This article discusses the delivery of pregnant women with cholestatic hepatosis, their somatic history, as well as perinatal outcomes and complications of childbirth in women with a diagnosis of CGB.

Relevance: Pregnancy and childbirth is an important stage in the life of not only the expectant mother and her family, but also the child being born. Well-known facts demonstrate a high dependence of the fetal state on the emotional mood of the mother and the level of her anxiety. A large number of factors, such as emotional experiences, hormonal disorders, deviations from the normal functions of organs and systems, cause a pregnant woman to experience fears and doubts, which has a direct or indirect impact on the health and life of the unborn child. According to numerous literature data, some pregnant women have a high level of anxiety that affects the condition of the fetus.
Objective: Study the level of personal and situational anxiety in pregnant women with a gestation period of 37 weeks or more due to the influence of various disorders of somatic, reproductive and social health.
Tasks:
1. Analyze the data of obstetric, gynecological, somatic and social anamnesis of the examined pregnant women;
2. Assess the level of situational anxiety in pregnant women with a gestation period of 37 weeks or higher;
3. Assess the level of personal anxiety of pregnant women in the study group;
4. Assess the influence of the number of factors aggravating the history on the level of personal anxiety.
Methods: We used a questionnaire for self-assessment of the level of anxiety by CH. D. Spielberger modified by Yu. L. Khanin, as well as data from the medical history and exchange card of 40 pregnant women with a gestation period of 37 weeks or more. Based on the analysis of the survey results, the level of personal and situational anxiety of the subjects was determined. The influence of obstetric, gynecological, somatic and social anamnesis on the indicator of personal anxiety was studied. Data processing was performed using descriptive statistics methods.
Results: According to the results of the study, it was found that high indicators of personal anxiety of pregnant women before childbirth are more common than similar indicators of situational anxiety. In the study sample, there were no women with a low level of personal anxiety. When analyzing the effect of the number of factors burdening the anamnesis, on indicators of trait anxiety found no direct relationship between the number of complicating medical history factors and increasing the level of personal anxiety.
Conclusion: Anxiety is an inherent character trait of pregnant women, which in reasonable manifestations is a way of adaptation and protection. One of the most important roles of an obstetrician-gynecologist is to provide psychological training for women before the planned pregnancy, during its duration and in the postpartum period.

This paper presents the results of a study of the relationship between physical health indicators and anthropometric characteristics in female students of RSMU. Currently, representatives of the fair sex for various reasons have become more likely to resort to the use of modern technologies and turn to reproductive health centers, which, in turn, has led to an increase in the frequency of multiple births.

Objective: to investigate the relationship between physical health indicators and anthropometric features in 2nd-year female students of RSMU and contextually link them with the features of natural and artificial mechanisms of pregnancy.

The research was carried out in accordance with articles 5, 6 and 7 of the universal Declaration on bioethics and human rights. Based on the analysis of the data obtained, the BMI of the subjects was calculated and they were divided into 3 groups by body type: asthenic, normosthenic and hypersthenic types. The survey also revealed such parameters as: blood type, the presence of identical and fraternal twins in the family, and cancer patients.

Determination of the level of physical fitness of the subjects was made according to the standards of the TRP-jumping rope or Martinet test (30 squats, if there are contraindications). They were asked to make more skipping rope jumps in 30 seconds. To reach the norm, the subjects had to make at least 50 jumps. If there were any contraindications, the subjects performed 30 squats as another exercise.

Before and after physical exercises, we measured the arterial pulse for 1 minute and blood pressure (BP) of students, after which they were divided into 3 groups (low, medium and high level of training) according to asthenic, normosthenic and hypersthenic body type.

We determined the level of physical fitness of the subjects of different body types. It was revealed that at the current time, the identified contraindications were identified in 40% of the studied female individuals (age from 19 to 24 years, category: students). Accordingly, they are at risk of developing, first of all, diseases of the cardiovascular system, as well as other systems, and, therefore, without proper correction, the use of drugs to stimulate ovulation in the future is not recommended.

