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Background. The available comparative studies on issues of choosing antibiotic regimen in dental implantation are often observational and describe only visible postoperative signs. More objective assessment of postoperative period and comparison of approaches requires laboratory tests. One of the methods to be used at a dental appointment is to study examination of the biochemical properties of saliva.Objective. To carry out comparative evaluation of single and prolonged regimens of amoxicillin/clavulanate administration after dental implantation indicated by nonspecific immunity in mixed saliva.Methods. A randomized uncontrolled trial of 30 partially edentulous patients was conducted. The clinical phase of the study was performed at the Department of Propaedeutics of Surgical Dentistry, MSUMD; the laboratory phase — at the Pharmacology and Biological Chemistry Departments, MSUMD, in 2021–2022. The study included patients aged 18 to 75 years, anatomically suitable for dental implant placement. Patients with somatic diseases in the decompensation stage were excluded from the study. Patients were randomized into 2 groups. The group 1 was prescribed to take amoxicillin/clavulanate pills (875+125 mg) 30 minutes before surgery. The group 2 was to take amoxicillin/clavulanate (875+125 mg) 30 minutes before surgery and then 1 pill of Amoxicillin/ Clavulanate (500+125 mg) 2 times a day for 7 days after surgery. To evaluate the efficacy of the applied antibiotic therapy, unstimulated mixed saliva was collected from all patients on an empty stomach, 1 ml before surgery and on the third day after surgery. The amount of immunoglobulins of G, M, A classes (mg/l) and б-amylase activity (IU/l) were determined spectrophotometrically in the saliva samples. Statistical processing of laboratory data was performed using Welch's t-test by means of Statistica 10 Pro (StatSoft, USA). Intergroup and intragroup differences were considered significant at p ≤ 0.05.Results. Based on the saliva proteins examined, the most pronounced difference between the patient groups was obtained for IgA. For other studied parameters of saliva, no significant difference between the groups was obtained on the third day after the surgery. However, despite the absence of a statistical difference, a tendency to a stronger increase in the amount of IgA, G, IgM, salivary amylase activity was noted for all indicators; moreover, a high correlation between immunoglobulins of class A, G, immunoglobulins of class G, M, and immunoglobulins of class A, M was revealed.Conclusion. Among patients with the prolonged regimen, the groups did not differ significantly in such saliva parameters as immunoglobulins G and M and salivary б-amylase activity, however, a tendency to a stronger increase of the mentioned immunoglobulins in the saliva of group 1 patients was revealed. The most significant difference was recorded for immunoglobulin A in saliva, the amount of which was significantly lower in the group of prolonged antibiotic administration (p < 0.05).

Introduction. A review of the scientific literature showed that the current standards for assessing the quality of drugs does not include an assessment of the osmotic activity of drug solutions and their local irritant effect on tissues at the sites of subcutaneous, intramuscular and intravenous injections. Therefore, currently injectable solutions considered to be of high quality may not have isotonic activity and high postinjection safety.Text. A study of the concentration range of quality drug solutions ready for injection showed that the acceptable concentration value of the main ingredients is in the range of 0.01 to 76 %. Direct measurement with an osmometer of the osmotic activity of injection solutions, considered qualitative today, has shown that injection solutions can have hypotonic, isotonic and hypertonic activity and their osmotic activity can be in the range of 0 – 3900 mosmol/l water. Study of acidic activity of drug solutions showed that in accordance with pharmacopoeial requirements of drug quality modern quality drug solutions ready for injection can have acidic, neutral or alkaline activity. Solutions with hypertonic activity have been found to have a local irritant effect. Moreover, an increase in hypertonic activity of drug solutions increases their local irritant effect. It has been found that excessively high hypertonic activity of drug solutions may be the cause of the development of a local postinjection complication known as "Nicolaou syndrome", the cause of which has remained unknown for a long time. Nicolaou syndrome includes local pain syndrome, aseptic inflammation, necrosis, and abscess.Conclusion. The authors conducted a literature review, the results of which led to conclusions and assumptions. Solutions containing drugs in concentrations greater than 10 % may have the highest hypertonic activity, which can cause excessive dehydrating, local irritating and cauterizing effects. Therefore, injections of such drugs are most dangerous with the development of post-injection necroses and abscesses. That is why timely dilution of concentrated drug solutions with water by 2–10 times increases injection safety. It is proposed to include the assessment of osmotic activity and local irritant effect of drug solutions in the standard of drug quality control.

The aim of research is to investigate the features of staphylococcal microflora of sportsmen of different specializations.

The article discusses the training of students at the department of disease prevention and healthy lifestyle at a medical university.

