the cardiovascular system in comparison with the control test in the normal geomagnetic field.

Introduction. Varicose disease of the lower limbs (VDLL) is an independent disease and is an important medical and social problem due to its widespread and tendency to progress among people of working age and mainly in the female half of the population. Features of professional activity are risks in the form of static loads of a constant nature or weightlifting and other risk factors (for example, genetic predisposition, hormonal imbalance during pregnancy and menopause, obesity, diabetes mellitus, hypercoagulation, treatment with hormonal drugs, irrational nutrition, alcohol abuse, the presence of osteopenia and osteoporosis (OP). A feature of the disease is the presence of concomitant (often combined) pathology of the musculoskeletal system, which is characterized, as a rule, by early manifestation, relatively rapid progression, and complicated course. Radiologically, relatively often revealed pathology of the feet (flat feet, hallux valgus and deformity of the 1st finger) and degenerative-dystopian changes in the spine (osteochondrosis, spondyloarthritis, spondylosis, scoliosis, kyphosis). The most pronounced combined pathology of the musculoskeletal system is observed in patients with active trophic disorders. Considering the comorbidity of the disease, changes in regional hemodynamics and microcirculation in the lower limbs undoubtedly affect the indicators of hemostasis, carbohydrate, lipid and mineral metabolism. Therefore, a significant interest to improve the diagnosis of OP are often present in the form of a clinical syndrome, which is characterized by decrease in bone density, a violation of their micro-and increased fragility, due to the metabolic disorders of bone tissue with a predominance of catabolism over the processes of bone formation and increased risk of fractures. The state of bone mineral saturation, in particular in the female half of the population, depending on the severity of venous insufficiency remains insufficiently studied. Treatment of VDLL and its concomitant OP syndrome is not always a solvable problem, so the optimization of the diagnosis of this disease, especially at the initial stages, as well as in the process of dynamic monitoring and control of the effectiveness of therapeutic and preventive measures remains relevant. The aim of the study was to study the diagnostic possibilities of using radiometry (radiocomparametry and digital osteodensitometry) for precision assessment of mineral saturation of the spongy structure of the calcaneus in patients at risk for the appearance and development of VDLL. Materials and methods. As part of the general clinical examination, special comparative X-ray studies of the state of mineral saturation and dimensional characteristics of bone trabeculae of the spongy structure of the calcaneus were performed in 129 women with clinical signs of VDLL, which in accordance with the international classification of CEAP were divided into stages: C1 - 36 people, C2 - 32 people, C3 - 39 people, C4 - 30 people, C5 - 22 people. The comparison group included 119 practically healthy women, comparable to the main group by age, work experience and morbid history. The X-ray diagnostic complex included, in addition to convective (routine) radiography of various parts of the osteoarticular apparatus, performed only according to indications, the following methods: interactive radiography (digital low-dose radiography) of the foot with a calibrated wedge-a standard of density, a posteriori testometric X-ray parametry of bone trabeculae of spongy structures of the calcaneus. Modern equipment was used: digital X-ray diagnostic complexes DR-(GEBrivo), AXIOMLuminas (Siemens), dichromatic osteodensitometer "PRODIGY" (Lunar). Results. As part of the general clinical examination, X-ray examinations were performed before the implementation of therapeutic measures and after 24 months. Radiometric indicators of mineral saturation and thickness of trabeculae of the spongy structure of the calcaneus showed a direct dependence on age, reaching maximum values in the age category of 25-30 years with a clear tendency to decrease in older age groups. The mineralization parameters relative to the control were initially reduced, revealing variability depending on the severity of the main pathological process (from relatively high at C1 to relatively low at C5). There was also a pattern of increasing levels of mineralization and thickness of bone trabeculae depending on the period of observation (in fact, on the volume of complex therapeutic and preventive measures) in almost all patients, but mainly in groups C4, C5. Subjective symptoms and objective clinical picture of the condition of the examined patients with the presence of VDLL and OP syndrome correlated with the data of osteorentgenometry. Conclusions. The examined women, whose production activity makes them belong to the risk group for the appearance and development of VDLL, have a opioid structure of the calcaneus. The use in complex clinical and radiological diagnostics of the methodical technique of precision assessment of mineral saturation in (mg/mm 2 ) and thickness of bone trabeculae (mm) makes it possible to objectify the reconstruction of the bone structure at the submacroscopic level of its visualization. Quantitative densitometric indicators of changes in the spongy structure of the calcaneus can be considered as markers of the severity of the condition and the direction of the course of VDLL with concomitant OP. Postprocessing radiometry the calcaneus performed on digital radiographs and the screens of computers using programs "LINS MAKHAON workstation of the DOCTOR" available, not associated with additional radiation exposure and, therefore, can be widely applied both at the stage of primary diagnosis of the health status of the studied patients and in monitoring the effectiveness of remedial measures.