Relevance. Flooding is the most common natural disaster compared to other natural disasters. Floods are regularly observed on most of the rivers of our country and occupy the first position in a number of natural disasters in terms of frequency, area of distribution and real damage.
Goal. To study the organization of medical care in case of floods, to perform the preparation of forces and means of the Ministry of health to work in emergency situations hydrology, and to assess the work of medical institutions carrying out medical and sanitary-epidemiological measures on liquidation of consequences of floods.
Methods. In the course of the scientific work, the material was analyzed and data on health care in the event of hydrological disasters in the far Eastern Federal district in 2013 were summarized.
Results. Proper organization of interaction of forces of the QMS of the Ministry of health of Russia, divisions of Rospotrebnadzor and FMBA of Russia, as well as timely implementation of necessary measures would prevent an increase in the degree of morbidity among the population to prevent the spread of viral and bacterial diseases, to maintain favourable sanitary-epidemiological conditions and the disease at its natural level.
Conclusion. Preventive measures carried out purposefully can significantly reduce material damage, and timely provision of the entire complex of medical and evacuation measures can save lives and preserve the health of the population in this emergency, that is, reduce the number of both irrevocable and sanitary losses.

Relevance. According to the publicly available literature, burnout occurs in human-to-human occupations, including physicians and other healthcare professionals. In addition, there are not many data in the literature on the prevalence of this syndrome among pediatric healthcare workers. This paper analyzes the prevalence of burnout syndrome among medical workers of the admission department of a children's hospital, its impact on the health of workers, and the general patterns of its development.
Goal. The aim of the study was to identify the burnout syndrome in medical workers of different ages, with different length of service and working conditions, to assess the level of its development, to identify possible links between the presence of the syndrome and the occurrence of health abnormalities in workers and the emergence of bad habits, the presence of chronic diseases, analysis of industrial the environment in a particular department and the attitude of the workers themselves to it, the influence of the production environment on the formation of the syndrome.
Methods. As a research method, an anonymous questionnaire survey was adopted using the MBI method as edited by N.Ye. Vodopyanova.
Results. When analyzing the questionnaires, it was found that the emotional burnout syndrome is most clearly manifested in workers with little work experience, having part-time jobs, night shifts or combining work with studies at a university; In addition, the generally weak manifestations of the burnout syndrome in the team are noteworthy.
Conclusion. The data obtained suggest that burnout syndrome may be not only a consequence of chronically acting work stress. In addition, the article proposes methods for the prevention of burnout syndrome in employees of a particular department.

Relevance: childhood and adolescent injuries are much more likely to cause death than illness. Moreover, young men predominated among the injured children. In addition, their injuries were more severe. Closed-type paramilitary educational institutions imply further admission to military service, which is associated with a risk to life.
Purpose: training cadets in the basics of self-and mutual assistance, both in peacetime and in wartime.
Methods: students of V.G. N.N. Burdenko conducted a cycle of classes on life safety in frontal and group form. The proposed topics covered the most common life-threatening emergencies and the algorithm of actions in case of their occurrence.
Results: the students successfully mastered the basics of desmurgy, methods of stopping bleeding, the algorithm for self-and mutual assistance in case of airway obstruction, and the skills of cardiopulmonary resuscitation.
Conclusion: The most effective way to organize the educational process is the frontal and group form. Demonstration of educational films, practicing practical skills on dummies, training with the use of standard first aid aids can interest the cadets and motivate them to further cognitive process.

