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The article analyzes the regional features of the provision of medical personnel in Russia in the context of various subjects and federal districts. P u r p o s e of the study is to analyze the features of staffing of medical organizations in the constituent entities of the Russian Federation in modern conditions and the main directions of policy to improve the staffing situation at the regional level. M a t e r i a l s a n d m e t h o d s . According to the official statistics, an analysis of the staffing of medical and paramedical personnel was carried out in the context of the constituent entities of the Russian Federation; in the course of the study, methods were used such as: analytical, statistical, study and generalization of experience. R e s u l t s . The analysis showed that the provision of doctors and the provision of emergency medical services for different regions of the Russian Federation is different. The lowest values of the indicator of the provision of doctors in 2019 were recorded in the Ural FD, the Southern FD and the North Caucasian FD, while in the constituent entities of the Russian Federation the most pronounced tendency towards a decrease in the level of provision nursing staff was noted in Moscow, Tyumen region, Chukotka Autonomous Okrug, Republic of Kalmykia, Udmurt Republic, as well as in Yaroslavl, Murmansk, Novgorod and Kirov regions, which emphasizes the need to take appropriate management measures, both at the local and federal levels. F i n d i n g s . The existing imbalance in the country between the provision of the population with doctors and nurses in various regions (the difference between low and high rates is more than 2.3 times), as well as between the provision of medical workers in the city and rural areas is the main problem of staffing the system. To overcome this situation, further implementation of new measures of social support and moral incentives for medical personnel in Russia is required.

Health status of the younger generation in Russia is of particular relevance, since it is this period that forms the development potential of future generations.Objective. To study and analyze regional features of the incidence rates of the adolescent population in Russia.Material and methods. The authors have used various literature sources, statistical reports; the method of studying and generalizing experience. For the statistical analysis of the morbidity dynamics they used the indicators of absolute and relative growth, they assessed the chain and basic growth rates. Also the authors generalized the characteristic of the incidence dynamics by means of regression analysis.Results. The paper provides a detailed analysis of the incidence of the adolescent population in the Russian Federation in 2012–2018. It describes the dynamics and structure of both primary and general morbidity, identifies classes of diseases with a stable trend of growth, and compares with similar indicators in other countries; the authors analyze the regional characteristics of the incidence of adolescents; compare the level of morbidity in the Russian Federation for all classes of diseases.Conclusion. The authors revealed classes of diseases, characterized by a stable increase in indicators of both primary and general morbidity: neoplasms, endocrine diseases (obesity), eye diseases, injuries. Thus, the article identifies the directions for the health care system that require special attention and development of specific measures to reduce the level of these diseases. The results of the study demonstrate a low medical activity of adolescents, which should be taken into account when developing a set of measures aimed at increasing the coverage of adolescents with medical examinations.

The disability is one of the main indices of public health, along with medical and demographic characteristics, morbidity and physical development that characterizes level of social economic development and is a major problem of health and social care authorities. The availability of statistical data and analysis of problem of population disability will allow to properly plan activities of various administrative bodies. The article presents trends of persistent disability in the Russian Federation during the studied period. In recent years, total number of disabled people has been gradually decreasing. In Russia, most of disabled people have disability group II. At the same time, the percentage of persons with group III increases and proportion of disabled persons with the groups I and II gradually decreases. The children disability in Russia tends to increase. In the Russian Federation, the analysis of regional differences in disability is presented. The analysis and assessment of regional characteristics of disability are necessary for planning and forecasting measures of medical and social support of persons with disability. The analysis of available statistical data permitted to established interdepartmental dissociation on this issue. The results of the study permitted to conclude that the need of increasing attention to the problem of disability results in strengthening interdepartmental interactions and developing of unified register of disabled people.

The palliative care is determined as "a complex of medical interventions targeted to deliverance from pain and relief of other severe manifestations of disease, for improving quality of life of terminally ill citizens" (Art. 36 of the Federal Law of 21.11.2011 № 323FZ) on the stage of uncontrolled progression of disease. The actual status and accessibility of palliative care was analyzed, including development of this issue in both the Russian Federation and number of foreign countries. According to the WHO, in Russia, 360-460 out of 100,000 population need palliative care. Out of them, 200 individuals with oncologic diseases, 150 individuals with non-malignant diseases and 12 individuals with AIDS/HIV. The health authorities face the task of significant increasing of scope of palliative care to make it more accessible. In recent years, issues of palliative care were intensively considered at the level of patients, of public organizations and legislators, as well as at the level of physicians, the Ministry of Health Care officials and others. Despite the great attention of researchers to issues of palliative care, the majority of physicians confirm its low accessibility to patients, as testify the results of survey of health workers carried out by the Foundation of Independent Monitoring of Medical Services "Zdorovie". The article also considers issues of normative base regulating palliative care provision and application of narcotic analgesics. The analysis of study results permits to conclude that despite considerable attention to palliative care, the issue of its accessibility continoue to be very actual.