Currently, the problem of reducing the risk of developing fat liver hepatosis from exposure to household and industrial toxicants among the working-age population continues to be an important medical and social problem, since not timely diagnosis of the disease can lead to its progressive course with the development of inflammatory changes, necrosis and liver fibrosis up to cirrhosis and hepatocellular cancer. In this regard, the search for methods and techniques that optimize the diagnosis of fat hepatosis is relevant. Modern methods of radiation diagnostics of liver density characteristics can significantly reduce subjectivity in the assessment of changes due to the use of quantitative indicators. The aim of study - improving the quality of x-ray diagnostics of fat liver disease based on a precision assessment of the density of the liver parenchyma using computed tomography. A comparative retrospective analysis of the results of a comprehensive clinical and radiological examination of 115 men of working age in the range of 40-55 years was performed. The main group (48 people) - employees of machine-building plants: shapers, stumpers, fitters-assemblers who had industrial contact with such factors as local vibration, dust, noise, muscle strain, burdened with a long alcoholic history and the presence of signs of metabolic syndrome: hyperlipidemia, impaired tolerance to carbohydrates, diabetes, abdominal obesity. The comparison group included representatives of auxiliary professions without clinical signs of pathology (47 people), comparable in age and experience with the main group. X-ray examinations were performed using computer tomographs: "HI Spead CT/e Dual" by GE Medical Systems and "Aqulion 64" by Toshiba. To measure the liver density in Hounsfield units (HU), the ROI (zone of interest) tool was used, which allows determining the desired value over areas of different dimensions. Measurements were performed on computer screens in 4 zones of interest at 4 levels of scanning of the liver lobes (apex, level of the caval gate, level of the left lobe, level of the portal gate) with the calculation of the average values of the density index (IDH) and density gradients (IDG) relative to the aorta, spleen and kidney. Analysis of the results of a posteriori CT densitometry of various parts of the liver within the framework of the developed algorithm, including the use of absolute and relative (gradient) x-ray density indicators of hepatic, vascular (aorta),splenic and renal structures, allowed us to expand our understanding of the quantitative density characteristics both in normal and in patients with signs of diffuse fat hepatosis (FH). It was found that the liver parenchyma density indicators can be a kind of (conditional), sometimes the only indicators of the degree of severity of changes that objectively manifest positive or negative dynamics of pathophysiological processes and, in particular, at the initial stages of the development of the studied pathology. Density differences in the right and left liver parenchyma in the control group (conditional norm) in terms of absolute density and its gradient, regardless of the level of scanning, were insignificant (statistically unreliable). In patients with clinical signs of fatty liver infiltration at the stage of steatosis, in the absence of x-ray morphologically detectable structural changes, a decrease in IDH and the dynamics of its increase (recovery) at various stages of observation were revealed. Even with comparatively equal IDH of the evaluated departments, the IDG of different people differed, manifesting the individuality of metabolic processes occurring in the body, in particular in the liver, is a kind of indicator of their direction and severity. The significance of density indicators as predictors of the subsequent stages of the pathology under consideration was particularly evident in the analysis of the results of primary diagnostics and its development in the dynamics of observations. The application of the developed methodological approach allowed us to expand our understanding of the possibilities of KT-liver densitometry in patients with metabolic syndrome (hyperlipidemia, impaired carbohydrate tolerance, diabetes mellitus, abdominal obesity) in the diagnosis of fatty liver disease (FLD) at various stages of examination, including in the early subclinical phases of pathology development. The results obtained indicate the predominant role of ethyl alcohol as a hepatotoxicant in the development of FLD in the estimated cohort of the working-age population. The use of an original algorithm for evaluating tissue density makes it possible to significantly ensure the objectivity of the interpretation of research results.

