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Fresh vegetable raw materials have a limited shelf life, therefore, it is necessary to develop gentle methods of canning tomatoes, which allow to preserve the valuable components of the raw material to the maximum extent. In this regard, the task of improving the drying method with maximum preservation of physiologically valuable substances of the raw material is very urgent. Research has been carried out on the kinetics and modeling of the tomato drying process, the task of which was to develop the technology of gentle drying of tomato raw materials with the maximum preservation of the original useful properties. We have developed a technology for obtaining protein, lipid and other products of increased biological value from tomato pomace and recommendations for their use. The method of obtaining lycopene from tomatoes is crushing the fruits, from the resulting mass, the pulp is extracted using the solvent used ethyl acetate. The resulting extract consists of tomato oil, which, in addition to lycopene, contains a number of other components, such as fatty acids (myristic acid, palmitic acid, steoric acid, oleic acid, linoleic acid, behenic acid, and others), unsaponifiables and soluble substances in water, phosphorus compounds, phospholifids. The obtained lycopene extract from tomatoes is also intended for use in the following food categories: baked goods, breakfast cereals, dairy products, carbonated drinks, fruit and vegetable juices, sweets, soups, salad dressings. The lycopene extract obtained from tomatoes can also be used as a dietary supplement. It is stable when stored at room temperature and at 4 ? for 37 months.

Aim. The aim of the research has been: to study the theoretical basis of the application of assessment of economic damage from environmental pollution in the field of environmental auditing and accounting, to identify problems in existing methods and approaches and to propose specific ways to solve them taking into account current legislation and international experience.Material and Methods. The research carried out by the authors was based on the provisions of current legal regulations in the fields of environmental safety and environmental protection, damage assessment in the environmental sphere together with data from scientific articles by both domestic and foreign experts in the field of environmental auditing. The study was conducted using theoretical methods of research including analysis, deduction and prediction.Results. The authors propose moving away from traditional cost (taxation) methods to the consolidation in regulatory practice of a single approach to the assessment of economic damage taking into account actuarial valuation methodology, application of sanctions instruments to those unscrupulously infringing environmental regulations and the possibility of discounting the costs of restoring the environment and damage done to public health.Conclusion. Adoption of common approaches and principles in the assessment of economic damage will help eliminate negative manipulations when imposing economic sanctions on those unscrupulously engaged in activities impacting on the environment and will provide an opportunity to improve the environmental situation and public health in the long term.

The special conditions during the pandemic show the problems and raised actuality of questions about the safe organization of planned work of non-infectious hospitals for the managment of oncological patients. The surgical component of treatment, as an integral part of oncological care, should be considered as urgent, since the delay in its realisation inevitably worsens the results of treatment. On the other hand surgical operations in the epidemic condition is associated with the obvious additional risks. The article describes the experience of implementing elements of the system of anti-epidemic measures in a oncological surgical hospital, examines the objective characteristics of the situation that affect its components and analyzes their effectiveness.

The article describes a clinical case of kidney stone disease (KSD) in a child of 4 y.o. with calcium urolithiasis. Analysis of chemical content of the kidney stones revealed their calcium-oxalate composition. According to the results of clinical exome sequencing the patient found to be a heterozygous carrier of a pathogenic variant c.695A>G (p.Tyr232Cys) in the gene SLC7A9, attributable for an autosomal recessive form of cystinuria type B. Because of the uroliths calcium composition the patient was also genotyped for SNPs in 15 genes involved in calcium metabolism. Polymorphisms associated with increased risk of calcium urolithiasis were found in 8 of 15 tested genes. The findings could explain clinical features of the patient.

