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Introduction. The study of youth ideals is of traditional interest because they provide an understanding of youth values and social orientations, which determine the choice of future and current social behaviour. Ideals are a component of a single image of the world; they are interrelated with the actual (present), possible/impossible and anti-ideal as fundamental modes of human existence. The correlation of ideals with these categories reveals their functionality as regulators of social behaviour. The theories of self-concepts and identity most fully use this system of categories. However, there is still no research of these categories as a single functioning system when studying the image of the social world of young people.Aim. The aim of the current research is to study the ideals of student youth in the context of the desired/present, possible/impossible, and permissible/unacceptable (anti-ideal).Methodology and research methods. The object of research is images of “other people” with socio-group and characteristic features, freely reproduced by students. The online study involved 284 second-year students; they reproduced 6472 images of “others” and attributed 13961 features. To identify the implicit structure of the desired categories, the respondents evaluated “others” on an ungraded scale of “Bottom” (anti-ideal) – Self – “Top” (ideal). The implicit structure includes ideals; images of the present (equivalent Self); images of the desired-possible; images of the undesirable, but possible and permissible; images of the unacceptable (anti-ideals). The author compared the ideals with other evaluative and normative categories by three parameters: 1) the frequency of actualisation in consciousness (relevance); 2) socio-group (institutional) specificity; 3) the value-added content of characteristic features.Results. The frequency of updating images was determined: ideals (7.9%), present (15.4%), desirable-possible (21.9%), undesirable, but possible and permissible (44.9%), anti-ideals (5.6%). Frequency reflects the relevance of categories in the general evaluation and regulatory system, and the probability of their occurrence in students’ minds in a situation of uncertainty. The socio-institutional specificity of ideals lies in the predominance of older and female images, images of relatives, parents and representatives of science. The priority of “loved ones” combines ideals-standards with the composition of the present, and orientation to “distant ones” as anti-ideals. It was found that the content of the ideals represents the hierarchy of personal students’ values and includes several levels: 1) central values are communicative and altruistic; they have the same frequency in all the compared categories; 2) the first level of significance is the values of knowledge; their relevance increases in terms of the possible-desired; 3) the second level is the values of achievement, struggle and risk, practical activity, physical data and comfort; their relevance increases in the samples of the possible (desirable and undesirable); 4) the third level is the values of social normativity; their relevance increases for anti-ideals. The images of the present indicate a low relevance of struggle, risk and achievements. The images of the possible correspond to ideals in the content of values, and reflect the values of the second level most specifically and differentiated. The most relevant are the samples of the undesirable possible.Scientific novelty. The values and social attributes of ideals are considered in relation to the categories of the present, possible (desirable and undesirable), anti-ideal. Quantitative relations of these categories in the current consciousness of young people are described.Practical significance. The results are useful for analysing and predicting the social behavior of young people.

Background. Carotid artery restenosis is a rare complication of carotid stenting. The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) reveals an in-stent restenosis rate of 0–6 %, a fairly low value given an extensive study sampling of patients. Restenosis still lacks an adequate explanation in endovascular carotid surgery. Intravascular ultrasound visualisation, drug-coated balloons, stent reimplantation or reconstructive surgery have actively been used since relatively recently to tackle restenosis. Drug-coated balloons may fail in certain cases due to hampered restenosis angioplasty in a markedly rigid neointimal hyperplasia. Surgical reconstruction also possessed drawbacks, mostly due to obstacles in the stent removal and the procedure infeasibility in high-risk surgical patients.Materials and methods. The article describes a clinical case of stent-in-stent restenosis correction with drug-coated balloon-expandable re-stenting of right internal carotid artery and a long-term prognosis estimation with optical coherence tomography.Results and discussions. This tactic was adopted due to haemodynamically and clinically significant internal carotid artery restenosis, the patient’s denial of carotid endarterectomy and insufficiently effective balloon angioplasty. The choice of the correction technique was conclusive basing on a negative stent deformation testing that showed the lack of deforming stress factors at internal carotid artery restenosis. Intravascular imaging greatly enhances our ability to understand and assess endovascular processes.Conclusion. We consider clinically significant restenoses in previously stented carotid arteries as requiring further research effort, with the clinical case presented describing an individual solution.

Currently, hemorrhagic fever with renal syndrome (HFRS) remains the most common natural focal disease of viral etiology in the Russian Federation. Effective antiviral drugs have not yet been developed. Pathogenetic and symptomatic drugs are mainly used in the treatment of HFRS.The aim of the study was to evaluate the clinical and laboratory effectiveness of intravenous gabriglobin in the treatment of moderate forms of HFRS.Materials and methods. The study included 22 patients with a diagnosis “HFRS of moderate severity” in the febrile stage of the disease. In the febrile period of HFRS, patients of the main group (n=10) were given gabriglobin via intravenous route at a dose of 0.1 g/kg per day along with pathogenetic therapy. The course of treatment was 2–3 infusions. The control group (n=12) received only pathogenetic therapy.Results and conclusions. As a result of the studies, the clinical and laboratory efficacy of intravenous administration of gabriglobin in the treatment of patients with moderate-grade HFRS was revealed, which was manifested by a decrease in the duration of the febrile period by 2.1 days, the severity of oliguria and a decrease in the duration of thrombocytopenia by 3.5 days compared with the group of patients receiving only pathogenetic therapy.