The physical accessibility of pharmaceuticals considering space-time factors and assortment accessibility is minutely considered on the example of the Sakhalin oblast. The conclusions considering universality of factors of accessibility and availability in every subject are made emphasizing necessity of characteristics to be taking into account. The analysis of factors of accessibility in the subject permits to establish risk zones preventing accessibility of pharmaceutical for population.

The Sakhalin oblast is considered as a detailed example of physical accessibility of pharmaceuticals with regards to time-space factors and assortment accessibility. The conclusions are made concerning universality of factors of accessibility and availability of characteristics to be taken into account in every subject. The analysis of factors of accessibility in the subject permits to establish risk zones preventing accessibility of pharmaceuticals to population.

Sphingomyelinosis in a 1.5-year-old girl with unusual clinicomorphological manifestations without hepato- and splenomegaly is described. The diagnosis was established on the basis of postmortem biochemical examination of the brain.

Generalized herpetic infection (GI) with a predominant involvement of the brain, eye, liver and spleen, in which cell rhexis and hyperchromatosis and large necrotic foci were observed, has been experimentally reproduced in newborn rabbits. Administration of herpes simplex virus at the dose of 5LD50 resulted in the suppression of immune reactions and animal death 4-5 days later. Dose of 2LD50 resulted in the immune response in the lymphoid organs, but the signs of the disease disappeared 5 days after the injection of the virus. The hypothesis on the existence of several clinico-morphological variants of GI is postulated.

The post mortem content and composition of cerebrosides, sulfocerebrosides and gangliosides found in different sections of the spinal marrow of the healthy persons and 5 patients with spinal tuberculosis were analysed. It was shown that the changes in the content of gangliosides were varying in the lesion focus of different patients. In all patients with chronic tuberculous spondylitis, a significant drop in the content of cerebrosides (myelin markers) and sulfocerebrosides in the lesion focus, as compared with controls, was detected. There were some changes found in the content of cerebrosides and gangliosides in the spinal marrow lesion focus, which are also typical of the disease associated with demyelination of the nervous system. The findings suggest that identification of blood anti-cerebroside antibodies in patients with spinal tuberculosis allows one to make an early diagnosis of abnormalities in the cellular structures of nervous tissue in this form of the disease and to predict its course.

Results of morphological examination of brain herpetic lesions in 29 children are presented. There were 5 observations of necrotic meningo-encephalitis, among children with generalized intrauterine herpes, less severe changes were found in other cases. 14 children suffered from acute necrotic meningo-encephalitis developed after birth. Changes typical for herpes are described in neural, glial and ependymal cells; the type of response in different forms of lesions is shown. The correlation between the gangliosides content in the brain tissue and the surviving neural cells and a specific increase of ganglioside GD1b fraction in brain tissue were demonstrated by biochemical and morphological studies.

The paper presents brief characteristics of the causative agent and methods of its detection in tissues. The time course of the development of morphological changes in the central nervous system (CNS) is characterized on the basis of the authors own studies. In particular, the possibility of formation of congenital CNS defect upon intrauterine infection with toxoplasma has been demonstrated. A direct correlation between the results of morphological and biochemical examinations of the CNS has been found. A case of toxoplasmosis developing postnatally as a result of exogenous infection with a description of the primary focus in the lungs is presented.

Content and composition of gangliosides were studied in brain white and grey substances of patients with mongolism. Content of gangliosides, which are typical components of plasmatic membranes of nervous cells, was decreased in brain grey substance of the patients as compared with control group, whereas content of the lipids was increased in white substance. Differentiation of neurones appears to be inhibited in mongolism. Content of disialoganglioside GDIa exceeded the content of other gangliosides in brain white and grey substances in normal state; content of GMI, GTI, GDIb was also increased. Composition of gangliosides from brain of the patients with not distinctly altered as compared with that of children of control group.