Relevance. The effectiveness of vaccination of the working population against COVID-19 in the Russian background has not been studied enough.Aim. To evaluate the effectiveness of vaccination of the working population with Gam-COVID-Vak (Sputnik V) in the Russian Railways as an example.Materials & Methods.The effectiveness of vaccination with Sputnik V among employees of Russian Railways in the period from January 21 to November 31, 2021 was performed with the Cox regression method.Results. The effectiveness of Sputnik V against COVID-19 infection with was 97.8% (95% CI 97.8–97.9%) for two doses, 91.9% (95% CI 91.6–92.2%) for a single dose, and 97.9% (95% CI 97.6–98.1%) for revaccination, all after socio-demographic factors adjusted. The effectiveness of vaccination against COVID-19 with hospitalization was 97.5% for two doses of Sputnik V (95% CI 97.1–97.9%), 86.1% (95% CI 83.7–88.1%) for a single dose, and 98.2% (95% CI 96.3–99.2%) for revaccination. The effectiveness against lethal COVID-19 was 95.2% (95% CI 93.1–96.6%) for two doses of Sputnik V and 94.8% (95% CI 89–97.6%) for one dose. The high efficiency of vaccination could be associated with a fairly young age composition of the employees of the Russian Railways.Conclusions. The study showed the high effectiveness of vaccination with Sputnik V against COVID-19 among the working population.

Acellular dermal matrices (ADMs) are gaining popularity as surgical materials for operations on the pelvic organs, as well as in burn therapy and plastic surgery. Evaluation of the biocompatibility of surgical materials is an important and necessary step in the development of new ADMs.The aim of the study was to compare the results of subcutaneous implantation of ADM and native porcine skin in rats.Materials and methods. To obtain ADMs, detergent – enzymatic decellularization was used. On days 7, 14, 21, and 60 after the implantation of ADMs (the experimental group) and native porcine skin (the control group), the animals were removed from the experiment. The histologic sections were stained with hematoxylin – eosin and Masson’s trichrome stain, then an immunohistochemical reaction with antibodies to CD3 and CD68 was performed. Computer morphometry was carried out using the ImageJ software.Results. On day 7 after the implantation, moderate sterile inflammation in the experimental group and pronounced sterile inflammation with eosinophil infiltration in the control group were observed. On day 14 of the experiment, the samples from the experimental group were characterized by a relatively low content of macrophages and T-lymphocytes with insignificant edema and no signs of ADM biodegradation. The control group showed pronounced inflammation, a large number of infiltrating macrophages and T lymphocytes, as well as fragmentation of collagen fibers. On day 21 of the experiment, a thin capsule was formed around ADM, there was a small number of infiltrating T lymphocytes and macrophages, the collagen fibers of the implant were intact. In the samples of the control group, there was pronounced inflammation with the presence of a significant number of lymphocytes and macrophages, as well as fragmentation and vascularization of the implant. On day 60 of the experiment, no inflammatory response was observed around ADM, biodegradation was minimal, and a dense fibrous capsule was formed around the fragment of the native porcine skin.Conclusion. The experimental ADM has low immunogenicity and a low degree of biodegradation, which makes it possible to use it for further research to create efficient surgical material that is safe for use in clinical practice.

Comorbidity is an important problem of modern medicine, the study of which is a priority for public health. According to the literature, the prevalence of comorbidity reaches a third of the population in some countries, while there is a tendency for an increase in the number of such patients in all age groups. In the context of the COVID-19 pandemic, the presence of comorbidity in patients is a significant risk factor affecting the course and prognosis of a new coronavirus infection; at the same time, it is comorbid patients who belong to the most vulnerable group. The review presents data indicating a significant impact of comorbid pathologies on an increase in the number of complications and mortality; the most common combinations of diseases in patients with a new coronavirus infection were analyzed. There is an increase in the prevalence of comorbidity in all age groups, which dictates the need to develop an integrated interdisciplinary approach for such patients. The vast majority of clinical guidelines for the treatment of comorbidities in COVID-19 are mainly focused on individual diseases, which limits the use of these algorithms in comorbid patients. Due to the high risk of contracting a viral infection, as well as the frequent development of complications and mortality in comorbid patients, preventive measures should be focused simultaneously on two tasks: measures aimed at preventing infection with COVID-19 and compensating for comorbid pathology. In the case of SARS-CoV-2 infection, careful monitoring of such patients, most often in a hospital setting, is necessary in order to prevent complications and adverse outcomes.

