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Experts discussed the problem of comprehensive medical treatment of vertigo through vestibular rehabilitation. Peripheral vestibular vertigo is most commonly caused by benign paroxysmal positional vertigo, Meniere's disease and vestibular neuronitis, while central vestibular vertigo is caused by vestibular migraine and stroke. Vestibular rehabilitation is one of the most effective areas of treatment for patients with various disorders of the vestibular system characterized by chronic dizziness. Vestibular rehabilitation improves patients' walking and stability and can lead to an improvement in patients' daily activities and quality of life. Currently, in our country medical rehabilitation centres are being established where patients with various causes of vestibular vertigo can receive complex therapy, including vestibular rehabilitation. The Expert Council recommends the comprehensive personalised use of vestibular rehabilitation in the complex treatment of various diseases manifested by dizziness. An educational program is needed for neurologists, ENT specialists and rehabilitation specialists in treatment of patients with different types of vestibular dizziness.

In Russia, a complex approach to diabetes mellitus and diabetic retinopathy (DR) treatment is adopted, yet certain issues remain in the system of medical care for DR patients. The statistical data are important to assess the availability and quality of medical care in each region of the Russian Federation, to plan resource distribution, and determine the volume of medicinal and technical support. The article presents an analysis of the territorial differences of DR prevalence and of dispensary follow-up of DR patients. In order to eliminate certain territorial defects in the organization of medical care for such patients, an improvement of outpatient medical aid organization and a more effective interaction between ophthalmological and endocrinal health services is required.

Headache and dizziness are the two most common complaints with which patients turn to physicians of various specialties. A thorough examination often reveals a combination of these two symptoms. Currently, the term “vestibular migraine” (VM) is recognized by the worldwide community of otoneurologists and neurologists as the most appropriate for the combination of vestibular vertigo and migraine headaches. The difficulties in diagnosis and differential diagnosis are related to the lack of possibility to confirm the disease (and to detect) instrumentally and to the fact that the dizziness may be different in different VM episodes, even in one patient. The complexity of therapy is in the need to choose a relatively individualized treatment regimen and in the lack of an ideal vestibular suppressant (which quickly suppresses dizziness and has no significant side effects). In this context, finding the most effective drugs for emergency and elective treatment of patients with VM is undoubtedly important. For patients with VM, the use of the drug Arlevert (dimenhydrinate 40 mg + cinnarizine 20 mg) can be recommended for the relief of acute vestibular crisis at home, since the drug is highly effective and well tolerated. In addition, and most importantly, Arlevert has no known interactions with other medications used for migraine prevention.

The paper presents an analysis of the latest literature data on the problem of obesity and breast cancer (BC). This review presents modern approaches to the diagnosis of BC in obese patients, new molecular methods of breast imaging, analyzes the features of the course of BC with obesity depending on menstrual status, molecular biological subtypes of the tumor, the mechanisms of the development of BC against the background of obesity.

The article presents the results of a review of the data of Russian and international research of social-urban development as presented at the scientific events in the Saratov region. In contemporary urbanism, there is a number of trends: temporal, of universal design, and social-cultural. The Russian urban development follows agglomeration trends that are increasingly evident in the processes of settlement, which means active development of suburban areas, changes in their landscape characteristics, cultural spaces, and mobility of citizens. The covid-19 pandemic had a complex impact on the social-urban features of cities in Russia and the world by transforming the structure and functionality of many urban locations, creating conditions for the emergence of a post-coronavirus city. The empirical data show that such a city is the most socially sensitive to negative and positive aspects of social life and to manifestations of inclusive practices that unite people. Under the low, fragmented accessibility of social, cultural and other infrastructure of cities that are designed for healthy people, there is a synchronization of urban infrastructure elements in the context of inclusion due to the social demand for a coronavirus transformation of the architectural and urban environment in terms of social distancing. Based on the research data from different regions of Russia, the authors identify priority directions of the inclusive development of social urbanism: models of the inclusive culture of urban communities; monitoring of the city accessible environment for citizens of different age and mobility (in particular, with the tracing and walk along approaches); model of participatory urban planning and social expertise of the inclusiveness of the urban space; educational model of professional training in the field of social urbanism and universal design.