The relevance of the study of the general principles and patterns of legal regulation of access storage processes and data protection of genome sequencing in foreign countries is determined by the need to develop a general concept of legal regulation of this type of activity in Russia. The purpose of this study is to develop the system-forming principles and patterns of access storage and data protection of genome sequencing in Russia. To achieve this goal, tasks were set and solved to identify and study the general principles and patterns of legal regulation of access storage processes and data protection of genome sequencing in foreign countries. The international documents regulating the features of regulation of access storage processes and data protection of genome-wide sequencing, the doctrinal sources of Great Britain, the USA, France, Israel, and Japan are studied. Methods used: general philosophical, general scientific, private scientific, special (structural-legal, comparative-legal, formal-legal). The general principles for the formation of the concept of legal regulation of genome sequencing in Russia are proposed. It was revealed that the creation of a universal regulatory regulator aimed at protecting the subject of personal data in view of the prevalence of public interests over private ones and the constant expansion of the scope of application of genetic data obtained as a result of genome-wide sequencing is the main problem in developing a legal regulation mechanism in the studied area. For the first time, the authors determine the basic principles for developing the concept of genome-wide sequencing in Russia, including: recognition of human rights and human dignity as the highest value, the necessity of researchers’ responsibility for the well-being of participants in view of the obtained research results, the mandatory informed consent of which should be voluntary, permanent, their right to get acquainted with the results obtained if it concerns their health, access to such information, ensuring the right to non-knowledge of research results and others.

Introduction. Nitrosamines that are introduced with food produce both general toxic effects on a body and specific and remote ones (allergic, mutagenic, teratogenic, or carcinogenic effects). Nitrosamines that occurred in food products aimed for infants nutrition are priority contaminants for working out standard as per health risk criteria. Data and methods. We assessed impacts exerted by chemicals contained in canned meat for babies on 120 white Wistar rats. Our examined product was canned meat with N-nitrosamines in their minimum and maximum concentrations. For an approximation of the experiment to real conditions as it was only possible, we took rats with their age being comparable to that of human babies. Results. Laboratory animals from test groups were fed with canned meat that contained N-nitrosamines for 28 days. As a result, we detected significant discrepancies in AAT, ALT, and GGT levels in blood between an intact group and test ones. We established NOAEL to be equal to 0.00064 mg/kg a day. We also conducted an experiment aimed at determining the benchmark dose level (BDML) for N-nitrosamines introduced with canned meat for babies and applied its results to perform mathematic modeling for “dose - effect” dependence. This modeling allowed establishing authentic cause-and-effect relations between canned meat contamination with a total of N-nitrosamines and increased values of hepatotoxicity markers. We chose the lowest level out of all the control ones obtained via “dose - effect” dependence modeling; it was equal to 0.00063 mg/kg a day. Conclusion. Obtained reference dose (0.00063 mg/kg) for a total of N-nitrosamines introduced with canned meat for babies can be a starting point for determining MDM and MPL of total N-nitrosamines in examined food products

The relevance of the chosen topic is due to the need to resolve ethical problems that arise in the framework of legal regulation of genome-wide sequencing in Russia and foreign countries. The purpose of this research is to form ethical principles that should become a reference point for law - making in this area. In order to achieve this goal, we have solved the tasks of studying the normative legal acts of Russia and a number of foreign countries from an ethical point of view. General scientific, private scientific and special methods of scientific knowledge (system-structural, formal-legal) are used. In order to comply with the ethical boundaries of legal regulation, to store access and protect full-genome sequencing data in Russia and foreign countries, it is proposed to develop a set of restrictions that prevent possible discrimination on genetic grounds, to create the necessary conditions for the inadmissibility of disclosure of personalized data, disclosure of information about a genetic disease to the subject and his relatives, as well as the boundaries of editing the genome of a human embryo. For the first time, the authors substantiate the need to establish clear ethical boundaries in the implementation of genome-wide sequencing in Russia based on foreign experience.

