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Background To prevent alcohol-based chlorhexidine from reaching the cerebrospinal fluid, it is recommended that the antiseptic solution be allowed to dry before skin palpation or puncture. However, no guidelines specify a drying time interval. Manufacturers recommend 3 min of air drying, based upon the isopropyl alcohol component. Therefore, to fill this knowledge gap, we designed a simulation study to investigate the incidence of primary chlorhexidine transfer from skin to gloves following three drying time intervals. We also investigated the incidence of secondary chlorhexidine transfer from gloves to another surface following one drying time interval. Methods An alcohol-based chlorhexidine antiseptic solution with dye, ChloraPrep®, was applied to the skin of the lumbar region of 20 volunteers. Cotton-tipped applicators wrapped in material from gloves were taken from the application area at 3, 4, 5, and 10 min following application. Transfer of chlorhexidine from skin to gloves, and gloves to another medium, was assessed through a chemical assay that produced a color change when chlorhexidine was present on the sample. Results The incidence of primary chlorhexidine transfer from skin to gloves at 3, 4 and 10 min following application was 99.5%, 99.4%, and 99.6%, respectively. The incidence of secondary chlorhexidine transfer from gloves to another surface was 68.9%. Conclusion Gloves are routinely contaminated with chlorhexidine during central neuraxial blockade. The high incidence of secondary transfer in our simulation suggests a pathway by which chlorhexidine may gain access to the neuraxial space.

The article examines the negative impact of the prison subculture on society, studies the roots of the problem. Protracted communication with bearers of the prison subculture can lead to individual degradation and loss of the ability to cope with the deforming influence of the prison subculture. This contributes to a decrease in the individual cultural and intellectual development and devalues such human values as compassion, love, trust and socially acceptable behavior. Thus, in the focus of the study there was the problem of the prison subculture as a factor of professional deformation of employees of the penal system. At the same time, the subject of research was the prison subculture, and the topic of research was the direct influence of the prison subculture on the professional deformation of penal system employees. As a result of the work carried out, the problems of the prison subculture’s influence of the on society were investigated and measures to counteract its impact on the professional deformation of employees of the penal system were proposed. Key words: prison subculture, society, destructive influence, expansion, socialization.

The article analyzes the situation with the procurement of medicines, carried out to support the activities of healthcare institutions of the Federal Penitentiary Service of Russia in 2019–2020. Based on the survey data, problems and main factors were identified that reduced the efficiency of procurement, an analysis of the causes of the current situation was carried out. Based on the results of the study, proposals were prepared to amend the current procedures governing the procurement of medicines. Key words: procurement of medicines, healthcare institutions of the Federal Penitentiary Service of Russia, legal regulation, the right to health, wholesale premium, electronic auction, competitive procurement.

BackgroundIn some patients with osteoarthritis (OA), moderate or severe joint pain may persist for a long time and functional limitations may increase, which requires long-term administration of nonsteroidal anti-inflammatory drugs (NSAIDs).ObjectivesTo evaluate the efficacy and safety of long-term use of NSAIDs in patients with OA in real clinical practice.Methods611 patients with OA (knee or hip) were included in an open observational study. 64.5% were female, mean age 58.3±11.0years. All patients received aceclofenac at a dose of 200 mg / day. Pain at movement was determined on a 10-cm visual analog scale (VAS). The number of patients with severe pain (≥6 cm by VAS) and the number of patients with pain reduction ≥50% were evaluated. The assessment was carried out 2 weeks, 3, 6, 9 and 12 months after the start of therapy. Adverse events were noted at each visit.ResultsBy 12 months of follow-up, 53.3% of patients had completed the study. The mean pain severity at baseline, after 2 weeks, 3, 6, 9 and 12 months was 6,5±1,2; 4,8±1,4; 3,2±1,4; 2,6±1,4; 2,2±1,1; 1,4±1,1 cm VAS (pConclusionTaking into account the large number of drop-outs from the study (46.7%), approximately half of the patients can have long-term pain control with NSAIDs in real clinical practice. Aceclofenac is effective and well tolerated and can be used for long-term pain control in patients with OA.Disclosure of InterestsNone declared