Introduction. As recent research works show, scholars tend to disagree about the origin of the Kipchak plural form. K. M. Musaev hypothesizes that the Proto-Kipchak form of this affix was *-tar/*-ter whereas, according to O. A. Mudrak, the protolanguage form was *-lar/*-ler. Indeed, it seems impossible to reconstruct the form of the plural affix for the *-n, *-ŋ, *-m, *-C-stem words based on the modern data for the Kipchak languages. Furthermore, the Proto-Turkic reconstruction of the plural affix for these stems is also unclear. Purpose of research: It follows that a systematic analysis of the forms of the plural affix with different stems in the first books in the Kipchak languages (Tatar, Bashkir, Kazakh, Teleut, Tubalar) will help to 1) reconstruct their Proto-Kipchak and Proto-Turkic forms, 2) date the changes in the suffixes, 3) determine if these changes were areal in nature. Materials and methods: The grammars of the modern Turkic languages as well as the first Cyrillic books in Tatar, Bashkir, Kazakh, Altai, Teleut, Tubalar have been analyzed using a comparative historical method. Results: The analysis reveals that the late Proto-Turkic form of the plural affix remained unchanged in most of the Turkic languages. In some of the Kipchak languages (Kazakh, Kyrgyz, certain dialects of Bashkir and Altai) located at the junction of the “-lVr-form vs.- tVr-form of the plural affix” territories, the *-lVr-form (in voiceless *-C-stems) and the *-nVr-form (in *-n, *-ŋ, *-m-stems) changed into *-tVr. Conclusion: The material of the first Kazakh books in Cyrillic shows that the change in the Kipchak plural affix in voiceless *-C-stem and in *-n, *-ŋ, *-m-stem words was quite late, took place due to contacts with the Kyrgyzs, and was not yet complete at the end of the 19th century.

Pancreatic cancer is the 12th most common malignant neoplasm and the 7th most common cancer related death worldwide. Early diagnosis of pancreatic cancer is complicated, since the disease proceeds for a long time without pronounced clinical symptoms, and the identification and screening of the so-called risk groups of patients is difficult, since the etiology of pancreatic cancer is currently a matter of scientific debate. Early diagnosis of pancreatic cancer can be based on the anamnestic analysis of the psychoemotional status of patients. Back in the early 20th century, based on an analysis of the results of a survey of patients with pancreatic cancer, researchers described a triad of affective signs, including depression, anxiety and a sense of impending death, which worried patients in the early stages of development of the disease. According to literature, the psychiatric symptoms of pancreatic cancer can appear 43 months before the somatic symptoms and occur in more than 50 % of patients. To date, there are a number of concepts in the literature that point to a significant contribution of affective disorders to the development of pancreatic cancer. The aim of this review is to analyze the literature data on the relationship between affective disorders and the development of pancreatic cancer.

AIM to evaluate the medico-economic significance of neurogenic lower urinary tract dysfunction (NLUTD) in the Russian Federation, to calculate the economic burden of NLUTD in patients with targeted entities and to prepare suggestions for improving the methods of payment for the provision of medical care to patients with NLUTD in inpatient practice. MATERIALS AND METHODS an analysis of the literature and an expert assessment of the prevalence of NLUTD in the Russian Federation were performed. Due to the various etiology of NLUTD, the following entities were considered: craniocerebral trauma, acute stroke, multiple sclerosis, spinal cord injury (hereinafter referred to as targeted entities), characterized by the highest rate of NLUTD and high social significance (damage to the working-age population): traumatic brain injury, acute stroke, multiple sclerosis, spinal cord injury. The calculations of the economic burden of NLUTD and its main complications (stage 5 of chronic kidney disease (CKD), urinary tract infection) in the Russian Federation (using mainly the normative method) were carried out, based on national statistics, regulatory legal acts and expert assessments of healthcare specialists. Proposals have been prepared for improving the reimbursement (tariffs of the KSG) for payment of NLUTD in the inpatient practice. RESULTS according to the study, the number of patients with NLUTD due to the group of targeted entities is estimated at 910 000. The economic burden (excluding indirect and unaccounted costs) of the NLUTD is 33.3 billion rubles per year. The burden associated with secondary complications (stage 5 CKD, urogenital infection) due to ineffective diagnosis and treatment of NLUTD is 51.6 billion rubles. The total costs on the NLUTD is estimated at 84.9 billion rubles. Direct costs, calculated by the normative method based on the analysis of standards of medical care per patient are 36,546 rubles per year. Provision of medical care to patients with NLUTD in accordance with federal guarantees within the framework of the compulsory medical insurance is provided in accordance with the tariffs of KSG st30.005 (profile "urology"). The KSG tariff for 2019 (taking into account the established standards of financial costs for one case of hospitalization in the inpatient department and the established cost-intensity coefficients (CZ) established by the CG is 21,495.07 rubles, which is 58% of the minimum need, excluding the cost of treatment of complications, according to the normative method of calculation. The real estimate of the tariff for the payment of treatment of NLUTD in the constituent entities of the Russian Federation is 35-38% of the minimum need, excluding the cost of treatment of complications, according to the normative method of calculation. The real estimate of the costs for the treatment of NLUTD in regions is 35-38% of the minimum need, excluding the cost of treatment of complications, according to the normative method of calculation. To provide effective specialized urological care in the framework of compulsory medical insurance at the rates of the CSG for neuro-urological care (st30.005), expert calculations of the actual cost of NLUTD therapy were made. The proposed average cost of the CSG and the values of the cost intensity factors: CSG (min) st30.005.1 - 39,936 rubles, CZ - 1.65; CSG (max) st30.005.2 - 68,531 rubles, CZ - 2.75. The weighted average savings while expanding the availability of complex neuro-urological care for patients with NLUTD in accordance with the proposed payment rates is 9.4 billion rubles per year. CONCLUSIONS Evaluation of the prevalence and burden of NLUTD showed the high medical and economic significance of NLUTD in the Russian Federation. The results of the study indicate a significant discrepancy between the requirements and the real costs within federal guarantees for the organization of medical care for patients with NLUTD. To provide effective specialized urological care in the compulsory medical insurance at the rates of CSG for neuro-urological care, it is necessary to increase funding, through the correction at the federal level of the cost-intensity coefficient from 1.65 to 2.75 for the CSG st30.005, which will ensure the increase in the cost for a case of treatment in inpatient department in form 39 936 to 68 531 rubles. The weighted average savings while expanding the availability of complex neuro-urological care for patients with NLUTD in accordance with the proposed payment rates is 9.4 billion rubles per year.