The article shows that in the analysis of the labor market statistical and administrative data are used as an empirical base, which is insufficient for understanding current trends on it and making decisions. The authors determined the scope and features of the presentation of information about the labor market on online job portals, revealed differences in the formation and structuring of information, substantiated the need to use the data of online job portals in the Republic of Belarus to obtain a comprehensive picture of the labor market, since they cover different segments of the Belarusian labor market. Online job portals in the Republic of Belarus were evaluated and ranked. The authors formulated the difficulties of forming a single portal of vacancies for labor market analysts: - different criteria for structuring information in the description of vacancies and resumes, the use of different classifiers; - lack of unification in the use of methodological and methodological approaches (understanding the labor market situation, division into types of economic activities, categories of vacancies and resumes); - weak structuring and arbitrariness in the description of the required skills; - closed information. The directions of formation of the digital ecosystem of the labor market in the country are determined, including the collection and processing of information about the labor market from different sources, their relationship and integration with the education system, business entities, management bodies, ensuring the unity of methodological approaches in the formation of information (terminology, taxonomy, classifiers, etc.) and its provision to all interested users (management bodies for the development of programs and forecasts, personnel services of organizations, educational institutions, the population - employed, unemployed, who want to change jobs, find additional work, students, applicants, etc.).

The goal of the present study was to extract and purify lysyl oxidase from rodent’s tissues by a fast, simple, effective and inexpensive method and to develop a sensitive, time-saving lysyl oxidase specific activity assay for routine in vitro experiments. Lysyl oxidase was purified by elaborated purification procedure which relies on negative adsorption principle, that is, an effective decrease in the concentration of ballast components by the polar hydrophilic adsorbent and increasing the concentration of the protein of interest. Peroxide-coupled lysyl oxidase activity quantification methods based on luminol chemiluminescence in the presence of horseradish peroxidase as a catalyst and fluorescent detection using folic acid and Cu(II) with 1,5-diaminopentane as the substrate, were designed. Lysyl oxidase was partially purified from urea extracts of rodent’s tissues. Used purification procedure ensures the fast release of 93% of ballast proteins as shown by polyacrylamide gel electrophoresis. Lysyl oxidase specific activity after purification was 10-22-fold higher than that of the original extract. The molecular mass of murine lysyl oxidase from lung and heart was estimated to be ~32 kDa. We elaborated two sensitive methods for lysyl oxidase activity quantification and fast inexpensive procedure for partial enzyme purification useful in bulky in vitro experiments.

Upper airway inflammatory diseases account for about 90% of all infectious diseases and are the most common causes of patients’ visits to the otorhinolaryngologists, pediatricians and general practitioners. Acute otitis media and rhinosinusitis are considered the most common complications of acute respiratory infections. Auditory disorders often occur during respiratory infections, which may be directly caused by Eustachian tube dysfunction, acute otitis media and acute sensorineural hearing loss. Sensorineural hearing loss (SNHL) is a type of diminished hearing (up to loss), which affects any of the parts of the soundperceiving apparatus of the auditory analyser, ranging from the neuroepithelial structures of the inner ear to the cortical representation in the temporal lobe of the cerebral cortex. It is extremely important to timely detect sensorineural hearing loss and immediately start therapeutic measures, especially in children, since de-socialization occurs much faster in this age group.

The review presents modern technologies of vision restoration, with special emphasis to retinal prosthetics: Argus, Alpha IMS, Intelligent Medical Implant, Artificial Silicon Retina, Photovoltaic Retinal Prosthesis, Epi-Ret, Boston Retina Implant Project, Bionic Vision Australia, and Semichronic Suprachoroidal Transretinal Prosthesis. Types of visual implants are described, reviewing technical parameters, surgery procedures, clinical trials and application experience. Basic issues and prospects of new artificial vision technologies are discussed.