Aim. To study modifiable risk factors for cardiovascular disease (CVD) among rail transport workers, depending on the place of work: Russian Railways and Moscow Metro.Material and methods. The study involved 2638 workers of locomotive crews: 778 persons worked at Russian Railways, 1860 — Moscow Metro. The workers were offered a questionnaire assessing general data, features of medical activity, and lifestyle. The collection and processing of data was carried out using Microsoft Excel and Statistica programs.Results. The studied groups were comparable in age structure. Slightly above 40% of respondents in both groups currently smoked, while ~70% did not eat enough vegetables. Workers of Russian Railways were 2 times more likely to drink alcohol ≥2 times a week and 1,2 times more likely to eat at fast food restaurants. Also, ~40% of participants in both groups often or always added salt to food, almost 20% did not engage in athletics. Workers of Russian Railways were less physically active. Moscow Metro workers ate less regularly and did not consume enough fruit. The average body mass index of both groups corresponded to overweight.Conclusion. The leading behavioral risk factors for CVD in rail transport workers are insufficient consumption of vegetables and fruits, low physical activity, and smoking. The obtained results will allow to improve the guidelines for lifestyle modification of rail transport workers, to develop and refine corporate programs for primary CVD prevention.

The treatment of long-term non-healing wounds in the conditions of purulent surgery departments, widely uses solutions of chemotherapeutic and antiseptic agents. The most common are the solutions of 3–6 % hydrogen peroxide and solutions of 2–10 % sodium chloride. As a rule, solutions of these drugs are used to treat non-healing, particularly, purulent wounds, bedsores and trophic ulcers. Therefore, solutions are injected into the wound area repeatedly in the form of course therapy. The findings show that the mechanism of action of these drugs and the effect of treating long-term non-healing wounds is largely determined by such physical and chemical factors of their local interaction as concentration of the main ingredients, osmotic, alkaline activity and local temperature. The findings point out the leading role of the local temperature and the dependence of the local effect on the concentration. They describe the essence of the innovative method of treatment.

The article provides an overview of global trends in various treatment approaches for COVID-19 in terms of pharmacoeconomic effectiveness. Different strategies for managing patients with the new coronavirus infection, separate groups of drugs are considered. The current clinical trials for COVID-19, the main directions, problems and challenges facing the healthcare system are discussed in detail. The aspects of the economic efficiency of various measures to prevent the spread of COVID-19 are presented. A thorough study of the pharmacoeconomic features of the new coronavirus infection will allow to develop effective standards for planning the process of supply for medical organizations in the pandemic.

Corporate health programs are a common measure for the primary and secondary prevention of chronic non-communicable diseases.Aim. To study the first implementation results of a Targeted comprehensive program to reduce morbidity and prevent mortality from circulatory system diseases and early cancer detection in employees of JSC "Russian Railways" for the period from 2019 to 2023.Material and methods. The study used a survey of employees of locomotive crews (RLC), which was conducted twice: in the summer of 2018 and February-March 2021. The survey was conducted using a specially designed questionnaire that takes into account the health status of drivers and their assistants, production, and non-production risk factors. In 2018, 10476 questionnaires were collected (>7% of employees), and in 2021 — 14403 questionnaires (>10% of employees). The age structure of railways has not changed, which made it possible to analyze the frequency of occurrence of risk factors in dynamics.Results. In general, the mention of the RLC of the interfering effect of the noise factor, uncomfortable temperature, and undesirable odors in the driver’s cabin decreased for JSC "Russian Railways". The number of smokers on the South-Eastern Railway significantly increased during the study period. The number of people consuming insufficient amounts of vegetables and fruits has increased on the Far Eastern, West Siberian, Krasnoyarsk, and Volga railways. The frequency of workers’ meals at fast food restaurants has increased on the Southeastern Railway. The number of people with a good commitment to the basic principles of a healthy lifestyle has increased on the East Siberian, Trans-Baikal, West Siberian, Kuibyshev, Oktyabrskaya, Sverdlovsk, North Caucasian, and South Ural railways.Conclusion. The conducted research has shown the effectiveness of the initial stage of the implementation of the corporate program to reduce morbidity and prevent mortality from diseases of the circulatory system in RLC. The heterogeneity of the results for different railways was revealed.

Relevance. A viral pandemic caused by the SARS-CoV-2 coronavirus has led to the development of a new coronavirus disease-2019 (COVID-19). The COVID-19 pandemic has forced the mobilization of all available health system resources. There are separate publications on reducing the risk of developing coronavirus infection in people vaccinated against influenza. Objective: to study the cost-effectiveness of influenza vaccination in the conditions of the» first « wave of COVID-19. Materials and methods. The archival data of 2,452 people from among the sick employees of JSC «Russian Railways» were analyzed. The control group consisted of 2,911 employees who were not infected with COVID-19, comparable by gender, age and territory of residence. Scores on the Charlson comorbidity scale were calculated for all individuals. The pharmacoeconomical cost of the patient’s treatment was predicted using the Markov model. Results. Having a flu shot reduced the likelihood of getting COVID-19 by 1.3 times. In the presence of a diagnosis of coronavirus infection, inpatient treatment for influenza vaccinated patients was required 2 times less often than for unvaccinated patients. Compared to the situation of the absence of vaccinated persons, in the «first wave», the estimated cost savings for the treatment of patients with coronavirus infection amounted to 124 million rubles. When the number of points on the comorbidity scale increased from 1 to 8, the average cost of treatment of patients without previous influenza vaccination increased by 2 times, and in the presence of vaccination, the average cost of treatment increased by 1.7 times. Conclusion. Thus, this study shows that influenza vaccination is cost-effective against COVID-19. The effect is achieved by reducing the likelihood of getting a coronavirus infection in the presence of a flu shot.