Currently, there is a trend towards the increase in invasive forms of infection (liver abscess, meningitis, endophthalmitis, etc.) caused by “hypervirulent” strains of Klebsiella pneumoniae (hvKP) in adults. We have studied the frequency of hvKP release in newborns and infants with various forms of community-acquired and nosocomial klebsiella infection. Strains of Klebsiella possessing the rmp A gene, which is associated with hypermucoid phenotype, were considered “hypervirulent. Klebsiella strains with the “hypermucoid phenotype”-associated rmpA gene were considered “hypervirulent”. The gene was detected by polymerase chain reaction. The authors studied a total of 85 strains. The rmpA gene was found in 20 (23%) Kl. pneumoniae strains, including 14 (33.3%) intestinal strains, 3 (25%) urine strains, 3 (15.7%) pharyngeal mucosa strains. The Klebsiella strains isolated from blood (n=5), endotracheal tube (n=6), cerebrospinal fluid (n=1) did not contain the gene. hvKP were significantly more often isolated in children with community-acquired infection (32%) than in children with nosocomial infection (11.4%; OR 3.647; 95% CI 1.100—12.096). Out of 20 children infected with hvKP, 12 (60%) patients were asymptomatic carriers, 3 (15%) children had symptoms of a urinary tract infection, and 5 (25%) children had symptoms of an intestinal infection. Infected children have both a potential risk of endogenous dissemination of the pathogen, and they are an epidemiologically dangerous to others.

On the basis of the literature the article analyzes the methodological aspects of preoperative planning and surgical techniques for the prevention intra- and postoperative complications for colproctectomy with J-pouch reservoir. Knowledge of these features can reduce the number of complications and improve the functional results of surgical treatment.

In the SFHI (State Funded Healthcare Institution) Republic’s Centre for Cardiology the method of alcohol septal ablation has been introduced in 2015. The paper presents one case of a successful treatment of a patient with hypertrophic cardiomyopathy with left ventricular outflow tract obstruction treated with the use of the method of alcohol septal ablation under control of contrast enhanced echocardiography of the ablation area in the interventricular septum.

Introduction. The use of intravascular imaging techniques, in particular intravascular ultrasound, makes it possible to reduce the number of subsequent revascularisations. The method of optical coherence tomography (ОСТ), due to its high resolution accuracy, makes it possible to establish and assess the edge dissection, stent thrombosis, tissue prolapse, and strut fracture and malposition. This paper aims to assess the impact of routine use of OCT on long term outcomes in patients with scaffolds implanted.Materials and methods. 32 stenting procedures with the use of bioresorbable coronary intravascular scaffolds (Absorb, Abbot Vascular) were performed in 2014-2015 with subsequent visualisation and assessment with optical coherence tomography. In the control group (n=16) scaffolds were implanted without the use of OCT under traditional contrast enhanced X-ray imaging. The analysis of the combination of outcomes that included subsequent emergency revascularisation in the target artery, cardiac death, myocardial infarction and 12 months post-op OCT imaging data, served as the end.Results. The total of 55 BVS were implanted, 22 in the OCT group and 23 in control. Suboptimal results were registered in eight cases out of 16 in the OCT group (50%). These included: one dissection and atherosclerotic plaque prolapse — implantation of a second BVS and postdilatation, one eccentric stent expansion — a model for acute thrombosis, resolved with postdilatation, and stent underexpansion in the remaining six. Once the OCT revealed the intima dissection following predilatation; this was stabilised with the implantation of a second scaffold. The examination results at 12 months follow up established that there were 3.215 more scaffold restenoses in the control group.Conclusion. The cutting edge technique of intravascular revascularisation with bioresorbable coronary scaffolds requires careful preparation and intraoperative control. The results of our study support the use of intravascular imaging techniques as methods of choice for the assessment of the expansion, areas of dissection, thrombosis and scaffold eccentricity.

The authors studied microbial composition and metabolic activity of the intestinal microbiota in 20 babies born by caesarean section (main group) and 20 babies born vaginally (control group). There were isolated bifidobacteria from meconium at a concentration of 105– 1010 CFU/g by the bacteriological method in 4 (20%) children of the main group and 6 (30%) children in the control group. The gas-liquid chromatography revealed the metabolic activity of various representatives of the intestinal microflora in children of both groups, regardless of the mode of delivery; the indicators of metabolic activity were significantly lower than in the infants. The children in both groups had similar absolute and relative content of short-chain fatty acids in meconium. The data of gas-liquid chromatography indicate the metabolic activity of the meconium microbiota, which is dominated by anaerobic microbial populations and there is a high proportion of proteolytic and conditionally pathogenic flora. The data obtained confirm the process of intrauterine translocation of microbes from mother to child and indicate the importance of the microflora of the future mother in the process of forming the intestinal microbiota of the child.

Since the spread of multidrug-resistant Klebsiella pneumoniae (MDRKP) strains is considered as a challenge for patients with weakened or suppressed immunity, the emergence of isolates carrying determinants of hypervirulent phenotypes in addition may become a serious problem even for healthy individuals. The aim of this study is an investigation of the nonoutbreak K. pneumoniae emergence occurred in early 2017 at a maternity hospital of Kazan, Russia. Ten bacterial isolates demonstrating multiple drug resistance phenotypes were collected from eight healthy full-term breastfed neonates, observed at the maternity hospital of Kazan, Russia. All the infants and their mothers were dismissed without symptoms or complaints, in a satisfactory condition. Whole-genome shotgun (WGS) sequencing was performed with the purpose to track down a possible spread source(s) and obtain detailed information about resistance determinants and pathogenic potential of the collected isolates. Microdilution tests have confirmed production of extended-spectrum β-lactamases (ESBL) and their resistance to aminoglycoside, β-lactam, fluoroquinolone, sulfonamide, nitrofurantoin, trimethoprim, and fosfomycin antibiotics and Klebsiella phage. The WGS analysis has revealed the genes that are resistant to aminoglycosides, fluoroquinolones, macrolides, sulfonamides, chloramphenicols, tetracyclines, and trimethoprim and ESBL determinants. The pangenome analysis had split the isolates into two phylogenetic clades. The first group, a more heterogeneous clade, was represented by 5 isolates with 4 different in silico multilocus sequence types (MLSTs). The second group contained 5 isolates from infants born vaginally with the single MLST ST23, positive for genes corresponding to hypervirulent phenotypes: yersiniabactin, aerobactin, salmochelin, colibactin, hypermucoid determinants, and specific alleles of K- and O-antigens. The source of the MDRKP spread was not defined. Infected infants have shown no developed disease symptoms.