Purpose: to compare subtle changes in retinal and optic disk morphology and microcirculation and the functional activity of visual channels in patients with multiple sclerosis (MS) and optical neuritis (ON) in the medical history. Material and methods: 19 patients with remitting MS (duration of about four years) and ON developed about six months ago were tested by standard neurologic and ophthalmologic techniques, optical coherent tomography (OCT) with the angio OCT (RTVue XR 100 Avanti) protocol. The pattern ERG (PERG), as well as visual evoked potentials (VEP), on the reversing black/ white, pure luminance (black/yellow) and chromatic (red/green and blue/yellow) chess stimuli were recorded (RETI-port/ scan, Roland Consult, Germany). Results: At the level of superficial capillary plexus, the density and the area of vessels were reduced in the parafoveal zone, and the blood flow index dropped significantly (to 82.6% against the control). No statistically significant changes of blood flow were found in the peripapillary zone. The peak latency of P50 in the PERG responses to all stimuli showed a statistically significant reduction. The peak latency of N95 was delayed by an average of 10 % as compared to the controls. The amplitude of PERG N95 was moderately reduced for stimuli of all sizes. The elongation of the culmination time for the peak P100 was shown to be significant only in the VEP responses to blue/yellow patterns with angular sizes of 16° and 0.3°. A decrease in the thickness of the ganglion cells (GCC) complex correlated highly with reduced microcirculation in the superficial capillary plexus. Conclusion: Early changes of the retinal function were documented in patients with recent MS and ON history with almost equal involvement of the retinal ganglion cells of the parvo-, mango- and koniocellular systems into the pathological process. For the first time, we established direct correlation between the parameters of microcirculation and morphometry of the inner retina. Clinical significance of the simultaneous detection in MS patients of the delay of P100 latency in the VEP and reduction of the thickness of the SCC and the retinal nerve fiber layer was shown. For citations: Lantukh E.P., Zueva M.V., Tsapenko I.V., et al. Microcirculatory and functional changes in the retina and visual channels in multiple sclerosis. Russian ophthalmological journal. 2017; 10 (3): 29-41. doi: 10.21516/2072-0076-2017-10-3-29-41 (in Russian).

The paper presents the evaluation of Retinalamin efficacy administered intramuscularly to 90 patients (180 eyes) aged 47 to 75 (averagely, 65.9 ± 7.18 years) with various stages of dry age-related macular degeneration (AMD) once or twice in 6 months. The data of multifocal electroretinography (MfERG) showed that in 80 % of cases of early and intermediate AMD stages, the functional state of the retina improved after a course of Retinalamin, reaching a peak 2 months after the start of treatment. A second course of Retinalamin, given 3 months later, resulted in a more pronounced improvement of the functional parameters, achieving the maximum in the month 5 of the follow-up period. This is confirmed by a change in the P1 component of Mf ERG, which proved to be the most pronounced in the central ring, corresponding to the foveal area. In more than 70 % of cases with atrophic AMD, a positive dynamics of the functional activity of the macula was noted only after a repeated course of intramuscular injections of Retinalamin, whose curative effect reached the maximum in the month 5 of the follow-up. An increase in the density of the P1 component of MfERG was more noticeable in the last two rings, corresponding to the periphery of macula // Russian Ophthalmological Journal, 2016; 1: 39-46.

The levels of erythropoietin (EPO) in biological fluids were studied on 43 patients with diabetes mellitus type I and II who suffered from a variety of clinical manifestations of heavy proliferative diabetic retinopathy (PDR) which incuded stable PDR, 12 patients with rhegmatogenous retinal detachment and 15 healthy individuals The correlation of EPO levels with the clinical features of heavy PDR was noted only at the local level (intravitreally). The highest intraocular levels of EPO were associated with severe features of the disease, abundant vascularizarion of fibroglial tissue, and intraoperative hemorrhagic complications, which corroborates the theory of active participation of locally secreted EPO in ocular neoangiogenesis, including the progression of PDR // Russian Ophthalmological Journal, 2016; 2: 55-60. doi: 10.21516/2072-0076-2016-9-2-55-60 .

The paper analyzes the data of a survey, conducted among the chief ophthalmologists in 34 regions of Russian Federation, on the state of medical care of patients with diabetic retinopathy. The questionnaire of the survey was developed by WHO within the international program "Tool for the Assessment of Diabetic Retinopathy and Diabetes Management System" (TADDS) and adapted to Russia’s conditions. We analyzed the scope of practical use of regulatory documents, the availability of medical care, screening quality, diagnosis, monitoring and treatment of diabetic retinopathy, cooperation of medical facilities, and education of medical staff // Russian Ophthalmological Journal, 2016; 2: 5-10. doi: 10.21516/2072-0076-2016-9-2-5-10.

Aflibercept is a hybrid protein-imitation of VEGF receptor with a prolonged activity. The review describes the structural properties of the Aflibercept molecule, the impact of the medication on the pathogenesis of retinal diseases, and the results of clinical studies into the safety and effectiveness of Aflibercept in the therapy of age related macular degeneration (VIEW1, VIEW2), diabetic macular oedema (VISTA, VIVID), macular oedema caused by the occlusion of the central retinal vein (GALILEO, COPERNICUS) or its branches (VIBRANT), and myopic choroidal neovascularization (MYRROR) Russian ophthalmological journal. 2017; 10 (2): 103-11. (in Russian). doi: 10.21516/2072-0076-2017-10-2-103-111.

