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Introduction. The primary focus for improving medical care is introduction of inpatient-replacement forms of healthcare for patients, particularly, with prostate cancer (PCa). Day-care facilities at outpatient institutions and hospitals are considered the most cost-effective and convenient for patients. It is expected that the introduction of new survey methodologies and the optimization of their use in day-hospitals of outpatient clinics will reduce the use of other diagnostic procedures, including invasive ones, and will allow the specialist to determine the treatment tactics and method.Objective. To improve the quality of PCa diagnosis with the use of high-tech advanced outpatient medical care.Materials & methods. To assess the appropriateness and effectiveness of transrectal prostate biopsies (TRPBs) in the day hospital, we have compared the statistics obtained in outpatient clinics with inpatient hospital divisions of the corresponding urban district. A comparative analysis of the data obtained using a standard examination algorithm was carried out: prostate-specific antigen analysis, digital rectal examination and transrectal ultrasound examination with a group of men who used multiparametric magnetic resonance imaging (mpMRI) in the examination algorithm prior to TRPB.Results. The average annual number of TRPBs performed in inpatient urology divisions (three сapital hospitals from Western urban district) was 344, and the PCa detection was 142 (41%). In the outpatient urological unit of the Branch No. 2, Moscow Outpatient Clinics No. 195 for the period from 2010 to 2017, the average annual number of TRPBs was 440, and the PCa detection was 153 (35%) Thus, from the above data, it appears that with inpatient-like PCa detection, one large outpatient urological unit performed on average 24% more TRPBs (440 versus 344) than three inpatient urological divisions in a comparable period of time. When comparing histological data obtained after TRPBs in the absence and presence of pelvic mpMRT, a reliable difference (42% vs 35%) was found in PCa detection, respectively.Conclusion. mpMRI due to its high sensitivity and specificity in PCa diagnosis, which can be recommended as a mandatory diagnostic step before TRPB. In addition, mpMRI can significantly reduce the number of unnecessary TRPBs, increase the effectiveness of timely PCa diagnosis at the early stages.

To study the whole range of problems that should be resolved in the process of innovation management in education it is necessary to realize that teaching is flexible, supple and requires continuous research. The goal of the article is to corroborate rightness of theoretical vectors by permanently changing practice. Theoretical and methodological foundation of the step-by-step research presented in the article is formed by principles of economic and comparative analysis, methods of induction and deduction and finally the method of archive search. The authors proposed an innovation approach to achievements in the field of education and showed the efficiency of Russian experience of well-known economists and experts in economics, psychology and sociology.

Motor disorders are among the most common consequences of severe craniocerebral injury (traumatic brain injury — TBI). Deeper insights into pathophysiological mechanisms of these disorders is important both from a theoretical point of view and in terms of improving neurorehabilitation approaches.The aim of the study was to investigate the correlation of right–sided posttraumatic hemiparesis severity with composite characteristics of fractional anisotropy (FA) in the segments of the corpus callosum (CC), corticospinal tract (CST) and the inferior fronto-occipital fasciculus (IFO) at different stages of traumatic disease (acute, subacute and long-term periods).Material and methods. Cases of 43 patients with TBI were analyzed (28 men and 15 women aged 13 to 59 years, mean age 28±9 years). Forty patients were diagnosed with severe TBI with diffuse axonal damage, three patients had moderate severity TBI. Long-term follow up included continuous clinical and neurological examination with evaluation of patient’s level of consciousness using the CRS-R scale, and the degree of motor deficits in right-sided hemiparesis using a five-point scale. During three post-TBI periods (up to 1 month, from 1 to 6 months, and from 6 to 12 months), patients were examined using diffusion tensor MRI (DTI), tractography and FA. Motor, cortico-spinal tracts and IFO were divided by measurement grid, correlations between FA and scores of right-sided hemiparesis were calculated for each segment.Results. FA correlations (P0.05) with the severity of hemiparesis were established not only for CST motor-specific segments, but also for some CC and IFO segments. In the early period of TBI significant correlations with hemiparesis severity were found not only in the contralateral CST segments, but also in the ipsilateral ones. Significant differences in FA in the related CC and CST segments were found between the groups with good and limited motor recovery: at all stages after TBI, FA was higher in patients with successful recovery.Conclusion. The results of the study provide better insight into pathophysiological mechanisms of post-traumatic motor disorders development, therefore favoring optimization of therapeutic strategies.