Aim: to establish the role of insulin-growth factor (IGF)-1 in myocardial remodeling in female patients with arterial hypertension (AH) and metabolic syndrome (MS) and different stages of obesity Materials and methods. The study included 108 women with AH and MS, divided into 3 groups according to stage of obesity, and 28 healthy women. It was assessed the concentration of IGF-1, status of hemodynamic and types of left ventricle's remodeling. Results. Concentric remodeling and IGF-1 elevation prevailed in patients with AH and first stage of obesity. Concentric hypertrophy of left ventricle and normal level of IGF-1 were established in patients with second stage of obesity. Lack of IGF-1 were determined in women with obesity 3rd stage and eccentric hypertrophy. Correlation analysis in patients with 2-3 stages of obesity showed the linkages between concentration of IGF-1 and hemodynamic parameters. Conclusion. The level of concentration of IGF-1 in patients with AH and MS correlates with remodeling types and stage of obesity.

Introduction. Pulmonary arterial hypertension (PAH) is a rare disease of unknown etiology, characterized by increased resistance of pulmonary vessels, which leads to right ventriculae heart failure and, eventually, death. At the same time, according to the literature, it has been established that the presence of an atrial septum defect in patients with idiopathic PAH (iPAH), is accompanied by a longer life expectancy, improves its quality and is the prevention of sudden death due to the development of a pulmonary hypertensive crisis. We decided to perform an operation to create an atrial septum communication (ASC) in patients with iPAH.Materials and methods. Clinical cases showed efficiency in creating interatrial septum fenestration by implantation of intentionally fenestrated occluder in patients with PAH.Results. It was in studies revealing that the advantage of this method as compared to others is close good fixation of the device on interatrial baffle which reduces possibility for the device to migrate from fixed position in the heart cavity and to reduce intra-operative complication. After implantation of fenestrated occluder the patients showed significant improvement of life quality: decrement of breathlessness, higher tolerance to physical exertion, less swelling in lower limbs, absence of syncopal condition. Such procedure perhaps prolongs life time.Conclusion. Implantation of fenestrated occluder, modified in intra-operative conditions, can be an adequate method to help patients with iPAH, under conditions of unavailability of special devices in the market.

Introduction. Presently there is no unified tactics to treat patients with aberrantly localized coronary arteries of “muscular bridge” type. There are controversial data regarding the benefit of coronary artery stenting due to often stent breakage or perforation of tunneled vessel. There are no major randomized studies regarding this issue. In this regard the goal of this research was to assess strength characteristics of stents in the model of muscular growth that we restored.Materials and methods. The originally developed model enabled to determine the strength limit of coronary stents under conditions that are maximum close to the physiological ones. The stents were placed into a polytetrafluoroethylene tube, the bridge-imitating oscillation frequency was configured to 250 beats per minute. The results of the experiment were recorded on USB-camera each 30 minutes in order to register mechanical defects of the stent.Results and discussion. The stent consisting of cells that are joined with V-shaped connections, showed first signs of strut deformity on the 10th day. Complete breakage happened on the 17th day after implantation. After 2 months observation the stent preserved mechanical firmness without V-shaped connections.Conclusion. Thus, it is not quite correct to support the hypothesis on infeasibility of stent implantation into the coronary artery with a muscular bridge. Taking into consideration the findings it is possible to suppose that the structure, design, form and content of stents predetermine the possibility to implant it into coronary artery with muscular bridge, but require individual approach to every particular patient.

Objective: presenting the latest finding about the process of the formation of the intestinal microbiota of children in the early stages of development and the factors that influence this process.Intestinal microbiota plays a key role in the physiology and maintenance of the homeostasis of the human body. The results of molecular genetic studies show that the formation of the intestinal microbiota begins in utero, and the child receives mother’s microflora throughout pregnancy, childbirth and breastfeeding. The microbial colonization of a child by mother’s and environmental microorganisms is the most intensive in childbirth and the postnatal period. Both intrauterine and neonatal periods are critical stages in the formation of the child's microbioma, which significantly determine the state of their health throughout further life. The composition of the microbiota being formed depends on the gestational age of the child, the mode of delivery, the type of feeding, antibacterial therapy, the sanitary and hygienic environmental conditions, geographical conditions, etc. A deeper understanding of the processes of intestinal microflora formation will allow developing effective methods for the prevention and correction of microecological disorders in the child.

The incidence and mortality rate of C. difficile infection (CDI) has increased remarkably over the last 10-20 years. CDI is a leading cause of healthcare-associated infections and antibiotic-associated diarrhoea. Increasing incidence and severity of CDI may be related with frequent antibiotic use and the emergence of a hypervirulent C. difficile strain. The epidemic strain NAP1 / BI / ribotype 027 is more resistant to antibiotics and produces more toxins and causes outbreaks around the world with increasing mortality and severity. Recent reports have documented that C. difficile infections occur among patients without traditional risk factors and the incidence of community-acquired CDI has increased. The clinical presentation of CDI ranging from the asymptomatic carrier to pseudomembranous colitis and toxic megacolon. The rate of recurrent CDI is 20-30 %. Early surgical consultation should be considered in all patients with severe or fulminant CDI. The preferred method for diagnosis CDI is stool testing using enzyme immunoassay (EIA) screening to look for glutamate dehydrogenase (GDH) antigen and toxins A and B. Metronidazole and vancomycin are recommended antibiotics for the treatment of CDI. Novel approaches include fidaxomicin therapy, monoclonal antibodies, and fecal microbiota transplantation. Fecal microbiota transplantation has shown relevant efficacy to overcome C. difficile infection and reduce it.