For the new socialist state, the issue of providing qualified personnel was of key importance, because the implementation of the tasks outlined by the Soviet government depended on it. The article uses documentary materials extracted from the funds of the Central State Archive of the Republic of Dagestan and monographic research to highlight the policy of nomination in solving the personnel problem of the Republic of Dagestan in the 1930s.

The article examines the modern direction of information visualization in the context of educational activities. Graphics is a visualization language and it "speaks" with graphemes. Infographics call their works infographics. In our understanding, grapheme is a consequence of information processing by the infocartographic method that we have developed. The method integrates techniques of cartography and infographics. Educational information is a didactically processed scientific information representing concepts, patterns, laws, structure, functioning of systems within the framework of the discipline being studied. Or, we can say that this is information about the subject itself and the methods of studying it. The versatility of the infocartographic method lies in its "end-to-end" capabilities to show, visualize any information, "translate" it from verbal language into the language of gratification.

Aim. This article is devoted to the conversion of solar radiation into electricity using the joint effect of several methods, which complement each other by transforming the disadvantages of one method into the advantages of another method. Methods. Heat exchange processes occurring under multiple re-reflection of the light flux on a cylindrical solar concentrator were simulated. Results. It is proposed to form an integrated set of semiconductor photon conyerters together with a photoelectric effect on metal electrodes, thus producing a low electron output and a thermoelectric effect. This approach increases the energy efficiency of the entire structure with an additional multiple rereflection of photons on the solar flux concentrator in the form of a cylindrical surface with radially arranged mirror metal electrodes. When reaching a power-effectiye integrated thermoelectric con-yerter of solar radiation to electricity, photons will either be conyerted at the p-n junction of a solar cell, or participate in the photoelectric effect at the electrodes, or be absorbed by the construction material to produce thermoelectric power. This approach allows the efficiency of the entire system to be maximized. Conclusion. All the photons that hit the proposed power-effectiye integrated thermoelectric solar radiation conyerter will be conyerted to electricity to a certain extent, with only their small part being scattered outside in the form of heat losses or re-reflections.

The main feature of agricultural production is its direct dependence on natural and climatic conditions that leave their mark on all reproduction processes in the agricultural sector. The article is devoted to the analysis of peculiarities of agricultural production. Shown is the work of governing organs on determination of the correct strategy of development in the study period. The attention is paid to the scientific and technological progress and influence of these factors on the creation of progressive forms of labor organization in Southern Daghestan in the 60–70s of the XX century.