Purpose: to develop a logistic regression model for early differential diagnosis of viral and bacterial community-acquired pneumonia in children. Materials and methods. A prospective study of the clinical and laboratory features of community-acquired pneumonia (CAP) was carried out in 130 children. A complex approach using bacteriological, molecular genetic, serological diagnostic methods (material – nasopharyngeal swabs, pleural effusion, blood) was used to establish the etiology of CAP. Two etiological groups of CAP were distinguished: viral (n=76), bacterial (n=44). The binary logistic regression method was used to create a differential diagnosis model. Potential predictors of CAP etiology were anamnestic, clinical, laboratory (complete blood count), instrumental (chest x-ray) data. The quality of the constructed regression model was evaluated on a validation set of 42 children with CAP. Results. A statistically significant (p

Assessment of viral load levels in various biological samples taken from the respiratory tract can be an indicator of an ongoing process of active viral replication and may be used to monitor severe respiratory viral infections. The study of the relationship between SARS-CoV-2 viral load and immunological laboratory parameters is an important step in the search for clinical markers of COVID-19.The aim of this research was to quantify viral load in patients with COVID-19 and to identify the relation-ship between viral load and changes in the parameters of the cellular component of the immune system.A laboratory examination was carried out on 74 patients diagnosed with COVID-19, they were divided into 3 groups based on the severity of the disease: mild, moderate, severe. Total viral load in clinical samples was determined by the number of SARS-CoV-2 RNA copies per 100 copies of the reference RNaseP gene. A comprehensive assessment of the cellular component of the immune system was performed using flow cytometry and direct monoclonal antibodies, and the IL-6, and C-reactive protein concentrations were determined.We revealed a relationship between the development of serious clinical conditions in the patients with COVID-19, and the levels of viral load. High levels of viral RNA in biological samples correlate with main indicators of the T cell component of the immune system associated with disease severity. In a subgroup of patients with an extremely high viral load, strong positive correlations were found between the relative numbers of cytotoxic lymphocytes (CD3+CD8+), activated T lymphocytes (CD3+HLA-DR+), as well as absolute and relative numbers of activated B lymphocytes and NK cells (CD3-CD25+).Laboratory monitoring of the cellular component of the immune system, along with the assessment of viral loads, should improve early assessment of clinical condition in the patients with COVID-19. Changes in expression levels of activation markers on immune cells can be potentially viewed as indicators of recovery during COVID-19.

Diseases caused by Streptococcus pneumoniae are a serious medical and social problem for healthcare systems of all leading countries around the globe. In this regard, the relevance of their laboratory diagnostics increases, as the effectiveness of therapeutic, preventive, and anti-epidemic measures depends on it. Currently, there is no universal method of intraspecific identification of S.pneumoniae, which simultaneously possess high specificity, sensitivity, and reproducibility. For this purpose, new alternative strategies aimed at improving the quality of research are being developed. The review presents data from domestic and foreign publications (electronic search databases eLibrary.Ru, ScienceDirect, Scopus, PubMed, Springerlink) on serotyping and genotyping of S.pneumoniae; the advantages and disadvantages of the methods are analyzed. Epidemiologically significant serotypes and widespread clonal complexes of S.pneumoniae circulating on the territory of the Russian Federation have been identified. The necessity of improving new methods of intraspecific typing of the pathogen is recognized.