The etiological structure and clinical manifestations of neonatal infections in 194 newborns hospitalized in an infectious hospital werestudied. 44 children were born by cesarean section (CS), 150 children – by vaginal delivery (VD). Children born by cesarean section were significantly more often hospitalized for mixed infections of the respiratory, gastrointestinal tract and pyoinflammatory skin diseases (CS-20.5% and VD-3.3%, p

Objective research: compare the efficacy of different types of therapy for rotavirus gastroenteritis in children.Materials and methods. A study was carried out, the design of which corresponded to the case–control type. The main group is children hospitalized in a hospital with laboratory confirmed rotavirus infection (35 cases), who were prescribed a modern regimen of therapy that included a low-carbohydrate diet, rehydration with low osmolar oral solutions, dioctahedral smectite, probiotic containing Saccharomyces boulardii. For each child of the main group was selected another patient (control), the corresponding sex, age, the period from the onset of the disease to admission to hospital, and the degree of dehydration. Patients of the control group (n=35) were assigned a traditional «old» therapy regimen, including a diet corresponding to Table No. 4 in Pevznur, oral rehydration solutions with osmolality of 282 mOsm/l, anthibacterial therapy (ceftriaxone), dioctahedral smectite and pancreatin at age-dependent doses. The duration of the observation was 5 days. Results: By the 5th day of treatment, the normalization of the stool was recorded in 91.4% [95% CI 82.1–100.7], 32/35 in the main group and 71.4% [95% CI 56.5–86.3], 25/35 children in the control (p

Low cardiac output and circulatory insufficiency is a risk factor for wound complications in operated patients with coronary heart disease (CHD). The analysis of the number of wound complications in patients with coronary artery disease with low ejection fraction of the heart underwent CABG has done. Two clinical groups has for medin which the sternum fixation and suturing surgical approach produced by traditional (control group) and original (main group) methods. In the study group the number of wound complications was significantly lower and it was allowed to offer this method as a prophylactic.

The article presents a retrospective analysis of patients admitted to the Republican out-patient clinic of cardiology with a diagnosis of acute myocardial infarction, no later than 4 hours from the time of occurrence of symptoms of acute coronary syndrome. The relationship infarct related artery with the development of atrioventricular conduction disturbances in patients undergoing stenting and / or balloon angioplasty of the coronary arteries. A group of patients with persistent atrioventricular conduction disturbances that took place in the future implantation of a permanent pacemaker.

Klebsiella is one of the most common causes of neonatal sepsis. Cases caused by extended-spectrum β-lactamase-producing Klebsiella strains are of the most relevance. The infections caused by these bacterial strains are resistant to the majority of cephalosporins commonly used in practice and lead to significant mortality. The development of their clinical forms, including severe ones, is determined by a number of virulence factors that include capsular antigen, lipopolysaccharide, pili, and siderophores. Despite the fact that the probability of sepsis is highest in premature infants, full-term ones are equally at risk in the situations associated by the infection due to extended-spectrum β-lactamase-producing Klebsiella. Our investigation of the specific features of the course of neonatal sepsis caused by Klebsiella established that hemorrhagic syndrome evolving in the presence of thrombocytopenia is the most common condition developing in Klebsiella-induced sepsis that determines the severity of a patient’s condition and affects the outcome of the disease.

The aim of the work was to estimate a wound-healing effect of soft drug products from the Pentaphylloides fruticosa L. shoots on the model of planar skin-fascial wound. The liniment was developed with the use of the NanoDeBee 30 device and the ointment was developed with the use of pharmaceutical technology. Experiments were carried out on white male Wistar rats. The skin injury was simulated by inflicting planar wounds 2.0 x 2.0 cm in size. The 5%-liniment and 5% ointment from P. fruticosa were put on the wounds of the first and second experimental groups respectively. In the third group the wounds were treated with glycerin-vaseline ointment. Bioptate of the wound surface was taken on the 7th, 14th and 21st day. Histological preparations were studied using standard methods. Cell elements of the first group animals were displayed as fibroblasts and fibrocytes; it was noted high level of collagen organization that testified the effective staging of the wound process in this case. The amount of fibrocytes and fibroblasts and ratio between juvenile and mature forms of collagen-producing cells vary in the first and second groups. Biopsy material obtained from the animals of the third group only on the 21st day corresponded to the picture observed in animals of the 1st group on the 14th day. The findings of the study verify that the use of the product obtained on NanoDeBee device provides the earlier forming of the scar as compared with the ointment developed using pharmaceutical technology.