BackgroundCentral sensitization (CS) plays an important role in the development of chronic pain in osteoarthritis (OA).Objectivesto evaluate the effect of etoricoxib on pain and signs of CS in patients with OA.Methods790 patients with OA (knee or hip) were included in an open observational study. Most of them (71.6%) were female, mean age 54.5 ± 13.0 years. All patients received etoricoxib 60 mg/day for 2 weeks. The dynamics of pain was assessed on a numerical rating scale (NRS 0-10), the dynamics of the sign of CS was assessed using the Central Sensitization Inventory (CSI). CSI ≥ 40 was observed in 35.3% of patients.ResultsAfter 2 weeks of treatment with etoricoxib, the intensity of pain at movement, at rest and at night decreased by 58.8±24.1%, 69.7±32.6% and 70.1±32.8. There was a decrease in CSI values ​​by 33.1±14.5% (pConclusionEtoricoxib improved pain in OA patients and reduces the severity of signs of CS, supporting the central mode-of-action of the drug.Disclosure of InterestsNone declared

The experimental research of processes running in a linear pulse electromagnetic motor of a downhole vibration generator is described. Based on the research findings, design requirements and recommendations on basic geometrical proportions of the equipment are formulated.

The article describes the quality assessment system for infection control in penitentiary institutions that was developed using a mathematical model based on analytic hierarchy process (AHP). The following parameters were chosen as indicators of infection control quality level: HIV, tuberculosis, incidence of other infectious diseases, compliance with sanitary regulations and the water quality. The reliability and adequacy of the research has been proved. Quality assessment of infection control is an important criterion for the successful development of effective measures aimed at the improvement of the epidemiological situation in penitentiary institutions.

The study presents the stages of developing a HIV prognosis model in inmates. Correlation data analysis and regression modeling were used to develop the model. It was estimated that the developed model gives the best results for patients under the age of 40 years. On the obtained results there were developed an information system and a computer program. The study results application will help to predict correctly the HIV severity and to take timely treatment measures.

The article considers the possibility of using a point scoring system of medical parameters for HIV severity monitoring and modeling in numerical terms. There were investigated the features of the use of medical parameters in the form of a point scoring system as well as the possibility of applying a numerical model for determining the HIV severity when tuberculosis is joined. To solve the problem, it was developed a step-by-step algorithm for applying the point scoring system. Conclusions were drawn. The possibility to predict in numerical terms the outcome of the disease (in particular the AIDS progression) using the number of systematically collected medical parameters in HIV carriers is of great interest. The information system development allows to determine the most important properties of the process and to separate its non-essential characteristics. Often the information system and modeling allow us to formulate new hypotheses and gain new knowledge about the object, those which were not available during the research.

The article presents an algorithm for developing a software package for evaluation of penitentiary healthcare facilities efficiency. The algorithm is based on the data of penitentiary healthcare facilities of the Volga Federal District. To create a computer program algorithm there were chosen indicators and criteria for evaluation of penitentiary health facilities efficiency. Mathematical processing of indicators based on the Analytic Hierarchy Process allows to present the formula for calculating the total integral indicator, which is calculated automatically. The results of calculation are presented in the window interface of the computer program in the form of color charts. In this way it forms a rating of healthcare facilities, where green indicates high level of efficiency, yellow indicates its medium level, red indicates its low level.

The research describes the development of the forecasting information system that can predict the outcome of a disease in inmates with HIV-associated tuberculosis. The aim of the research is to develop an additional high-precision diagnostic criterion giving the possibility of the timely correction of diagnostic, treatment and organizational measures for patients with HIV and tuberculosis co-infection that helps to improve the quality of medical care. The research material is based on the data from clinical cases of patients with HIV and tuberculosis co-infection who were hospitalized in a tuberculosis hospital providing specialized medical care to inmates from 2012 to 2018. (367 people). The study methodology was developed in several stages with the use of the methods of system analysis and mathematical modeling (logical-statistical method of optimally reliable partitions, the method of analysis of hierarchies, artificial neural network, methods of statistical grouping). The result of a complex multi-stage research makes possible the development of the prognostic index forecasting outcome of HIV-associated tuberculosis in prisoners. For the automated calculation of the developed index a software package was created. Interpretation of the received data allows timely correcting of diagnostic and treatment tactics in order to improve the quality of medical care and reduce the hospital mortality rate. The developed information system does not require complex and expensive diagnostic measures, it is easy to use and can be suggested to use as a screening method.