Relevance. Natural fires are a powerful factor that can affect the environment, life and health of people, and cause serious economic damage to the state.
Purpose: analysis of the causes of the occurrence and spread of forest fires in Siberia; study of their impact on the environment and public health.
Methods. The method of expert assessments, statistical analysis of data from official agencies and the media, comparative analysis.
Results. The main causes of the fires were the careless handling of fire by people and dry thunderstorms, as well as (according to unofficial data) deliberate arson for the purpose of illegal logging for sale. The scale of the fires was due to the lack of measures for fires in hard-to-reach areas of the taiga, passive monitoring in order to save money and due to a lack of funding. According to Russia's Greenpeace, 5.4 million hectares of forest were affected. The Siberian fires had the most catastrophic consequences for flora and fauna. A number of areas were in the smoke zone. In the city of Kirensk, an excess in the atmospheric air of the maximum permissible concentrations for the content of carbon oxide - 1.2 times, sulfur dioxide - 1.02 times. In Krasnoyarsk, the content of suspended particles of the PM2.5 fraction, according to Rospotrebnadzor, was twice the norm. For a comparative analysis, we took Rospotrebnadzor data for the Voronezh region for August 2010 during the period of forest fires, when there was a strong relationship between the concentration of carbon monoxide and hospitalization, moderate - between the concentration of suspended particles and hospitalization, strong - between the concentration of suspended particles and mortality. Thus, the level of morbidity and mortality in the territories affected by the Siberian fires could differ insignificantly, which was confirmed by media reports. However, according to the official data of Rospotrebnadzor as of June 31, 2019, there were no high health risks.
Conclusion. The main causes of the fires were the careless handling of fire by people and dry thunderstorms, as well as (according to unofficial data) arson for the purpose of illegal logging. The scale of the fires was due to the lack of measures taken in case of fires in hard-to-reach areas of the taiga. 5.4 million hectares of forest were affected. A number of areas were in the zone of smoke with an excess of the MPC. Based on the results of our comparative analysis with data on fires in the Voronezh region in 2010, an increase in morbidity and mortality in the areas of Siberian fires with smoke was predicted. This forecast was confirmed in the media, however, according to the official data of Rospotrebnadzor, there were no high risks to public health.

Relevance: acute viral respiratory diseases are the most common pathology. Their contribution to the infectious morbidity of the Voronezh region is 85%, of which 12-16% is caused by influenza. Due to biological features, new, previously unknown flu viruses appear. Due to the fact that the flu virus is an anthoponosis, spreads easily among people, and is unfamiliar to modern generations due to its surface antigens, in 2009 the world health organization named the influenza a (H1N1) virus as a candidate for pandemic strains.
Objective: to identify the epidemic characteristics of influenza depending on the prevailing flu serotypes in different years of the study period.
Methods: the analysis of flu incidence in the Voronezh region for 2016-2018 was performed. The analysis of clinical and laboratory studies of 118 patients with a diagnosis of "Flu" (22% of them are inpatient treatment, children). In the course of the work, the clinical picture of influenza and its course were evaluated. A survey of medical University students about their attitude to influenza vaccination was completed.
Results: in 78% of cases, the diagnosis of "flu" was confirmed in the laboratory with the installation of the virus group A (H1N1 pdm 09). The most dangerous complication is pneumonia. Patients with influenza pneumonia showed a higher intensity of viral load and long-term detection of the virus in the bronchial contents. Early diagnosis and treatment provided effective therapy and prevention of complications.
The survey showed a negative attitude of students to active immunoprophylaxis against influenza. 59% of students do not consider a reliable method against flu, 77% do not consider flu vaccination mandatory, and only 19% get a flu shot every year.
Conclusion: patients with influenza pneumonia have a higher intensity of viral load and long-term detection of the virus in the bronchial contents. Laboratory diagnosis was made in 78% of cases and influenza a (H1N1) pdm9 was diagnosed. In other cases, the diagnosis is based on clinical symptoms.
The conducted survey allowed us to objectively consider the problem of negative perception of active immunization against this disease, when the high variability of the influenza a/H1N1 virus, which causes pandemics and most epidemics, is a problem for creating effective etiotropic treatments and anti-influenza vaccines. The emergence of new technologies for making vaccines, such as genetic engineering and DNA technologies, allows us to take a new look at the problem of eradicating influenza on the planet. Vaccination of not only high-risk groups, but continuous continuous vaccination should be included in all national vaccination programs. Only such a policy will help solve the problem of flu incidence.
Keywords: influenza; clinical and laboratory examinations; epidemiological features