The development of HIV vaccine remains an important goal in prophylaxis and therapy of HIV/ AIDS epidemics. There are various approaches for development of а candidate vaccine based on induction of neutralizing antibodies and cell-mediated immunity. Synthetic peptides are considered promising vaccine antigens since they are capable of activating both humoral and cellular immune response. HIV-1 envelope gp120 is the target for neutralizing antiviral antibodies. The V3 region of the HIV-1 gp120 is highly immunogenic and important for the virus-coreceptor interaction. In a RV144 vaccine trial, the levels of vaccine-induced IgG antibodies recognizing V1V2 regions from multiple HIV-1 subtypes show inverse correlations with a risk for HIV-1 infection. Meanwhile, HIV is characterized by high diversity. The consensus and mosaic immunogens are complete but artificial proteins, which are computationally designed to elicit immune responses with improved cross-reactive broadness. We have been studied immunogenic properties of synthetic peptides derived from V1, V2, V3 loop regions of the consensus M HIV1 (CON-S) sequence group of the gp 120 envelope protein and V3 loop derived from a Russian RUA022a2 isolate. These peptides specifically reacted to HIV-positive sera in ELISA, thus indicating their similarity to appropriate HIV proteins. The peptides proved to be weakly immunogenic. Therefore, Freund complete adjuvant was used to enhance peptide immunogenicity. To assess the immunogenicity, the mice were immunized with a peptide mixture. Antibodies have been developed to every peptide from the mixture, being, predominantly, of IgG isotype. The antibody titers depended on the length of peptide sequences. However, the sera from immunized mice did not have a HIV neutralizing activity. The serum neutralization was assessed by pseudovirus-based assay, using a molecular clone of virus isolates CAP 45.2.00.G3 and QH.209.14.M.EnvA2. The virus neutralization is a complex process and may be influenced by several factors, such as antibody titer, isotype, or antibody structure. Probably, to induce neutralizing antibodies by this peptide mixture, it is necessary to choose appropriate adjutants and immunization schedule. Moreover, it was shown that peptides could increase in vitro virus infectivity in pseudovirus-based model, using the CAP 45.2.00.G3, QH209.14M.ENV.A2, QD435.100M.ENV.E1 molecular clone. These viral isolates belong to different HIV-1 subtypes.

Despite widespread vaccination, pertussis remains an important cause of infant morbidity and mortality. About 16 million people are ill with this disease and approximately 195 thousand children die worldwide every year. However, only 5—10% of all pertussis cases are diagnosed and notified. In spite of wide immunization coverage, there is really a pertussis epidemic in many countries of the world now; moreover, vaccinated children constitute a high proportion of disease cases. Adolescents and adults are a major reservoir for cyclic outbreaks of pertussis; however, they are rarely diagnosed with the disease. The review gives scientists' opinion on the causes of this phenomenon and proposed measures to reduce morbidity in different age groups. The severe and complicated forms of pertussis and fatal outcomes occur in babies during the first months of life and therefore current vaccination strategies should be aimed at preventing the infection just in this age group of children.

Aim. Determination of enterotoxigenicity and ability to synthesize TSST-1 in S. aureus strains, isolated from breast milk of women, feeding children with infectious pathology. Materials and methods. 35 S. aureus strains, isolated from breast milk of women, feeding children with varying infectious pathology in hospitals and as outpatients, were studied for the presence of staphylococci enterotoxins (SE) of types A and B and toxic shock syndrome toxin (TSST-1). Determination of SEA, SEB and TSST-1 was carried out by enzyme immunoassay. Results. Toxins were detected in 94.2% of S. aureus strains. SEB was synthesized by 86.7%, SEA - 34.3%, TSST-1 - 42.8% of S. aureus strains. Toxins were detected with equal frequencies in healthy women and women with inflammatory diseases ofbreasts. Differences in frequency of colonization of intestines of children receiving breast milk, infected with toxigenic and non-toxigenic staphylococci strains was not detected. Conclusion. A high frequency of occurrence of enterotoxins and TSST-1 in S. aureus, isolated from breast milk of the mother during infectious pathology in the child, was discovered. Enterotoxigenic strains can be detected in breast milk in healthy women. Study of the role ofbreast milk, infected with S. aureus, producing SEA, SEB and TSST-1 in development of child pathology is necessary.

Aim. To study the frequency and characteristics of alcohol use in outpatients with cardiovascular diseases and to determine their preferences regarding the help in limiting alcohol consumption.Material and methods. Voluntary and anonymous survey using AUDIT-C and CAGE questionnaires was conducted in 199 patients. The data of 182 patients (82 women and 100 men, mean age 56.4±5.8 years) was included in the analysis.Results. Arterial hypertension (70%), heart rhythm disorders (25%), ischemic heart disease (20%), functional class I-II chronic heart failure (21%) predominated among all clinical entities. Positive AUDIT-C test was found in 30% of men and 7.3% of women. 17% of men and 23.2% of women did not use alcohol at all. Positive responses to all 4 questions of the CAGE test were given by 3% of men and none of women, positive answers to 3 questions – by 15% of men and none of women, to 2 questions - by 17% of men and 11% of women. Positive answer to the question about the need to reduce alcohol consumption was given by 36% of men and 13.4% of women.Conclusion. Simultaneous testing using AUDIT-C and CAGE questionnaires in outpatients with cardiovascular diseases allows identifying a subgroup of patients (more in men) who have a potential problem with an excessive alcohol consumption and need to reduce the intake of alcoholic beverages.

The authors measured the changes of hemodynamics in 72 patients. It was also estimated a blood oxygenation and volume of liquid sectors of the organism in different degree of obesity before and after liposuction of the large volume. It was shown, that this operation facilitated to an improvement of respiratory lung function due to changes of pulmonary circulation.

According to the current understanding, the hyperactivation of platelets may lead to increased intravascular coagulation and thrombosis. Today a relevant issue is the search for new anti-thrombotic agents that are able to modulate the activity of platelet receptors, thus, influence the processes of activation and aggregation of platelets. The aim of this study was to investigate the effects of newly synthesized thiosulfonate derivatives on platelet aggregation. The activity of the compounds was tested in vitro using platelet-rich plasma. As a result of the screening test, structural formulas of four agents with high antiaggregative activity were established. These compounds inhibited ADP- and collagen-induced platelet aggregation in a dose-dependent manner. Two of these compounds were shown to be more effective inhibitors of aggregation induced by ADP (IC50 ~ 8-10 µM), as well as collagen (IC50 ~ 1.5-2.0 µM).