Objective: to determine the content of hormones, as well as some macro- and microelements in athletes-wrestlers outside the period of competition and active training.Materials and methods: the study involved 66 athletes-wrestlers and 107 students involved in sports professionally. The level of hormones and vitamin D was determined by the ELISA method. To analyze the content of macro- and microelements, the subjects were cut off a lock of hair from the back of the head in an amount of at least 0.1 g. The studies were carried out on an ICP-MS Agilent 7900 mass spectrometer.Results: levels of cortisol, TSH and T4 are higher, and levels of testosterone, T3 and vitamin D are lower in athletes compared to the control group. An increase in the content of sodium, calcium, potassium, magnesium, cobalt and a decrease in iodine were revealed in fighters from those who were not involved in sports professionally.Conclusion: the data obtained indicate an imbalance in the work of the body’s endocrine systems and impaired adaptation to stress. It is known that the determination of the hormonal status is used to assess the adaptation, the revealed changes in the indicators of vitamin D, macro- and microelements, allow the study of these indicators in order to prevent the syndrome of overtraining of athletes, to maintain and improve sports performance.

Hypertension is considered as one of the leading cardiovascular diseases in transport workers.Aim. In the context of epidemiological prospective study, to assess the prevalence of elevated blood pressure (BP) detected at pre-trip health screening (PTHS).Material and methods. We analyzed records of the database of PTHS automatic system for 15 years (2006-2020) to reveal elevated systolic (140 mm Hg) and/or diastolic (90 mm Hg) BP.Results. For 15 years, the detection rate of systolic BP >140 mm Hg has decreased by 4 times. For diastolic BP, the detection rate of values >90 mm Hg decreased by 8 times. The detection rate of non-normal systolic BP among railway staff correlates with the detection rate of non-normal diastolic BP (r=0,92; p

Introduction. In almost all diseases of the gastrointestinal tract, the inflammatory process plays an important pathogenetic role and affects the course of the disease and the determination of treatment tactics. The most physiological way to prevent and treat inflammatory diseases of the gastrointestinal tract, of course, is dietary nutrition.Purpose: To study the anti- inflammatory effect of a specialized product specialized therapeutic and dietary prophylaxis nutrition «Vegetable soup with oatmeal herbs» based on a study of clinical and laboratory parameters and dynamics of inflammatory markers.Materials and methods. An open single-center prospective observational study was conducted in parallel groups. The main group and the comparison group were 14 and 10 patients with gastrointestinal diseases, respectively. Only patients of the main group received a specialized product «Vegetable Soup with herbs and oatmeal». All participants were assessed the dynamics of clinical blood analysis indicators (hemoglobin, white blood cells, red blood cells, leukocyte formula indicators) and the dynamics of proteinogram indicators (total protein and protein fractions-albumins and globulins) and C-reactive protein (CRP).Results. The anti-inflammatory effect after administration of the specialized product occurs in 14 days and is expressed in a reliable reduction of leukocytosis, blood sedimentation rate (BSR), CRP. After 2 months after the start of the product intake, the BSR values decreased significantly by 35%, the CRP by 51% from the baseline and the leukocyte content decreased by 14.5%. Against the background of a dietotherapy in 14 days levels α1-глобулина, α2-глобулина and γ-globulin began to decrease, and in 2 months level a1-globulins decreased by 40% of initial level to the reference values. The level of α2-globulins and γ-globulin also decreased significantly, while the albumin concentration in the blood increased significantly. In the comparison group, changes in these parameters did not reach a reliable degree of significance.Conclusions: the specialized product «Vegetable Soup with herbs and oatmeal» has an anti-inflammatory effect, characterized by a decrease in anti-inflammatory laboratory parameters, which manifests itself after 14 days of administration, can be recommended for inclusion in the diets of patients with gastrointestinal diseases during exacerbation and during remissions as well.