Kidney stone disease (KSD) is an actual problem of modern health care. By now, more than 80 monogenic forms of urolithiasis have been described. To diagnose such forms of KSD different molecular genetic technologies are used. In the current article 5 clinical cases of KSD among the patients aged 1-9 years old are presented. All of them underwent comprehensive instrumental, clinical, laboratory and molecular genetic investigations. DNA analysis was carried out by Next Generation Sequencing method (NGS) (target NGS-panels and Whole Exome Sequencing). In all cases the molecular genetic cause of the disease was found - idiopathic infantile hypercalcemia type 1 (gene CYP24A1 - 3 cases) and cystinuria (gene SLC7A9 - 2 case). Several unknown genetic variants were found in CYP24A1 (c.1379G>T, c.1156A>T, c.1286T>C) and SLC7A9 (c.920T>A). The importance of genetic testing and the role of genetic counseling for patients with KSD were shown.

The literature review presents the results of a static perimetry for the study of the visual field in patients with compression in the chiasm-sellar region on the Humphrey Visual Field Analyzer (HFA) and Octopus. These models of perimeters are recognized as the “gold standard” and are most widely used in the global ophthalmic practice. The analysis of research results using traditional and function-specific perimetry with selective stimulation of the magnocellular and koniocellular (frequency-doubling technology perimetry, FDT; short-wavelength automated perimetry, SWAP) visual pathways was performed. The literature data analysis allows us to conclude that the static perimetry for the study of the visual field in patients with chiasmatic compression is carried out quite widely and is informative. But despite this, there are no generally accepted recommendations on the use of certain testing strategies and programs for the diagnosis and further dynamic observation of changes in the visual field in patients with this pathology. In this regard, it is advisable to conduct further studies that will allow the formation of standard perimetric protocols for diagnosing and monitoring visual field defects in patients with compression in the chiasm-sellar region based on a comparative analysis of the diagnostic informativity of various strategies and programs.

Objective. To increase efficiency of cavitary pulmonary tuberculosis treatment by developing modern indications and technology of extrapleural pneumolysis with filling material.Material and methods. We reviewed 25 patients with cavitary pulmonary tuberculosis and bacterial excretion who had undergone extrapleural pneumolysis with different types of filling material in 2004–2015. In 16 cases, we performed surgery in patients with one lung.Results. 56% of operated patients demonstrated extensively drug-resistant TB, 40% had multidrug-resistant TB. Cavities were closed and bacterial excretion ceased in 92% of patients at discharge. Long-term results with observation period from 1 to 12 years were analyzed in 24 patients, 17 (71%) of them had complete clinical efficacy.Conclusion. Extrapleural pneumolysis is a mini-invasive surgical treatment that can prove positive effect in patients with non-fibrotic changes in a cavity wall and pathological process in upper parts of the lungs.

The article involves the linguistic analysis of Boris Johnson’s speeches and allowed to establish lexical and syntactical expressive means. The analysis revealed the key ideas, values and political principles of the British Prime Minister, implemented through a number of stylistic figures and tropes. His statements represent clearly-build “friend or foe” conceptual relationship, he communicates the words of gratitude and appreciation to his associates and colleagues, however, he severely criticizes his political opponents. The means of creating expressive and emotional load used by Boris Johnson are focused on drawing potential listeners’ attention by using creatively different metaphors and comparisons, dynamic and pictorial reasoning, as well as shocking statements, given the fact that a number of politician’s speeches expose him as a person being behindhand in tolerance to the representatives of other ethnic groups, religions, political views and ideas.

Ureteral stents have a long history of use. Their main goal is to provide effective drainage of the upper urinary tract. Morbidity is mostly related to low biocompatibility of materials, from which stents are made. Since stent introduction, there have been many stages of evolution and modernization. However, there is a significant problem associated with their widespread use. Despite technological progress, stent-associated symptoms, incrustation, bacterial infection are the problems that still have to be resolved while creating an "ideal" stent. The continued development of new materials and coatings also will lead to the improvement of such an indispensable urological device as the ureteral stent.

In September 2018, a new Lak-Russian dictionary was published in Makhachkala. Its author, an outstanding Dagestan linguist, Isa Halidovich Abdullaev, an excellent connoisseur of the Lak word, devoted several decades to the work on this dictionary, starting it soon after the publication of the first Lak-Russian dictionary. We present to your attention a review of this book.