This article contains a review of Russian and foreign publications with the results of experimental and clinical studies of effectiveness and safety using of a new release active medicine — Ergoferon for the treatment of acute respiratory viral infection (ARVI), including influenza virus. The results of investigation of antiviral activities of Ergoferon and its components in adults are presented in the article, as well as absolutely new data about efficacy and safety of a liquid form Ergoferon in ARVI in children.

The experiments were carried out on white Wistar rats. The probable embryotoxic, teratogenic and fetotoxical influences of the plant remedy "Pancreophyt" at the doses of300 (1/10 DL50) and 600 mg/kg (1/5 DL50) were studied. The findings have shown that all indices of embryo lethality (the number of implantation sites, the number of alive fetus and the number of resorptions) in female white rats treated with the "Pancreophyt" do not differ significantly from the indices of the control group. The mass and craniocaudal dimensions of the fetus in the experimental group corresponded to the indices in the control group. In the second set of experiments the influence of the "Pancreophyt" (300 mg/kg) on the postnatal development of white rat offspring was studied. It was revealed that the death of infant rats was noted only on the 1st day of observation and was 4,7%; the liveweight gain and linear size of infant rats do not differ from the indices of those in the control group.

The aim of the work was to evaluate the influence of the linimentfrom Pentaphylloides fruticosa L. on lipid peroxidation in rats with experimental diabetes mellitus accompanied by wound process. The liniment was developed with the use of NanoDeBee30 device. Experiments were carried out on white male Wistar rats. Experimental diabetes mellitus was simulated by a single intraperitoneal introduction of alloxan in a dose of 100 mg/kg. The skin injury was simulated by inflicting planar wounds 2.0 x 2.0 cm in size. 5 mg of the 5%-liniment from Pentaphylloides fruticosa was put on the wounds of the first experimental group once a day for 14 days. The second experimental group was treated by the preparation of comparison - balsamic liniment. The wounds of the control group were treated with glycerin-lanolin ointment. On the 7th, 14th and 21st day the concentration of TBA-active products in the blood serum was determined to estimate the intensity of lipid peroxidation processes; the contents of reduced glutathione and catalase activity were determined to evaluate the antioxidant status. The results of the experiments verify the marked curative effect of the linimentfrom Pentaphylloides fruticosa L. on the healing of the wounds on the background of experimental diabetes mellitus in rats

Гипертоническая болезнь (ГБ) является одним из самых распространенных, прогрессирующих и неблагоприятных заболеваний сердечно-сосудистой системы. Потери населения трудоспособного возраста от инвалидизации и смертности из-за осложнений ГБ представляют серьезную социальную проблему. Цель. Оценить выявление поражения органов-мишеней и ассоциированных клинических состояний у пациентов c ГБ. Материал и методы. Был произведен скрининг всех пациентов, обратившихся на консультацию в Республиканский кардиологический центр в течение 1 мес (4905 человек). Из них выделены 1711 пациентов, у которых диагностирована ГБ. Проведено их последующее углубленное обследование. Обследованы 770 (45%) мужчин и 941 (55%) женщина, средний возраст которых составил 45,8±9,45 года. Установление диагноза ГБ проводилось путем проверки соответствия критериям диагностики, предложенным в клинических рекомендациях по диагностике и лечению артериальной гипертонии (АГ). Также изучалась распространенность основных поражений органов-мишеней (ПОМ) и ассоциированных клинических состояний в зависимости от длительности течения АГ. Результаты. Анализ возрастной динамики распространенности АГ среди населения выявил повышение ее частоты с возрастом. Если повышенное АД в группах от 18 до 29 и от 30 до 39 лет составило 11,2 и 14,0% от общего числа обследованных соответственно, то в категории 40-49 и 50-59 лет этот показатель достигал уже 26,8 и 29,6% соответственно. Среди старшей возрастной группы, старше 60 лет, повышенное АД составило 18,4%. Наиболее значимые показатели распространенности АГ установлены в возрастном интервале от 50 до 64 лет, как у мужчин, так и у женщин (29,0 и 31,5% соответственно). Наиболее часто встречающееся ПОМ - это гипертрофия миокарда по ЭКГ- или ЭхоКГ-критериям (у 83% пациентов с ГБ). Реже встречались увеличение комплекса интима-медиа - не менее 0,9 мм (62%), микроальбуминурия (49%). Остальные ПОМ выявлялись у незначительного числа пациентов (от 21 до 36%). Если у гипертоников «со стажем» (более 10 лет) высокая частота осложнений АГ (34%) объяснима, то при длительности течения АГ менее 5 лет вызывает большую тревогу число пациентов с сердечно-сосудистыми осложнениями. У больных с высоким уровнем АД часто встречалась сопутствующая патология в виде ишемической болезни сердца и сахарного диабета, а также имелись в анамнезе инфаркт миокарда и/или нарушение мозгового кровообращения. Заключение. Значительная распространенность АГ среди населения республики требует решения первоочередных проблем, важнейшей из которых является создание системы профилактики, раннего выявления и лечения больных с сердечно-сосудистыми заболеваниями.