The review considers the issues of the association of railway industry occupations with the hypertension (HTN) risk. There is a number of reviews have been published earlier, where the high prevalence of HTN in railway workers was mentioned. Scientific literature was studied using the following keywords: “railway” and “hypertension” both in Russian and in English. A large spread in HTN prevalence among footplate staff was revealed according to different sources — from 7 to 60%. When recalculating the literature data on HTN prevalence among footplate staff in the CIS unites, it turned out to be no higher than that obtained for working-age men according to the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF). A number of studies indicate that HTN is developing faster for locomotive drivers than for people not working in the railway industry. In our opinion, scientific work on the high frequency of HTN among railway workers can only be considered preliminary. Probably, the development of HTN could be influenced not only by occupational, but also by the major risk factors, such as metabolic ones, obesity, etc.

Goal. To identify key links in the pathogenesis of toxic myocardiopathy in conditions of endogenous intoxication in peritonitis. Materials and methods. Experimental studies were carried out on dogs (n = 24). The model of purulent fecal peritonitis. We studied the run-time content of toxic products in blood plasma, the lipid composition, the intensity of lipid peroxidation, the activity of phospholipase A2 and superoxide dismutase, and hypoxia of myocardial tissue. We evaluated loss of water and proteins, electrogenesis of the myocardium cells and changes in the ECG parameters. We also performed histological examination of the myocardial tissue. Results. Experimental studies in dogs showed that the development of endotoxicosis of peritoneal origin is accompanied by significant metabolic disorders and cardiac malfunction leading to the development of myocardiopathy. The most important role in the development and progression of myocardial damage in endotoxicosis is played by biomembrane damage and disruption of associated processes. The main processes are quantitative and qualitative modifications of phospholipids in cardiac cell membranes. Conclusion. The obtained data demonstrate the key role of the interrelation between dyslipidemia in the investigated cellular structures and intensification of lipid peroxidation, an increase in phospholipase A 2 activity, and hypoxia; which confirms the significance of these processes in destabilization of the phospholipid matrix of biomembranes.

Aim. To analyze factors that potentially influencing the incidence of members of locomotive crews.Material and methods. The survey method was used to survey 10476 members of locomotive crews. Overall 9309 individuals were included in the analysis. The study was conducted on all railways of the Russian Federation (63 subjects of the Russian Federation). The questionnaire included: the passport part, the results of medical research (blood pressure, cholesterol and blood glucose levels), questions on workrelated risk factors, risk factors for chronic non-infectious diseases, questions reflecting the subjective opinion of member on the problem.Results. The incidence of locomotive crews members is associated (p

Preventive workplace programs are one of the optimal organizational models for the prevention of noncommunicable diseases in the workingage population. Corporate health programs allow to effectively influence the lifestyle of employees, which makes it possible to reduce human resource risks due to morbidity and increase labor efficiency. First, programs for the prevention of cardiovascular diseases are being implemented. A number of researchers report that implementing prevention programs in the workplace can reduce the number of people with bad habits. The effectiveness of preventive workplace programs largely depends on the mechanisms of their implementation. A feature of railway companies is the presence of a large staff of employees of various specialties. Many factors affecting health are, in one way or another, related to the workflow, since most railway companies operate continuously. Low health literacy of railway workers on health protection and disease prevention was noted. Measures such as financial incentives, preventive counseling, the creation of personalized health profiles and the availability of healthy food in the workplace have been shown to be effective. The review also discusses Russian corporate preventive workplace programs.

Purpose: studying of efficiency of medical support of the workers of locomotive crews (WLC) on decrease in the incidence connected with temporary disability.Materials and methods. Data on five-year incidence (2013-2017) of WLC and costs of JSC "Russian Railways" of their medical maintenance are used. Calculations of the economic losses connected with temporary disability of WLC are executed.Results. The health service of JSC “Russian Railways” works effectively. About 5.9 billion rubles/year are spent for its contents. Due to decrease in the average duration of one case connected with temporary disability, the health service allows to save JSC “Russian Railways” to 5.3 billion rubles annually. Calculation shows that at reduction of a difference in the average duration of one case of temporary disability in JSC “Russian Railways” and one case of temporary disability for men of working-age of the all-Russian level up to 1.7±0.2 days, the health service can become inefficient from economic positions.Conclusions. From the economic point of view, the health service of JSC “Russian Railways” is justified at an essential difference in duration of one case of temporary disability for WLC and temporary disability of the all-Russian level for similar gender and age group.