The article presents the results of an in-house study aimed at assessing the safety, tolerability and therapeutic efficacy of Dishi plaster inhaler for the treatment of acute respiratory diseases in children. Our study showed that the administration of Dishi plaster inhaler since the first hours of ARD helps provide faster relief of catarrh symptoms, primarily nasal symptoms, reliably reduces the need for prescribing vasoconstrictors, thus reducing the drug load on the patient. The good tolerability and high efficacy of Dishi plaster inhaler enable us to recommend it as a remedy for symptomatic therapy of ARD in children over 2 years old.

Cough is one of the most frequent reasons for seeking pediatrician’s aid. The fact that, generally, cough has the function of airway clearance is not always taken into account. Short-term, non-persistent cough may be a manifestation of the normal protective reaction. Coughing is beneficial if the sputum has certain rheological properties and there are no obstacles for its evacuation. However, more often coughing indicates the presence of a disease and may be inefficient because of impaired mucus clearance due to various reasons. Therefore, the physician should be able to manage cough and optimize the process of sputum clearance using rational methods of treatment.

Infantile hemangiomas are the most common vascular lesions newborns and infants have and they are sure to be a socially significant problem. Despite the fact that modern research techniques allow you the problems of diagnosis methods, classification, ways of observation and treatment of children with this pathology remain important in foreign and national literature. All this determines the constant interest of researchers to the problem of differential diagnosis, pathogenesis, risk factors and treatment of infants. This article presents current epidemiological data regarding infantile hemangiomas and the problems of the classification, of possible risk factors for their development, the treatment methods of the specialist when confronted with this problem are discussed.

The study was carried out to investigate the effect of BCG vaccination on the functio­nal activity of immune blood cells in rats with alimentary osteoporosis. The findings indicate that chronic vitamin D deficiency led to osteoporosis and caused immunological disturbances. In particular, phagocytic activity of granulocytes and monocytes and their abi­lity to produce reactive oxygen species were found to be significantly decreased. It was also demonstrated a marked (2-fold) lowering of NAD(P)H-quinone oxidoreductase acti­vity in leukocytes. Additional BCG vaccination of rats with developed alimentary osteoporosis resulted in excessive stimulation of non-specific immune response. Phagocytic acti­vity of monocytes and granulocytes increased to values exceeding those in control rats. BCG induced elevation of NAD(P)H-quinone oxidoreductase activity in phagocytes that was accompanied by intensification of reactive oxygen species formation. These data suggest that administration of BCG increases the activity of phagocytic cells in the blood of osteoporotic rats, thus, leading to activation of non-specific immune defense.

This work is devoted to the study of the features of oxidative metabolism of hepatocytes in diabetic mice and those under the vitamin D3 action. We found out that a 2.5-fold decrease of 25OHD3 content in the serum was caused by chronic hyperglycemia in diabetes. Intensification of the reactive oxygen species (ROS) and nitrogen monoxide (NO) production, protein oxidative modifications (detected by the contents of carbonyl groups and 3-nitrotyrosine), accumulation of diene conjugates and TBA-reactive products of lipid peroxidation, and the decreased level of free SH-groups of low molecular weight compounds in the liver were accompanied by development of vitamin D3 deficient state. It was shown that there was a decrease in the key antioxidant enzymes activity (catalase, SOD), while the activity of prooxidant enzymes NAD(P)H:quinone oxidoreductase, xanthine oxidase and NAD(P)H oxidase was increased. The identified oxidative metabolism lesions caused the elevation of the hepatocytes necrotic death that was tested for the ability of their nuclei to accumulate propidium iodide. Prolonged vitamin D3 administration (during 2 months) at a dose of 20 IU to diabetic mice helps to reduce the ROS formation and biomacromolecules oxidative damage, normalizes the antioxidant system state in the liver and increases survival of hepatocytes. The results suggest that vitamin D3 is a key player in the regulation of the oxidative metabolism in diabetes.

This review focuses on the analysis of diagnostic value of the major bone remodeling markers, in particular synthesis and degradation markers of collagen type I. These include carboxy- and aminoterminal telopeptide, carboxy- and aminoterminal propeptide of procollagen type I, hydroxyproline, hydroxylysine, pyridinoline and deoxypyridinoline. Their measurement allows evaluating the structural and functional conditions and also the rate of metabolic processes in the bone tissue. The advantages and disadvantages of determination of these markers in the condition of different bone diseases were examined. It is shown that determination of bone collagen type I metabolism markers is the most informative for assessment of bone resorption, formation and turnover.