Цель. Эпидемиологические исследования последних лет свидетельствуют о неуклонном росте числа больных с гипертонической болезнью - одним из самых распространенных и прогностически неблагоприятных заболеваний сердечно-сосудистой системы. Поэтому выявление факторов риска (ФР) важно для организации эффективной медицинской помощи кардиологическим пациентам. Исходя из изложенного, было проведено изучение ФР. Материал и методы. В условиях консультативной поликлиники и стационара Республиканского кардиологического центра выполнено обследование репрезентативной выборки из неорганизованного взрослого населения Республики Башкортостан. Случайно отобраны и обследованы 1500 пациентов, обратившихся в Республиканский кардиологический центр на консультацию. Анкетированы 1433 человека (45% мужчин и 55% женщин), средний возраст обследованных 45,8±0,45 года. Опрос проводили по стандартным анкетам, состоящим из нескольких разделов: социально-демографические показатели, состояние здоровья, кардиологический опросник. Результаты. По результатам мониторинга эпидемиологической ситуации, связанной с артериальной гипертонией (АГ), установлено, что распространенность АГ среди населения Уфы (по критериям артериальное давление выше 140/90 мм рт. ст.) составила 38,6% среди мужчин и 38,1% - среди женщин. Из основных ФР наиболее часто выявлялся фактор отягощенного семейного анамнеза, который может учитываться у лиц молодого возраста при определении прогноза развития собственно АГ, тяжести ее течения и присоединения осложнений. Сахарный диабет чаще встречался у женщин с АГ (5,0% среди здоровых женщин и 12,1% среди женщин с АГ). Злоупотребление алкоголем чаще у мужчин (8,4% против 10,8%). Гиперхолестеринемия почти одинаково часто выявлена и у мужчин, и у женщин: у здоровых мужчин - 15,6%, у здоровых женщин - 17,9%, у пациентов с АГ - 27,0 и 30,3% соответственно. Стресс, избыточная масса тела одинаково часто выявлялась у здоровых мужчин и женщин (31,6 и 30,4%; 9,8 и 10,6% соответственно), в то время как у больных АГ эти факторы значимо выше у женщин (33,4 и 43,2%; 34,9 и 52,4% соответственно). Курение почти не выявляется у женщин, а у мужчин доходит до 72,1% у пациентов с АГ. Следует отметить, что стрессы, курение, избыточное употребление алкоголя, гиподинамию (выявленные при анкетировании) большинство пациентов не оценивали как ФР развития сердечно-сосудистой патологии. Это свидетельствует о недостаточной осведомленности по поводу проблемы профилактики сердечно-сосудистых заболеваний (ССЗ). При оценке информированности больных АГ о наличии у них заболевания установлено, что женщины чаще, чем мужчины, информированы о наличии заболевания (30,4 и 25%), женщины более эффективно лечатся по поводу АГ (34 и 14%). Заключение. Таким образом, результаты исследования установили высокую распространенность АГ и ФР среди населения Республики Башкортостан. Они обосновывают необходимость оптимизации мероприятий по первичной и вторичной профилактике ССЗ.

Цель. Оценить эффективность лечения пациентов с гипертонической болезнью, обращающихся за кардиологической помощью в лечебные учреждения Республики Башкортостан. Материал и методы. Был произведен скрининг всех пациентов, обратившихся в Республиканский кардиологический центр (РКЦ) в течение 1 мес (4905 человек), направленных на консультацию в РКЦ, из них выделены 1711 пациентов, у которых диагностирована гипертоническая болезнь (ГБ). Проведено последующее углубленное обследование отобранных больных. Обследованы 770 (45%) мужчин и 941 (55%) женщина, средний возраст которых составил 45,8±9,45 года. Установление диагноза ГБ проводилось путем проверки соответствия критериям диагностики, предложенным в клинических рекомендациях по диагностике и лечению артериальной гипертонии (АГ). Всем больным амбулаторно или стационарно выполнялись общеклиническое обследование, общий анализ крови и мочи, биохимический анализ крови, ЭКГ в 12 стандартных отведениях, ЭхоКГ, УЗИ сосудов. Результаты. Анализ возрастной динамики распространенности АГ среди населения выявил повышение ее частоты с возрастом. Если повышенное артериальное давление (АД) в группах от 18 до 29 и от 30 до 39 лет составило 11,2 и 14,0% от общего числа обследованных соответственно, то в категории 40-49 и 50-59 лет этот показатель достигал уже 26,8 и 29,6% соответственно. Среди старшей возрастной группы, более 60 лет, повышенное АД составило 18,4%. Наиболее значимые показатели распространенности АГ установлены в возрастном интервале от 50 до 64 лет, как у мужчин, так и у женщин (29,0 и 31,5% соответственно). Нами выявлено, что врачами в первичном звене здравоохранения из 5 групп препаратов назначаются наиболее часто ингибиторы ангиотензинпревращающего фермента (ИАПФ) - у 80% больных, на втором месте антагонисты кальция - 41%. Стали назначать реже b-адреноблокаторы (лишь у 21% пациентов) и диуретики (14%). Блокаторы рецепторов ангиотензина (БРА) встречают редко - только у 15% больных. Врачи первичного звена иногда назначают b-адреноблокатор и диуретик, это сочетание препаратов может иметь неблагоприятный прогноз в плане сахарного диабета. Не назначаются Адельфан и Клофелин. Кроме того, несмотря на многообразие комбинированных препаратов, их доля в назначениях оказалась невелика - лишь 16%. Причем наиболее частой комбинацией была ИАПФ + диуретик (75%). Проводя сравнительный анализ назначений врачей первичного звена и врачей-кардиологов консультативной поликлиники РКЦ, мы выявили, что последние одинаково часто используют в своих назначениях ИАПФ и БРА (48 и 45% соответственно). Чаще врачи РКЦ назначают комбинированные препараты, отдавая предпочтение комбинациям ИАПФ + антагонист кальция и БРА + антагонист кальция (81% назначений). Комбинация с диуретиками встречалась реже - только в 12% комбинированных препаратов. Заключение. При оценке лечения больных АГ установлено, что пациенты стали принимать современные антигипертензивные средства, чаще используют комбинированные препараты, предложенные в клинических рекомендациях по диагностике и лечению АГ.