Aim. To evaluate the effectiveness of the developed special sports complex in the prevention of hypodynamia and obesity among firefighters-rescuers.Materials and methods. A survey of 490 men with no history of chronic infectious and non-infectious diseases aged 20-59 was conducted. 328 people were the main group, 162 people were the control group. The baseline data included anthropometric development indicators, bioimpedance test results, the extraction of biochemical blood test results; the body mass index (BMI) and the ratio of waist and hip circumference were determined. A questionnaire was conducted to identify hypodynamia (according to the IPAQ questionnaire) and the nutrition structure (according to the questionnaire on the food label literacy questionnaire, past). Both questionnaires were adapted to the Russian Federation. Statistica for Windows 8.0 was used for statistical processing. We used a comparison of the means of the Student method. To compare the values expressed in percent, the method of inverse trigonometric Fisher transformations was used.Results. We have developed and proposed for firefighters-rescuers, included in the main group, special sports complexes, which were used for 6 months. These complexes represent additional physical training by the developed method. There are two of them: one with an emphasis on the prevention and rehabilitation of people with osteochondrosis of the lumbar spine, and the other for cervical and thoracic localization, including with a syndrome of shoulder-scapular periarthritis.Classes were held 3 times a week, the duration of 1 session was 45-50 minutes. The choice of the complex was carried out at the request of firefighters-rescuers. The first complex was selected by 52 people. Based on the results of the study, against the background of the use of sports complexes, there was a 2-fold decrease in the incidence of obesity. Such a high efficiency is due to the fact that obesity of the I degree prevailed among the firefighters-rescuers. In addition, the frequency of occurrence of dyslipidemia, hyperglycemia, and hypodynamia decreased.Conclusion. The use of this sports complex can reduce the risk factors for development of disability among rescue firefighters by preventing hypodynamia and reducing the incidence of hyperglycemia and dyslipidemia, as factors in the development of obesity.

The aim of this study was to evaluate the structure of etiotropic therapy used in the treatment of urinary tract infection in newborns, the frequency of using off-label etiotropic medicines, and assess the incidence of adverse drugs reactions (ADR). The work was carried out by a retrospective pharmacoepidemiology analysis of children hospitalized patient history (form 003/y) with infectious diseases in the period of the newborn. The object of the study is a case history of a stationary patient, the main method of research is the collection and analysis of information, the statistical processing of the data obtained. During the analysis, all the selected medical records were divided into two groups: the first - children, with the course of urinary tract infection, the second - with the course of infectious diseases of other localization. During the study it was demonstrated that the use of etiotropic therapy in children with urinary infection is higher than in children with the course of the infectious process of other localization. The frequency of off-label prescriptions for the treatment of urinary tract infection is 51%, and the incidence of ADR in the case of unadapted appointments is 1,4 times higher.

Aim. To study the dynamics of metabolic syndrome markers: insulin, glucose, uric acid, triglycerides, low and high density lipoproteides; of food addiction (ghrelin-leptin) in both genders, of 18-25-year-old patients with normal and extensive body fat tissue amount.Material and methods. Totally, 76 persons participated. At first stage, participants underwent survey on their food related behavior and physical activity. For the evaluation of fat tissue amount OMRON BF 506 devices were used, and the analizator of the balance of water-containing body sectors ABC-01 “Medass”. At the concluding stage of the study all participants underwent biochemical and hormonal blood tests.Results. Excessive amount of body fat by bioimpedance is common in normal body mass index. Nevertheless, the correlation data on leptin, insulin, lipids and uric acid with gender and amount of fat tissue makes it to suspect subclinical metabolism disorder in the presence of minimal excess of fat tissue.Conclusion. For the on time more effective prevention of obesity and its consequences as type 2 diabetes, arterial hypertension, etc., it is aimful to use the results of body fat tissue amount measurements, but not empirical calculations.

The most effective method of early diagnosis of tumors of mammary glands is selfcontrol. To develop practical recommendations for self-monitoring of the breast in everyday life the study included the analysis of scientific and patent literature, original technical solutions, with an assessment of their strengths and weaknesses. It is shown that for selfcontrol of the breast in everyday life the most suitable way is to monitor the color range of the infrared image of the breast using a thermal imager during and after air blowing air with a hair dryer in a room temperature. Principle of the method is based on the fact that tumors violate uniformity of structure of tissues, their thermal conductivity and/or heat. For examples the study reviewed clinical cases of self-control of the mammary glands in patients with breast tumor and without cancer. Identified steadiness of change in local temperature and color images of breast tissue allows to confirm the absence of lesions and the presence of a zone of unevenness and asymmetry of the local temperature and color images to diagnose a modified thermal conductivity or heat tissue glands and assume the presence of neoplasm in its projection. Thus, for domestic self-control of mammary glands it is advised to monitor the colour range of infrared thermal images on the screen during and after air blowing. When it is assumed that monocolor gland is indicative of the homogeneity of its structure, and multi-colored image of the gland suggests the presence of tumors.