Recovery and preservation of visual functions during compression in the chiasm-sellar region is possible in the case of early diagnosis of pathology and timely surgical decompression. Today optical coherence tomography (OCT) of the retina is one of the most informative methods for diagnosing pathology of the retina and optic nerve. It can, due to the presence of early diagnostic criteria, promptly detect the compression in the chiasm-sellar region and expand the indications for surgical treatment. The literature review presents the results of optical coherent tomography (OCT) of the retina during compression in the chiasm-sellar region. An analysis of literature data revealed that in patients with chiasmatic compression, the thickness of the nerve fiber layer in the peripapillary and macular areas decreases, the thickness of the macular complex, consisting of the retinal ganglion cell layer and the inner plexiform layer, decreases. Also, there is a change in the value of asymmetry between the GCC thickness indices in the nasal and temporal halves of the macular region. It has been established that a decrease in the thickness index of a macular complex may precede changes in the visual field. According to the results of single studies, a correlation was found between the parameters of the peripapillary RNFL thickness and the the internal capillary retinal plexus density in the same areas. The results of literature sources’s analysis are summarized in the table by the parameters studied, the OCT model; etiology, treating methods and the results of the OCT study. Despite the results obtained, the early specific and sensitive OCT diagnostic criteria for chiasmatic compression have not yet been developed. In addition, a change in the thickness of GCC and RNFL can also be observed in the absence of chiasmatic compression in certain types of tumors and in the presence of comorbidities (arterial hypertension). In this regard, it is necessary to conduct further studies that will reveal the informative OСT-diagnostic criteria for compression in the chiasm-sellar region, develop diagnostic algorithms taking into account the type of tumor, the presence of concomitant pathology. Early diagnostic criteria for chiasmatic compression will expand the indications and improve the result of surgical treatment of patients.

The purpose of the study was to improve quality of surgical treatable of destructive pulmonary tuberculosis in patients with diabetes.Materials and methods. D.B. Giller and employees of the Department of Phthisiopulmonology and Thoracic Surgery of the First Moscow State Medical University M.I. Sechenov performed operations on 200 patients with diabetes due to tuberculosis. Group 1 was mustered from 78 patients from 2004 to 2009. Group 2 was mustered from 122 patients from 2011 to 2017.Results. An analysis of the results showed that after 31 operations, 27 (13.5%) patients from both groups developed 33 complications. The second group (6,6 %) had fewer complications after surgery than the first group (24,4%) 3.7 times. The first group had more vulnerary and bronchopleural complications than the second group. 12 patients (15,4%) of the first group and 6 patients (4,9%) of the second group had bronchopleural complications (empyema, residual cavity, delayed expansion of the lung and intrapleural bleeding). 2 patients died in the hospital (30-day mortality was 0.66%) after 303 surgical intervention in both groups. 1 patient (0.9%) died after 106 surgical intervention in the first group. 1 patient (0.5%) died after 197 surgical intervention in the second group. The full effect was achieved in 75 (96.2%) patients in the first group and 114 (93.4%) in the second group. The survival value of patients of the second group was 100% after 1 year, 98% after 2 years, 98.8% after 3 years, 96.9% after 4 years, 95.2% after 5 years. The surgical treatable affected the occupational rehabilitation of patients from group 2. 61.5% of patients from group 2 became able to work after 1 year. 64.5% of patients from group 2 became able to work after 5 years.Conclusion. If doctors will use our tactics in patients with destructive pulmonary tuberculosis and diabetes, the risk of complications after surgery dropped and reactivation of tuberculosis will not occur.

The article presents the main molecular mechanisms of the pathogenesis of renal cell carcinoma. The molecular pathways that determine the development of histological variants of renal cell carcinoma and the role of stem cells markers in the carcinogenesis of these tumors are considered.

The prevalence of urinary incontinence at a young age is 20-30%, gradually increasing to 40% among older women. Urinary incontinence affects many areas of the patient's life, including social, psychological, work, sexual, etc. The main causative factors, which also influence on its severity, include age, pregnancy, childbirth and obesity. To date, there are many treatment methods for stress urinary incontinence. However, more preference is given to the sling procedures, in which mesh is placed under the middle part of the urethra. Despite being the "gold" standard for the treatment of stress urinary incontinence, it is difficult to determine indications for surgical treatment, since "nonmedical" view of the patient's problem is often required. The low awareness of primary care physicians about the possibilities of treating urinary incontinence often leads to an erroneous opinion in patients about their disease and methods of treatment. Many patients regard this condition as an integral part of aging, avoid situations in which urinary incontinence is possible, which limits daily activities, sexual activity, sports and other areas of life. Based on the latest data, a review of the literature on urinary incontinence in women, risk factors, as well as existing methods of surgical correction are presented in the lecture. Particular attention is paid to the impact of urinary incontinence on the quality of life of patients and current methods for its assessment.