Медицинская реабилитация является важной составляющей возврата к полноценному труду пациентов с патологией сердечно-сосудистой системы. В соответствии с приказом Минздрава России №1705н от 29.12.2012 «О порядке организации медицинской реабилитации» II этап медицинской реабилитации пациентов по завершении острого периода с последствиями заболеваний сердечно-сосудистой системы осуществляется в отделениях РКЦ г. Уфа. С 01.01.2014 в ГБУЗ РКЦ проводится медицинская реабилитация на базе кардиологического отделения №4. Цель. Оценка результатов медицинской реабилитации больных, перенесших острые сердечно-сосудистые события и имеющих реабилитационный потенциал (по шкале Рэнкин 0-2 балла). Материал и методы. В ГБУЗ РКЦ с 2014 по 2016 г. комплексная реабилитация была проведена 1341 пациенту (мужчины, женщины). В 2014 г. реабилитация проведена 355 пациентам, в 2015 г. - 551, в 2016 г. курс реабилитации прошли 435 пациентов. Основной объем реабилитационных мероприятий пришелся на пациентов после хирургической реваскуляризации коронарных артерий: 147 пациентов после аортокоронарного шунтирования и 448 пациентов после ангиопластики и стентирования коронарных артерий. На втором месте - пациенты после нестабильной стенокардии (381 человек), затем перенесшие острый инфаркт миокарда (365 человек). В небольшом количестве реабилитация проведена после протезирования клапанов, имплантации электрокардиостимулятора, после радиочастотной аблации. Сроки пребывания на койке медицинской реабилитации составили от 10 до 15 дней (в среднем 12,6). Для каждого больного составлялась индивидуальная программа реабилитации, включавшая продолжение медикаментозной терапии, физиотерапию (светотерапия аппаратом Bioptron, магнитотерапию, электросон), фитотерапию (фиточай), физическую реабилитацию (производственная физическая культура 30 мин, занятия на кардиотренажере Kettler 20 мин), дозированную ходьбу по 20-30 мин. Результаты. Все пациенты успешно завершили курс медицинской реабилитации. У больных не было жалоб, повысилась толерантность к физическим нагрузкам. Пройденная дистанция по результатам теста с 6-минутной ходьбы возросла с 310,5 м при поступлении до 490,6 м при выписке, средняя мощность выполненной в ходе нагрузочной пробы нагрузки увеличилась с 138,6 до 284,6 Вт. Средний уровень систолического артериального давления (САД) уменьшился с 152,8 до 117,4 мм рт. ст., диастолического (ДАД) - с 90,6 до 77,3 мм рт. ст. По завершении курса реабилитации содержание общего холестерина, триглицеридов, холестерина липопротеидов низкой плотности достоверно (p

Цель. Оценить влияние b-адреноблокатора (b-АБ) и препарата магния в моно- и комбинированной терапии на показатели толерантности к физической нагрузке (ТФН) и вариабельности ритма сердца (ВРС) у пациентов с первичным пролапсом митрального клапана (ПМК) и нарушениями ритма сердца (НРС). Материал и методы. Пациенты с первичным ПМК и НРС были рандомизированы на 2 группы, сопоставимые по полу, возрасту, степени ПМК, частоте НРС, клинико-гемодинамической характеристике. Первую группу составили 40 больных, получавших монотерапию оротатом магния (Магнерот, «Верваг Фарма ГмбХ и Ко», Германия) в дозе 1-3 г/сут; во 2-ю группу вошли 38 пациентов, получавших комбинированную терапию оротатом магния в той же дозе и бетаксололом (Локрен, «Санофи Авентис», Франция) 10-20 мг/сут. Исходно и через 24 нед оценивали показатели ВРС и ТФН. ТФН анализировалась при проведении субмаксимальной велоэргометрической пробы в режиме непрерывно ступенеобразно возрастающей нагрузки с начальной ступенью 50 Вт на системе «Валента» (Россия). Анализировались параметры пороговой мощности нагрузки, двойное произведение, число метаболических единиц (МЕТ), длительность восстановительного периода. Всем обследуемым проводился тест PWC 170. Результаты. При длительной терапии комбинацией бетаксолола и оротата магния отмечено повышение параметров ТФН, что характеризовалось увеличением общей продолжительности нагрузки (8,8±0,7, 10,8±0,6 мин; 22,7%; p

Abstract. We investigated levels of spontaneous and mitogen-induced cytokine production (IL-1β, IL-4, IL-6, IL-10 and IFNγ) by peripheral blood cells of 24 men with unstable angina (UA), including indigenous population (n = 12, Yakuts), and a group of Russian migrants to the Republic of Sakha (n = 12). Activation of inflammatory response was revealed in the total group of patients with UA, manifesting by increase of spontaneous and induced production of the pro-inflammatory IL-1β, IL-6 cytokines, and mitogen-induced production of IFNγ. As compared with healthy individuals, spontaneous and induced production of anti-inflammatory IL-4 was decreased in UA patients, whereas the mitogen-induced production of IL-10 proved to be enhanced. Therefore, it is highly possible that a pro-atherogenic Th1-immune response is developing during UA, along with suppression of Th2-driving response. The differences revealed for different ethnic groups suggest that severity and prevalence of atherosclerotic disease, which is more common in the non-native patients, is associated with increased production of pro-inflammatory IL-1β and IL-6 cytokines.

We determined promising sources of phytoecdysteroids - Rhaponticum uniflorum (L.) and Serratula centauroides (L.), growing in the Buryat Republic. Biologically active substances were founded: ecdysteroids, phenolic compounds, polysaccharides, flavonoids, tannins, saponins, vitamins.