The article considers the possibilities of using cluster analysis and modeling of cancer monitoring in inmates. The article presents the analysis based on the hierarchical clustering, the k-means method along with F-test criterion for the main indicators monitored in the penitentiary system. The application of modeling was analyzed using the example of regression analysis of the data. The development of the model was relative to the indicator of the proportion of mortality rate to the total number of malignant neoplasms. According to the statistic data of 2018, the main statistical indicators on oncopathology in inmates reflect a similar situation in the whole country. The researchers consider the possibility to apply the results obtained not only within the penitentiary system, but also to monitor the situation with cancer in the country in general.

Microbiological features of milk mixes and ice were studied during the principal process stages, which enabled to detect the highest risk points for bacterial contamination. Compared to known information, the impact was established of vegetable raw chemical composition and preliminary treatment on the presence and activity of certain groups of germs in higher water content mixes and ice. The microbiological features of higher water content milk mixes and ice were studied. The study purported to survey the bacterial contamination of milk mixes and ice of various chemical composition throughout the whole production cycle. Microbiological features were studied of typical composition milk mixes and ice stabilized with wheat flour and modern stabilization system. Comparative evaluation of microbiological features was conducted for new types of milk ices with apple puree and wheat germs. We analyzed the stage of development, stability, and die-off for various groups of germs at certain process stages. The initial raw materials as well as equipment, especially during freezing, were detected to be the worst sources of bacterial contamination. The necessity was proved to ensure thermal processing of cereals prior to adding them to the mix, before it is sent for pasteurization and freezing. The results of our study can be used to develop operational procedures for production of new types of ice, with due consideration for all specific conditions for prior treatment of vegetable raw and for sanitary state of facilities for production, sales, and consumption of finished product.

Biurate complexes with 4-phenylthiosemicarbazide, namely, [Mn(HL)2](Urat)2, [Co(HL)3](Urat)3, and [Ni(HL)4](Urat)2 (HL is 4-phenylthiosemicarbazide, Urat is anion of uric acid dissociating at first stage) are synthesized and their physicochemical properties and structures are studied by spectroscopic (IR and diffuse reflection) and DTA methods.

Coordination compounds of biurates with thiosemicarbazide [Mn(HL)2](Urat)2(H2O)2, [Co(HL)3](Urat)3(H2O)3, [Ni(HL)2](Urat)2(H2O)2, and [Ni(HL)2](Urat)2(H2O)4, where HL is thiosemicarbazide, and Urat is the anion of uric acid dissociated by the first step, were synthesized. The physicochemical properties and structures of the compounds were studied by IR and diffuse reflection spectroscopies, magnetochemistry, and DTA.

The idealized liquid-crystal structures of two cyclolinear organosilicon polymers, viz., poly(oxyhexaorganocyclotetrasiloxy-2,6-diyls), where the alkyl substituent is Et (1b) or Pr (1c), were modeled. The columns of monomer units in polymers have different conformations, viz., a distorted long boat in 1b and a distorted long chair in 1c. Both polymers have columnar structures with the most probable antiparallel arrangement of the columns.