To search for sensitive predictors of cognitive impairment (CI) and an integrative index of their severity.We assessed CI and diffusion-tensor MRI (DT-MRI) in the regions of interest (ROI) significant for CI in 74 patients (48 women, mean age 60.6±6.9 years) with cerebral small vessel disease (CSVD). The results of DT-MRI were used to construct a predictive model of CI using binary logistic regression and to calculate an integrative index of CI severity.According to the constructed model, the predictors of CI were axial diffusivity (AD) of posterior frontal periventricular normal-appearing white matter (pvNAWM), right middle cingulum bundle (CB) and mid-posterior corpus callosum (CC). ROC analysis showed strong model predictive power for CI in cSVD (AUC (95% CI): 0.845 (0.740-0.950)). The threshold value of the AD predictors model for CI in cSVD was 0.53 (sensitivity 84%, specificity 76%). AD predictors of CI showed significant correlations with white matter hyperintensities volume and MoCA scores. The presence of CI as measured by neuropsychological testing and regression equation solution was corresponded to individual AD predictors of patients exceeding the CI model's threshold.Disturbances in the AD of pvNAWM, right middle CB and mid-posterior CC associated with axonal damage are a predominant factor in the development of CI in CSVD. The predictors of CI and the integrative index of CI severity calculated on their basis can potentially be used as a tool for assessing the severity of CI and the effectiveness of treatment, as well as in clarifying the interaction between vascular and degenerative pathology and in developing measures for the prevention of CI in patients with MRI signs of cSVD.Поиск чувствительных предикторов когнитивных расстройств (КР) и интегративного показателя их тяжести.У 74 больных (48 женщин, средний возраст 60,6±6,9 года) с церебральной микроангиопатией оценивались КР и показатели диффузионно-тензорной МРТ (ДТ-МРТ) в значимых для КР областях. Полученные данные ДТ-МРТ использовались для построения методом бинарной логистической регрессии модели предикторов КР с последующим расчетом ее порогового значения в качестве интегративного показателя КР.Модель установила предикторы КР: аксиальную диффузию (axial diffusivity, AD) в перивентрикулярном неизмененном белом веществе задних отделов левой лобной доли, среднем отделе правой поясной извилины и заднесреднем отделе мозолистого тела. ROC-анализ показал ее высокую предсказательную способность диагностирования КР (AUC (95% ДИ): 0,845 (0,740—0,950)) с пороговым значением модели 0,53 (чувствительность 84%, специфичность 76%). AD-предикторы КР показали значимые корреляции с объемом гиперинтенсивного белого вещества, результатами Монреальской шкалы оценки когнитивных функций. Получено соответствие наличия КР по результатам нейропсихологического тестирования и решения уравнения регрессии с индивидуальными AD-предикторами пациентов при превышении порогового значения модели КР.Нарушение микроструктурной целостности, связанное с аксональным повреждением в перивентрикулярном неизмененном белом веществе задних отделов левой лобной доли, среднем отделе правой поясной извилины и заднесреднем отделе мозолистого тела, является облигатным условием развития КР при церебральной микроангиопатии. Установленные предикторы КР и рассчитываемый на их основе интегративный показатель КР потенциально могут использоваться в качестве инструмента диагностики, оценки тяжести КР, эффективности лечения, а также в уточнении взаимодействия сосудистой и дегенеративной патологии и при разработке мер профилактики КР у пациентов с МР-признаками церебральной микроангиопатии.

In everyday practice, urologists often encounter clinical manifestations of overactive bladder (OAB), without of organic or infectious disease. In such cases, OAB may appears in the structure of a somatized (more often depressive) disorder, and therefore an integrated psychosomatic approach to such patient management is becoming increasingly relevant. The relevance of studying the topic is due to the high prevalence of OAB symptoms, its recurrent course, insufficient effectiveness of urological treatment, a significant decrease in the quality of life and working capacity of the socially active part of the adult population. Our clinical observation illustrates the development of symptoms of OAB with massive "pseudo-urological" symptoms within the framework of recurrent somatized depression in a woman of involutional age.