In oncology practice, despite significant advances in early cancer detection, surgery, radiotherapy, laser therapy, targeted therapy, etc., chemotherapy is unlikely to lose its relevance in the near future. In this context, the development of new antitumor agents is one of the most important problems of cancer research. In spite of the importance of searching for new compounds with antitumor activity, the possibilities of the “old” agents have not been fully exhausted. Targeted delivery of antitumor agents can give them a “second life”. When developing new targeted drugs and their further introduction into clinical practice, the change in their pharmacodynamics and pharmacokinetics plays a special role. The paper describes a pharmacokinetic model of the targeted drug delivery. The conditions under which it is meaningful to search for a delivery vehicle for the active substance were described. Primary screening of antitumor agents was undertaken to modify them for the targeted delivery based on underlying assumptions of the model.

Purpose: to carry out pharmacoeconomic modeling for an early economic evaluation of the generic pegylated liposomal doxorubicin (PLD) drug.Materials and methods: a Markov model and Decision tree model were developed to simulate and to compare the costs and effects of new generic PLD versus doxorubicin. Using the threshold criteria for economic value (willingness to pay threshold (WTP) for Russia), we determine value-based pricing for new generic PLD.Results: pharmacoeconomic modeling can be used for an early economic evaluation of new medicines to determine value-based pricing for new pharmaceuticals and its financial impact on Russian health care system.

The aim of research is to study the possibility to increase the security of the internal jugular vein catheterization through the choice of access to puncture it, based on the values of its size.Materials and methods. Ultrasound scanning of IJV with the measurement of anteriorposterior and medial-lateral size was conducted among 20 healthy adult volunteers (control group) and 16 adult patients (observation group) who were treated in the Anesthesiology and Resuscitation Department.Results. It was found that the test values in the control group the anterior-posterior and medial-lateral vein is larger than 7 mm in both inhalation and exhalation. Under the conditions of hypovolemia (observation group) anterior-posterior size IJV inspiratory became less than 7 mm, and the medial-lateral vein size, despite its decrease retained value of more than 7 mm in most subjects. Among healthy volunteers it was found that the rotation of the ultrasonic sensor 45 ° is accompanied by increase in the average values of the medial-lateral vein size by more than 50%. This maneuver may be useful for patients whose value of the medial-lateral vein size inspiratory was less than 7 mm.Conclusion. The choice of central or lateral approach to puncture the internal jugular vein may be based on the actual values of the anterior-posterior and medial-lateral dimensions of it. The usage of lateral access for catheterization of internal jugular vein under ultrasound imaging can be more secure for patients with hypovolemia. The maneuver of ultrasonic sensor for 45° clockwise can be used to increase the size of the medial-lateral rotation.

In oncology practice, despite advances in methods for early detection, surgery, radiotherapy, laser therapy, targeted therapy, etc., chemotherapy is unlikely to lose its relevance in the near future. In this context, the development of new antitumor drugs is one of the urgent problems of modern conservative oncology. Despite the importance of the search for new compounds with antitumor activity, the clinical potential of the «old» agents does not yet seem to be exhausted. The transport of antitumor agents can give them a «second life» in the clinic. When developing the targeted transport for chemotherapeutic drugs, the changes in their pharmacodynamics and pharmacokinetics are of great importance. A pharmacokinetic model of targeted transport of drug substances has been described in this paper. There have been described conditions under which it is worth to search for facility of transport for the initial active agent. Primary screening of antitumor agents have been undertaken to modify them for the targeted transport based on underlying assumptions of the model.

Evaluation of the functional state of muscles is important in medico-biological provision of highly qualified athletes. Feature of swimming is a long-term training in water and physical training aimed at muscle development to overcome various distances in the shortest time. In the work carried out performance evaluation of anthropometry, physique, body composition and functional status of muscles of upper and lower extremities in athletes-swimmers. Systematic training for sport swimming increase muscle mass by 1,2 times, compared with persons not involved in sports, primarily due to the development of the muscles of the upper shoulder girdle and upper extremities and equal, but the specific distribution of fat mass in body composition. Have swimmers indices of aerobic capacity when working with the hands was higher in men 2,7, women have 3,3 times; for the feet of men and women is 2,3 times higher than in persons not involved in sports.

Aim. To assess the prevalence of the main cardiovascular risk factors (RF) and their concomitance in workers of highly harmful professions. Material and methods. In the study, men of dangerous professions participated, at the age 20-60 y.o.: 96 firefighters-rescuers, admitted to Russian centre of Catastrophe medicine (“Defense”, Moscow); 97 firefighters-rescuers at the central airmobile detachment “Centrospas” (Zhukovsky, Moscow region), 151 commando units of interior military forces of the Ministry of Internal affairs (Central regions of RF).Results. High prevalence of risk factors of CVD revealed: overweight and obesity — 40,7%, smoking — 47%. The relation found for lean glucose and cholesterol levels. Smokers have 37% decrease of serum iron comparing to non-smokers. Smoking also does impact transaminase level: AST increase by 31%, ALT by 46%, alkaline phosphatase by 19%, LDH by 19%. Smokers have alpha-amylase increase by 16% comparing to non-smokers. Also smokers have increased urea by 8% and creatinine by 15%. Non-smokers of any age have these parameters in normal range. Smokers have age-related changes more prominent, and in any age glucose and cholesterol levels are higher than in non-smokers. Conclusion. Smoking increases CVD risk from the point of view of the main biochemical markers of blood. These changes can be treated as an inset of protein metabolism disorders related to smoking.