Хронические нарушения сознания (ХНС) представляют собой синдромы тяжелого поражения центральной нервной системы, приводящие к длительной грубой инвалидизации и требующие значительных усилий по лечению и реабилитации, которые ложатся на медицинские учреждения и на плечи близких пациентов. ХНС развиваются у пациентов после комы и характеризуются наличием бодрствования при полном или практически полном отсутствии признаков осознанного поведения. К ХНС относятся вегетативное состояние (ВС) и состояние минимального сознания (СМС). Также для описания начальных стадий этих состояний используется термин «продленное нарушение сознания» (ПНС). Отдельно выделяют выход из СМС — состояние, которое формируется по мере восстановления когнитивных функций. Диагностика ХНС основывается на многократном структурированном клиническом осмотре с применением специализированных шкал при условии исключения обратимых причин нарушения сознания. Лечение пациентов с ХНС включает в себя поддержание жизненно важных функций, обеспечение оптимального питания и борьбу с типичными осложнениями и сопутствующими состояниями (пролежни, спастичность, боль, пароксизмальная симпатическая гиперактивность и др.). У пациентов с ХНС должна проводиться реабилитация с участием мультидисциплинарной реабилитационной команды в объеме, который определяется проблемами и возможностями конкретного пациента. Наиболее эффективной реабилитация является при условии ее раннего начала. На данный момент однозначных доказательств эффективности каких-либо специфических методов, направленных на восстановление сознания, не получено; изучается ряд соответствующих фармакологических и нефармакологических вмешательств, обязательным условием применения которых является максимально возможная коррекция соматических проблем пациента. Важную роль в ведении пациентов с ХНС играет вовлечение близких пациента, которые, в свою очередь, нуждаются в получении объективной практической информации о состоянии своего родственника и о направлениях реабилитации, а также в психологической помощи.

Topicality of the document prepared by the Ministry of Economic Development of the Russian Federation -the Forecast of the Social and Economic Development of the Russian Federation up to 2024 (hereafter referred to as the MED Forecast) implies both estimation of principle factors, which can affect the development of economy in the country within the set period and at the same time demonstration of the potential effect of steps planned by the government. The article shows that it is the draft of the forecast and of the strategy of the country development. The authors think that the document shall be reviewed as a proposal, where key factors of economy will be budget rule execution, i.e. fixing long-term restrictions on budget policy indicators; investment in the fixed capital attended by certain measures of the government aimed at creating conditions for their growth; monetary and credit policy providing economic development stability; pension reform connected with the supposed improvement on labour market. Methodological foundation of the research was formed by a number of academic methods, such as observation and collection of facts, modeling, analysis and synthesis, system approach, induction and deduction, historic and logical methods. It is a combination of modes that are used for comprehensive characteristic of phenomenon and process development through digital data. Nature of set tasks determined the necessity to apply such method as the archive search and the comparative method.

The idea of the category ‘property’ is diverse and it is studied by economists, philosophers, lawyers, politologists and other experts. It is one of the basic categories in researching economic systems, especially economies being transformed as well as transitional ones. The subject is undoubtedly acute. Property is a category, which is filled by specific terms of different sciences, it is changeable in view of public expediency, economic and political situation and it becomes a key one in economic comparativistic. The goal of the article is to study and compare opinions of Russian and overseas scientists, academic schools and at the same time to investigate archive materials and academic works by present day academics dealing with the topic. The novelty of the article is connected with the multi-sided research of the category ‘property’. Theoretical and methodological foundation of the article was formed by principles of historism, system and comparative analysis, which support investigation of phenomena in their development and can be used with due regard to historical-retrospective and comparative-historical approach to such a phenomenon as property. On the basis of historical-genetic method it is possible to define the substantial content of the phenomenon. The authors also provide definitions of the notion ‘comparativistic’.

Objective: to analyze the characteristics of the functional neuroanatomy of movements in severe traumatic brain injury (STBI) patients with varying severity of motor defect versus that in healthy individuals for the study of brain neuroplasticity as a basis of compensation.Patients and methods. Functional magnetic resonance imaging (fMRI, 3T) was used to analyze cerebral hemodynamic changes in 28 patients with STBI during an active right-hand finger tapping task. A control group consisted of 17 healthy individuals. The percentage of representation of individual brain structures involved in movements and volume activation (Vox) was determined in fMRI responses.Results. The patient group showed a tendency for an increased fMRI response diffusion with the emergence of activation zones (the left frontal and parietal regions, as well as the occiptal and temporal regions of the cerebral hemispheres) that are atypical for healthy individuals during motor exercises. This trend is more evident in patients with right-sided hemiparesis.Conclusion. The results of the study clarify the existing ideas about the neurophysiological mechanisms of motor impairment and compensation in traumatic brain injury, which is important for the development and improvement of neurorehabilitation techniques. There is evidence for the hypothesis that the extrapyramidal system may be actively involved in the compensation for post-traumatic musculoskeletal defect, which was earlier proposed by E.V. Sharova et al. (2014).

There is recommended in this article to change some principles in the formation of pedagogical and psychological aspects in teaching of informational technologies. Features for the development of tactic and strategy of the use of informational technologies in educational process are observed.