Из 150 больных с нетравматическими кровоизлияниями в заднюю черепную ямку окклюзионно-гидроцефальный синдром возник у 64, с выраженной прогредиентностью — у 36. Диагноз установлен на основании данных клиники и дополнительных методов — КТ и МРТ. По поводу прогредиентного окклюзионно-гидроцефального синдрома оперированы 36 больных, из них 22 умерли (летальность 61%)., From 150 patients with nontraumatic hemorrhages in posterior cranial fossa the occlusion hydrocephalic syndrome developed in 64, with expressive progression — in 36 patients. The diagnosis was established on the base of clinical data and additional methods — CT and MRI. 36 patients were operated because of progressive occlusion-hydrocephalic syndrome, 22 of them died (lethality 61%)., З 150 хворих з нетравматичними крововиливами в задню черепну ямку оклюзійно-гідроцефальний синдром виник у 64, з вираженою прогредієнтністю — у 36. Діагноз встановлений на підставі даних клініки і додаткових методів — КТ і МРТ. З приводу прогредієнтного оклюзійно-гідроцефального синдрому оперовані 36 хворих, з них 22 померли (летальність 61%).

The features surface morphology are considered for plasma-sprayed coatings used with various counterbodies under conditions of boundary friction. The tribotechnical characteristics of the coatings are examined in relation to the structure. There is found to be a substantial effect from the porosity on the formation of the secondary structures, the changes in topography, and the changes in elemental composition of the friction surface.

The study is concerned with the outcomes of the treatment of 364 patients with combined trauma (craniocerebral injuries of different severity and fractures of skeleton bones [453]). Patients management and fracture fixation methods are presented. Primary osteosynthesis (during the first day after trauma) was done in 45.9% of victims and delayed osteosynthesis - in 54.1%. The following fixators were applied: plates (46.6% of victims), external fixation devices (36.6%), rods (9.9%), other types (6.9%). Early osteosynthesis (during the first three days after trauma) did not increase the lethality and complication rate. At follow up period of 12-18 months the long term results were studied in 98 of 364 patients. Good outcome was achieved in 79.6% of cases, satisfactory - in 17.3% and unsatisfactory in 3.1% of cases. The authors consider that primary and early osteosynthesis in patients with the combination of craniocerebral and skeleton injuries enable to improve the outcomes, reduce the lethality rate, shorten the duration of hospitalisation and promote early rehabilitation.

Results of studying microstructural changes in eutectic alloys with different types of spraying are summarized. A distinctive feature of alloys which have eutectic carbides of the type MeC is that they do not change their shape and composition during different methods of spraying. The morphological characteristics of oxides phases are demonstrated. Addition of alloying elements with an affinity for oxygen makes it possible to alter the morphological characteristics.

Homological properties of associative algebras arising in the theory of helices are studied. A class of noncommutative algebras is introduced in which it is natural (from the viewpoint of the theory of helices) to deform projective spaces and also certain Fano varieties. It is shown that in the case of deformations of the projective plane this approach leads to algebras associated with automorphisms of two-dimensional cubic curves.

An analogue of the Bernshteĭn-Gel'fand-Gel'fand equivalence is proved for triangulated categories generated by exceptional sets with special properties. The proof uses the technique of mutations and helixes.

1. The corrosion resistance of multilayer nitride coatings is higher than that of single-layer ones, which may be explained by their greater thickness and features of their microstructure, including the absence of acicular crystals characteristic of singlelayer coatings. 2. Failure of nitride coatings under the action of a corrosive medium occurs at structural defects, which determine their corrosion resistance and electrochemical properties.

The effect of alloying with aluminum and cerium on morphological features and production characteristics of eutectic alloys based on iron is studied. An aluminum content from 0.5 to 3.0% modifies particle shape from compact and rounded to particles with a very developed surface. A reduction in the segregation point of impurity elements, primarily sulfur and phosphorus, is observed on adding 0.05–0.16% of cerium. Cerium also promotes formation of spherical particles which provides good production characteristics.

The paper is based on the analysis of 235 young and middle-aged patients with nontraumatic hemorrhage, with hypertensive disease and atherosclerosis of cerebral vessels having been by far the commonest cause of the trouble (82.9%). In all observations, diagnoses were verified with computerized tomography, magnetic resonance tomography and angiography and during surgery and in autopsy as well. Basically, in the clinical course of nontraumatic intracerebral hemorrhages, there have been identified three syndromes that reflect to a considerable extent the time-related course of dislocation-type changes. Depending on the site of hemorrhage and in accordance with the WHO classification, a comparative description is given for groups of patients presented with blood in the basal ganglia and of those with caudad-capsular, striocapsular hemorrhage, medial, mixed, and intralobar ones, with certain prognostic criteria established.