The OBJECTIVE was to evaluate the technical feasibility of endoscopic hernioplasty in recurrent inguinal hernia. METHODS AND MATERIALS. Personal experience of the authors covers more than 10 000 laparoscopic inguinal hernioplasties operated in 1996-2018. This paper analyzes the results of 127 patients treated for recurrent inguinal hernias after primary laparoscopic approach, reoperated using minimally-invasive surgical techniques. RESULTS. Possible causes of relapses after primary hernioplasty, both after TAPP and TEP techniques, were analyzed. The technical features of performing repeated laparoscopic interventions in this group of patients were considered. The developed and implemented technical methods, the tactics of the surgical treatment, the choice of the prostheses' type and size used in patients with various kinds of recurrent inguinal hernias were described. Results of the study included an analysis of the treatment while recommendations on the technique of repeated surgical intervention of recurrent hernias were formulated. The safety and effectiveness of the laparoscopic repeated surgery for recurrent inguinal hernias were shown. CONCLUSION. Laparoscopic approach to hernioplasty in recurrent inguinal hernia is equally effective after open and endoscopic primary repair. An increase in the number of hernioplasty for recurrent inguinal hernias with non-adhesive mesh grafts is promising. Contraindications to redo laparoscopic intervention may include high risk of general anesthesia and severe scarring in the lower abdomen.

Based on the existing concept of COPD pathogenesis, treatment and rehabilitation measures should be aimed at normalizing the functioning of the mucociliary system and forming an energy-saving stereotype of breathing. In this regard, the inclusion of flutters as breathing simulators in the complex of treatment and rehabilitation programs is scientifically justified. 43 patients with moderate-severity PCOS were examined without exacerbation. The subjects were divided into 2 groups: 1 (main) — 22 patients receiving FT, and 2 (comparison) — 21 patients without FT. To assess the effectiveness, we used data from functional indicators, the results of the 6-minute walking test (6MWD) and standard questionnaires CAT, mMRC, SGRQ. The state of the respiratory muscles was assessed by the size of the chest area and indicators of endurance to static loads of the back and abdominal muscles. Studies were conducted before the start of therapy and 3 months after its end. Use of FT leads to a signifi cant regression of clinical symptoms, a signifi cant increase in OFB1, positive shifts in the CAT, mMRC and 6MWD test results, increased strength and endurance of respiratory muscles and improved quality of life. This proves the feasibility of including FT in the complex of treatment and rehabilitation measures for PHOBL.

Metformin is a first-line drug for DM2 treatment and prevention, but its complex effect on impaired glucose tolerance (IGT), including its influence on myocardial resistance to ischemia-reperfusion injury, is not completely studied. We aimed to evaluate the influence of metformin on the intestinal microbiota (IM), metabolism, and functional and morphological characteristics of myocardium in rats with IGT. IGT was modelled in SPF Wistar rats with a high-fat diet and streptozotocin and nicotinamide injection. Rats were divided into three groups: IGT (without treatment), IGT MET (metformin therapy), and CRL (without IGT induction and treatment). IGT group was characterized by: higher body weight, increased serum glucose and total cholesterol levels, atherogenic coefficient, impairment in the functional parameters of the isolated heart during perfusion, and larger myocardium infarction (MI) size in comparison with the CRL group. IM of IGT rats differed from that of CRL: an increase of Bacteroides, Acinetobacter, Akkermansia, Roseburia, and a decrease of Lactobacillus genera representation. Metformin therapy led to the diminishing of metabolic syndrome (MS) symptoms, which correlated with IM restoration, especially with the growth of Akkermansia spp. and decline of Roseburia populations and their influence on other members of IM. The obtained results allow us to consider from a new point of view the expediency of probiotic A. muciniphila use for MS treatment.