Summary: The article reveals current data on the epidemiology of acute respiratory infections and antiviral defense mechanisms with regard to the anatomical and physiological characteristics of children's immune system and options for etiopathogenetic therapy. The focus is on the antiviral and immunomodulatory drug pranobex inosine (Isoprinosine), with data from literature on the use of inosine pranobex in children with respiratory infections. The efficacy and safety of inosine pranobex (Isopinosine) in pediatric practice is demonstrated.

Bronchial asthma (BA) in children is one of the common allergic diseases. Epidemiological studies show that 4 to 8% of population suffer from asthma; in children this figure comes to 5-10%. Over the last few years all over the world, including Russia, the incidence of asthma and its severity in children has tended to increase. The number of children infected with asthma at early age is rapidly growing. At it its initial stage the disease is usually manifested in bronchial obstruction accompanying respiratory viral infections. Today the disease is a challenge not only for healthcare, it has also acquired social and economic importance.

Aim: to study clinical efficacy, tolerance and safety of a new pelleted ibuprofen form for children in treatment of fever in patients with acute respiratory tract infection. Patients and methods: children aged from 6 to 12 years old with clinical manifestation of respiratory tract infections and requiring antipyretic treatment were included into the study. Children (n = 50) were administered ibuprofen at a single dose of 5–10 mg/kg of body weight, not more than 3–4 times per day. The efficacy assessment included time needed for temperature decrease (assessment was performed in 15, 30 and 60 minutes) and duration of the antipyretic effect (assessment in 6, 8 and 12 hours). Rapidity of analgesic effect in children with ear ache, headache and myalgias was performed in 15, 30, 60 minutes and 6, 8 and 12 hours after the drug intake. Results: antipyretic effect of pelleted ibuprofen for children begins in 15 minutes after its intake. Stable temperature decrease during the first 6 hours was observed in 58% of children (the mean temperature was 37,1 ± 0,3) and maintained up for 12 hours. Relief of pain intensity was established in 62,1% of patients during the first 3 hours, and in 37,9% the pain syndrome was arrested completely. Conclusions: the new pelleted form of ibuprofen for children was proved to have high clinical efficacy and safety in treatment of fever in children with acute respiratory tract infections.

Acute respiratory infections represent the most common disease among children. In addition to that, children with predisposition to allergy have respiratory infection more often and their clinical course is more severe than in non-allergic children at the same age. Respiratory infections in patients with predisposition to allergy often have complicated or chronic course without appropriate treatment. Timely and appropriate therapy of such conditions contributes to faster recovery and prevents complications. Modern macrolide antibiotics are the drugs of choice in treatment of acute respiratory mixed (viral and bacterial) or bacterial infections in children with allergy. One of the most commonly administered antibacterial agents in allergology practice is azithromycin. It is due to its high efficacy against out-of-hospital causative agents of respiratory infections, including atypical, significantly higher and more stable tissue concentrations, prolonged semiejection period and possibility of one-time intake per day, as well as low risk of allergic reactions. Appropriateness of azithromycin usage in allergic reactions is also caused by its non-antibacterial properties: anti-inflammatory and immunomodulatory activity.

The results of the open controlled prospective clinical and immunological trial indicate that including of pidotimod into the complex therapy of pyelonephritis in children (n=30) lead to reliable decrease of recurrence risk and frequency during 6 months after treatment withdrawal in comparison with children receiving antibacterial monotherapy (n=20). The duration of etiotropic treatment for arresting of the active manifestations of urinary tract infection was lower in patients who were administered the afore-mentioned drug. Immunological monitoring of the urine cytokine status during pidotimod treatment showed that there were signs of T helper 1 cells activation predominance (increase in interferon/interleukin 10 ratio), as well as decrease in granulocyte macrophage colony-stimulating factor concentration, which seems to cause the delayed influence of the drug on the course of urinary tract infection.

Электронный способ ведения документов обладает рядом преимуществ, позволяющих упростить процессы обработки, обмена, хранения информации, защиты медико-биологических данных и организации консультаций медицинских специалистов. Существующая задача перехода от бумажного способа ведения медицинской документации к электронному остается до сих пор актуальной, о чем говорит разнообразие стандартов ведения электронных медицинских записей: например, стандарты HL7, DICOM и другие.