The study included 12 operated patients with medullocervical gliomas. Two of them had hemangioblastomas, 6-ependymomas, 4-astrocytomas with different degree of dedifferentiation. The gross total tumor removals were achieved in 4 patients with ependymomas and patient with hemangioblastomas. Two patients with ependymomas and one with hemangioblastoma had their tumors removed subtotally. All astrocytomas were partially excised. The neurological long tract signs were alleviated almost in all ependymoma and hemangioblastoma patients after surgery. Complication rate was the highest in the astrocytoma group. The authors discussed indications and contraindications for surgery depending on the tumor type.

The paper is based on the analysis of 235 young and middle-age patients with non-traumatic cerebral hemorrhage. Tactics of treatment is determined for each group depending on bleeding localization in accordance with World Health Organization's classification (1981). Operative treatment is recommended for lateral site of hematomas of 25 cm3 and more signs of media structures dislocation of 5 mm and more. With the development of hypertension-hydrocephal syndrome surgical intervention is directed at its elimination and where possible at hematoma's ablation. The amount of operative interventions is limited in case of medial and mixed variants of hemorrhages especially when bleedings affect mesencephal structures. In conditions of a neurosurgical clinic a pharmacotherapy is used as an independent one, as a preparation for surgical treatment as well as during operation and in postoperative period.

Examination was done to 196 injured persons with the closed abdominal trauma and hepatic injury. Reverse dependence between the trauma severity and frequency of abdominal symptoms exposure was established. Importance of rational use of instrumental diagnostical methods to reveal the hepatic injury timely was stressed.

Heart activity was studied by electrocardiography (ECG) and variation pulsometry in patients aged from 17 to 44 1-21 days after light brain trauma. Homeostatic imbalance between suprasegmental structures of the brain was established. Disintegrated activity of these structures results in increase of ECG and variation pulsometry may be additional criteria for assessment of interactions between sympathetic nervous system and different levels of heart rhythm regulation.

The results of treatment of 82 patients with associated injury to the nerves of the extremities have been analysed. In rupture of a nerve, the clinico-neurologic examination has the most informative value, in its partial injury, the performance of electrophysiologic investigations is mandatory. A degree of restoration of the extremity function depends on timeliness and adequacy of the operation.

The authors analyze treatment results of 123 patients with neurological manifestations of cervical osteochondrosis. Complex treatment was used medical and surgical. In 110 patients hyperbaric oxygenation was used and it is suggested that in the complex treatment of such patients it proved rather effective. Use of hyperbaric oxygenation is indicated in treatment-resistant forms of cervical osteochondrosis and may also be an additional test for indications of surgical interventions.

In the article are presented the results of surgical treatment of 176 patients with associated craniocerebral injury. To the primary osteosynthesis in the first post-hospital day have been subjected 75 patients and to the postponed osteosynthesis--101 patient. For osteosynthesis there have been applied the methods of stable-functional osteosynthesis by plates (57.3%), by means of the external fixation apparatus (19.8%), by rods (10.8%) and by other means. The experience of the primary osteosynthesis, including the experience of simultaneous operation on 2-3 segments with application of the atraumatic technique, indicates that the operation doesn't aggravate the severity of injury but ensures more quick rehabilitation of the patients with craniocerebral injury, guarantees the complete restoration of function during 1-2 post-operative months.

The dynamics of brain edema and swelling was studied according to the indices of separate impedancemetry in the early posttraumatic period in 36 patients with severe craniocerebral trauma. Swelling of the brain predominated on the 1st and 2nd days in most patients. Later, depending on the severity of the posttraumatic period, the swelling may grow or be replaced by edema with subsequent normalization. A parallelism was revealed between the severity of brain edema and swelling, the intracranial pressure value, and the severity of the patient's condition.