Chronic recurrent cystitis (CRC) is one of the most common diseases of the lower urinary tract in the female population. Difficulties in diagnosis and treatment, despite the observance of modern clinical recommendations for CRC, are due to the versatility and polyetiology of the pathogenesis of the disease. The most difficult and discussed section of this problem is the diagnosis and treatment of CRC of papillomavirus (PV) etiology. The article presents its own clinical observation - Diagnosis and treatment of a patient with CRC PV etiology. CRC, in addition to bacterial uropathogens, can be caused by various representatives of a viral infection. Among all viral pathogens, HPV has the widest pathogenic potential. Currently, there is no single etiotropic therapy for PVI of the urinary tract and reproductive organs; there is no systemic treatment of patients with HPV-associated lesions, including the bladder. Nevertheless, an important principle of therapy, which has already become an axiom, is applied - an integrated approach that includes anti-inflammatory,antiadhesive, antiviral and immunoactive therapy.

To date, tuberculosis (TB) remains the primary cause of mortality in human immunodeficiency virus (HIV) patients in Russia. Since the beginning of 2000, a sharp change in the HIV patients’ structure, to the main known risk factors for HIV infection has taken place in Russia. The transmission of HIV through injectable drug use has begun to decline significantly, giving way to the prevalence of sexual HIV transmission today. These changes may require adjustments to organizational approaches to anti-TB care and the treatment of HIV-positive patients. Our study is aimed at identifying changes in TB-HIV coinfection patients’ structures in 2019 compared to 2000. Based on the results obtained, our goal was to point out the parameters that need to be taken into account when developing approaches to improve the organization of TB control care for people with HIV infection. We have carried out a cross-sectional, retrospective, epidemiological study using government TB registry data from four regions in two federal districts of Russia in 2019. The case histories of 2265 patients from two regions with high HIV prevalence, which are part of the Siberian Federal District of Russia, and 89 patient histories from two regions of low HIV prevalence, which are part of the Central Federal District of Russia, were analyzed. We found that parenteral transmission (69.4%) remains the primary route of HIV transmission among the TB-HIV coinfected. The unemployed of working age without disability account for 80.2% of all coinfected people, while the formerly incarcerated account for 53.7% and the homeless account for 4.1%. Those with primary multidrug-resistant TB (MDR-TB) comprise 56.2% of HIV-TB patients. When comparing the incidence of coinfection with HIV among TB patients, statistically significant differences were obtained. Thus, the chances of coinfection increased by 4.33 times among people with active TB (95% CI: 2.31; 8.12), by 2.97 times among people with MDR-TB (95% CI: 1.66; 5.32), by 5.2 times in people with advanced processes in the lungs, including destruction, (95% CI: 2.78; 9.7), as well as by 10.3 times in the case of death within the first year after the TB diagnosis (95% CI: 2.99; 35.5). The absence of data for the presence of TB during preventive examination was accompanied by a decrease in the chances of detecting coinfection (OR 0.36; 95% CI: 0.2; 0.64). We have identified the probable causes of the high incidence of TB among HIV-infected: HIV-patient social maladaptation usually results in delayed medical care, leading to TB treatment regimen violations. Furthermore, self-administration of drugs triggers MDR-TB within this group. Healthcare providers should clearly explain to patients the critical importance of immediately seeking medical care when initial TB symptoms appear.

The article presents the main electron microscopic signs of the main histological variants of renal cell carcinoma. The ultrastructural profiles of rare forms of renal cell carcinoma included in the latest International Histological Classification of Kidney Tumors (WHO, 2016) are considered.

The article examines the contribution of the intelligentsia to the development of the culture of the peoples of Daghestan, in particular to the development of the general education school, as well as the process of opening the first women's schools in the Daghestan region. A number of problems that exist in the educational sphere of the region during the period under study are noted. The chronological framework of the study covers the end of the XIX - beginning of the XX centuries, during this period Russian educational institutions began to arise in the places of deployment of military units and settlements with the Russian-speaking population.