The incidence among soldiers performing military service, higher compared to the civilian population and soldiers performing military service under the contract. Out of the total incidence of more than 50% are respiratory diseases. A high incidence of respiratory diseases can result in the disruption of service and combat missions. There is a high incidence among soldiers of the new replenishment. It is advisable to carry out individual selection in the military to determine the risk of respiratory disease by the method of pulse oximetry. Perhaps the use of pulse oximetry for selection in the special purpose units.

We investigated the oxygen-dependent metabolism of polymorphonuclear leukocytes (PML) in peripheral blood of patients with intolerance to non-steroidal anti-inflammatory drugs (NSAIDs) with different clinical manifestations with methods stimulated barium sulfate luminol- and lucigenin-dependent chemiluminescence. Revealed the violations of oxidative metabolism PML the blood in patients with asthmatic triad, resulting in a decrease in the total production of reactive oxygen species (ROS) and production of superoxide anion radical PML compared with healthy donors. In patients with chronic urticaria, worsening after administration of NSAIDs, significant changes in ROS production relative to such a healthy donors were not identified.

We investigated the intensity of barium sulfate stimulated luminol-dependent chemiluminescence (SLCHL) blood after pre-incubation of blood samples with nonsteroidal anti-inflammatory drugs (NSAIDs), food dye tartrazine in healthy donors and patients with intolerance to NSAIDS, tarirezine with different clinical manifestations. In patients with bronchial manifestations of intolerance to NSAIDS, tarirezine degree of suppression of SLCHL blood increases with the age of the intolerance. Only patients with skin manifestations of intolerance to NSAIDS (urticaria/angioedema) the degree of suppression of SLCHL blood degrades with the age of the intolerance of these agents.

Professional athletes represent a unique group of dermatological patients, since practically all of them, over the whole length of their sport career, encounter dermatological problems. It is known that in the case of origination of dermatological diseases, mainly of bacterial and fungal nature, the sport results level of professional athletes is known to decrease. In this connection, the need arises in a well-timed diagnosis of the athletes' skin microbiocenosis condition. We have improved a method that enables to determine the quantitative and qualitative composition of the mostly represented groups of the microbial population inhabiting the skin.

We investigated the intensity of barium sulfate stimulated luminol-dependent chemiluminescence (SLCL) blood after pre-incubation of blood samples with food dye tartrazine used at different concentrations in healthy donors and patients with asthmatic triad combined with tartrazine intolerance. Significant differences indicators SLCL blood from healthy donors and patients with intolerance to this dye allows us to use chemiluminescence method for the diagnosis of tartrazin intolerance.

The problem of schoolchildren's health functional reserves in the last decade gained global, epidemic scale. The researchers of this problem considering various risk factors affecting the health of the functional reserves of that category of persons, the most common of which is the development of excess body weight, ranging from the simple overeating and inactivity, genetic problems to complex mechanisms of metabolic disorders in tissue and molecular levels. We also know that there are certain age periods when obesity occurs most often from the moment of birth to one year, in 5-6 years and puberty. Multi-year tendency in the number of persons with reduced functional reserves health among schoolchildren entails the subsequent decline of health in all age groups and further affects the quality of human resources, reproduction of generations. Since the early 1990s, there is a tendency to deterioration of indicators characterizing the state of health, in particular, the growth of psychosomatic illness of adolescents and youth, especially in the final year of big towns and industrial cities. Meanwhile, the current data on the prevalence of obesity in Russia, as well as age-specific statistics on this disease around the world virtually non-existent. The purpose of this study was to examine age and gender-specific functional health reserves among schoolchildren, due to the urgency of upgrading health programs at the school level, aimed at disease prevention.

Aim. To investigate the association between heart failure (HF) and oral health. Material and methods. The study included 57 patients, aged 50-81 years (mean age 63,6±8,2 years), with Functional Class 0-II HF. Stomatological clinical status and functional status of circulatory system were assessed. Results. HF progression was associated with increased number of carious teeth and missing teeth. In HF-II, the disorders of temporomandibular joint and masseter muscles were 8 and 5 times more prevalent, respectively, than in HF-0.