Pain is a common symptom that impairs the quality of life for people around the world. Local anesthetics widely used for pain relief have a number of side effects, which makes the development of both new drugs and new ways to control their activity particularly important. Photopharmacology makes it possible to reduce the side effects of an anesthetic and control its biological activity in the body. The purpose of this work was to create a new light-controlled local anesthetic and study its biological activity in animals. A compound with a simple scheme of synthesis was chosen to shift the UV-Vis absorption band towards the visible range of the spectrum and was synthesized for the first time. Some computer calculations were performed to make sure that the aforementioned changes would not lead to loss of biological activity. The micellar form of the new compound was prepared, and in vivo biological studies were carried out in rabbits. The existence of a local anesthetic effect, which disappeared almost completely on irradiation with light (λ = 395 nm), was shown using the surface anesthesia model. Moreover, the possibility of multiple reversible changes in the biological activity of ethercaine under the action of light was demonstrated. The latter compound manifests no local irritating effect, either. The data obtained indicate the prospects for the development of new compounds based on azobenzene for light-controlled local anesthesia.

Critically ill COVID-19 patients have a high incidence of thromboembolic events, which significantly influence the risk of mortality. Anticoagulant therapy is generally recommended to these patients but the optimal dosing regimens require further investigations. The objective of this systematic review and meta-analysis was to assess the efficacy and safety of prophylactic, intermediate and therapeutic dose anticoagulation in COVID-19 patients admitted to the ICU. A systematic search for original prospective observational studies and clinical trials was performed in online databases from 2020 to 2022. A total of 13 studies (3239 patients) were included. The type of anticoagulant dosing showed no significant influence on short-term mortality (p = 0.84), deep vein thrombosis (p = 0.66), arterial thrombosis (p = 0.44), major bleeding (p = 0.35) and minor bleeding incidence (p = 0.46). An anticoagulation regimen significantly influenced pulmonary embolism occurrence (16% for prophylactic dose vs. 4% for therapeutic dose, p = 0.02), but the number of studies in the analysis was relatively low. In conclusion, the results of this meta-analysis suggest that critically ill COVID-19 patients admitted in the ICU have no benefit from therapeutic doses of anticoagulants and that all three thromboprophylaxis regimes have a comparable effect on short term mortality and venous thromboembolism incidence but for pulmonary embolism, for which the results were inconclusive.

Expression analysis of small noncoding RNA (sRNA), including microRNA, piwi-interacting RNA, small rRNA-derived RNA, and tRNA-derived small RNA, is a novel and quickly developing field. Despite a range of proposed approaches, selecting and adapting a particular pipeline for transcriptomic analysis of sRNA remains a challenge. This paper focuses on the identification of the optimal pipeline configurations for each step of human sRNA analysis, including reads trimming, filtering, mapping, transcript abundance quantification and differential expression analysis. Based on our study, we suggest the following parameters for analysis of human sRNA in relation to categorical analyses with two groups of biosamples: (1) trimming with the lower length bound = 15 and the upper length bound = \(Read\ length - 40\% Adapter\ length\); (2) mapping on a reference genome with bowtie aligner with one mismatch allowed (-v 1 parameter); (3) filtering by mean threshold > 5; and (4) analyzing differential expression with DESeq2 with adjusted p-value < 0.05 or limma with p-value < 0.05 if there is very little signal and few transcripts.

Background: Bilateral banding of the branches of the pulmonary artery in patients with hypoplastic left heart syndrome (HLHS) and other duct dependent critical neonatal heart malformations can significantly reduce the incidence of severe complications in the postoperative period, especially in severely unstable patients. In our study we compared different surgical techniques of bilateral pulmonary artery banding (PAB) in respect to their success in balancing systemic and pulmonary blood flow. Methods: We included 44 neonates with a HLHS and congenital heart diseases (CHD) with a functional single ventricle underwent a hybrid operation: bilateral PAB and patent ductus arteriosus stenting. The hybrid surgery for method No. 1 is performed as a one-stage procedure, together with patent ductus arteriosus (PDA) stenting. After median sternotomy, two Gore-Tex 1–2 mm wide bands with a diameter of 3–3.5 mm are put. When we apply method No. 2 then the thread is used to create bands. Method No. 3 is distinguished by intraoperative assessment of blood flow at the site of narrowing of the branches of the pulmonary artery and optional stenting of the PDA. The cuff for banding is made of Gore-Tex tubing. Effectiveness when applying method Nos. 1 and 2 is assessed by the change in invasive blood pressure and oxygen saturation after narrowing of the branches of the pulmonary artery. Also, with these techniques PDA stenting by inserting the introducer via pulmonary artery trunk is performed. Results: HLHS with mitral or aortic valve atresia or both was present in 19 patients (43.1%), with severe left heart obstruction resulting in PDA dependent systemic circulation in 16 babies (36.4%). CHD with single ventricle physiology occurred in 9 patients (20.5%). 14 babies (31.8%) undergo the procedure following the method No. 1, 8 patients (18.2%) method No. 2 and 22 patients (50%) method No. 3. Qp/Qs = 1/1 was achieved in 30 patients (30/44, 68.1%): as a result of the method No. 1 was achieved in 5 patients (5/14, 35.7%), method No. 2 in 4 patients (4/8, 50%), method No. 3 in 21 patients (21/22, 95.5%). Multivariate regression analysis revealed that method No. 3 significantly increases the chances of hemodynamic efficacy operations (OR = 35.0; p = 0.005; CI (95%) 3–411.5). Conclusion: Application of the operation technique No. 3 in combination with the intraoperative assessment of blood flow parameters at the site of banding of the branches of the pulmonary artery are the most optimal criteria for achieving Qp/Qs = 1/1. If there are signs of restriction at the level of the foramen ovale, atrioseptostomy should be done in the second stage after bilateral pulmonary banding.

Severe outcomes of COVID-19 are associated with pathological response of the immune system to the SARS-CoV-2 infection. Emerging evidence suggests that interaction may exist between COVID-19 pathogenesis and a broad range of xenobiotics, resulting in significant increases in death rates in highly exposed populations. Therefore, a better understanding of the molecular basis of the interaction between SARS-CoV-2 infection and chemical exposures may open opportunities for better preventive and therapeutic interventions. We attempted to gain mechanistic knowledge on the interaction between SARS-CoV-2 infection and chemical exposures using in-silico approach, where we identified genes and molecular pathways affected by both chemical exposures and SARS-CoV-2 in human immune cells (T-cells, B-cells, NK-cells, dendritic, and monocyte cells). Our findings demonstrate for the first time that overlapping molecular mechanisms affected by a broad range of chemical exposures and COVID-19 are linked to IFN type I/II signaling pathways and the process of antigen presentation. Based on our data, we also predict that exposures to various chemical compounds will predominantly impact the population of monocytes during the response against COVID-19.

International audience; In the direct searches for Weakly Interacting Massive Particles (WIMPs) as Dark Matter candidates, the sensitivity of the detector to the incom- ing particle direction could provide a smoking gun signature for an interesting event. The SCENE collaboration firstly suggested the possible directional de- pendence of a dual-phase argon Time Projection Chamber through the columnar recombination effect. The Recoil Directionality project (ReD) within the Global Argon Dark Matter Collaboration aims to characterize the light and charge re- sponse of a liquid Argon dual-phase TPC to neutron-induced nuclear recoils to probe for the hint by SCENE. In this work, the directional sensitivity of the de- tector in the energy range of interest for WIMPs (20-100 keV) is investigated with a data-driven analysis involving a Machine Learning algorithm.