Relevance. It has been proven that the presence of type D has a destructive effect on the quality of life, on the course of various diseases, etc. The concept of personality type D can be characterized as a combination of some human character traits - negative emotionality, anxiety, irritability. Most of these individual differences can affect physical and mental health, with the introduction into clinical practice of the concept of problematic character traits or type D personality, renewed interest in the role of personality.
Goal. Study of the prevalence of type D among students. Thus, we will highlight the special personality traits that make people more vulnerable to stressful influences. Also, we will compare types "A" and "D" in order to identify their physical characteristics and features of the world view. A survey was conducted with the participation of 65 students from two different universities.
Methods. The study involved 65 people. (8 males (12.3%), 57 females (87.7%). 19 respondents are students of the Tyumen State Medical University (29.2%), 46 respondents are students of the Tyumen Institute of Culture and College of Arts (80.7% The experiment was carried out as follows: each participant was offered a questionnaire compiled by Denollett (questionnaire DS 14).
Results. According to the results of the experiment, 21 out of 65 people (32.3%) with a high degree of probability belong to type D. Moreover, 20 people are trained in the field of culture. Thus, among the students of the medical university, only one student can be attributed to the studied personality type, while among the students of the institute of culture, this type includes 20 people (35%), of which one student and nineteen female students.
Conclusion. Psychological distress occurs in 32.3% of students. The presence of type D is associated with a high level of situational and personal anxiety and the highest values ​​on the depression scale than among students who do not belong to type D.

Relevance. The evacuation of the burned to specialized medical institutions, as well as the principles of organizing medical care, are important issues that arise during armed conflicts and emergencies. Currently, many scales have been created and are being used, with the help of which it is possible to give a more accurate assessment of the severity of injuries and the condition of the wounded, which are successfully used at the stages of medical evacuation (TS, TRISS, AIS, ISS, VHF scales, acute trauma scales, etc.) ... However, there is no generally accepted scale for the burned, thanks to which it is possible not only to assess the severity of the injury and the condition of the burned, but also to make a decision regarding their diagnosis and treatment.
Goal. Assessment of the impact of transportation time at the stage of specialized care, surgical tactics and the age of victims with severe burns on the results of treatment, as well as analysis of the possibility of creating new rating scales for burned patients to determine their condition severity.
Methods. A statistical and analytical study was carried out on 606 patients of the clinic for thermal injuries of the Military Medical Academy who were admitted in the period from 2003 to 2018. Using the Microsoft Excel software package, using descriptive statistics, important parameters were identified that can affect the severity of the condition of the affected.
Results. It was found that mortality was reduced in the group of burned patients who were operated on, delivered to the clinic within the first 3 hours after injury. The optimal tactics for treating such patients is to perform necrectomy on the 3rd day after receiving a burn. It was found that patients over 70 years old had the highest number of deaths. It was decided to create a scale of the severity of the condition for a more accurate assessment of the condition of the affected at various stages of evacuation, which will include, in addition to the main parameters: area, depth of the burn and the patient's age, additional criteria such as the time of transportation of the injured and performing surgical treatment, the duration of stay in department of intensive care and intensive care. The total sum of points calculated using this scale will be equal to the quantitative characteristic of the severity of the burned condition.
Conclusion. Such an important stage in the development of the concept of assessing the severity of the condition of patients with thermal trauma will contribute to a more efficient and accurate calculation of the probability of lethal outcome of burned patients, as well as to predict the results of treatment.

Relevance. Frequently ill children are a problem for the whole family as a whole, which depends on numerous factors: social, economic, psychological, and cultural. In preschool age, children who are often sick, through properly selected physical exercises, have a faster rate of improvement in the state of the respiratory system. In this regard, early identification of children with deviations in health is of particular importance.
Goal. The aim of our study was to study the functional state of the respiratory system of frequently ill children aged 4-6 years.
Methods. Generalization and analysis of scientific and methodological literature on the research topic;
assessment of the physical development of frequently ill children: somatometric indicators - height, body weight; physiometric indicators - vital capacity of the lungs (VC), NPV and hemodynamic indicator - heart rate and blood pressure; express assessment of the physical development and functional state of the external respiration system - determination of the Quetelet index, vital index, calculation of the respiratory-pulse coefficient, conducting the Stange test, Genche's test and Serkin's test; statistical processing of research results, the formation of conclusions and recommendations.
Results.
The study involved 12 children 4-6 years old - 6 boys and 6 girls.
The results of the study were preceded by anthropometric measurements and some hemodynamic parameters. VC was determined. The results of the study did not reveal any differences in this indicator in boys and girls, but VC, the VC value corresponding to the height, body weight, age and sex of the subject, had significant differences compared with VC and ranged from 43.7% to 63.2% ... The greatest deviation is observed in frequently ill boys and girls 6 years old.
The study of NPV and heart rate revealed a slight increase in the first indicator in boys and girls four years old. In 5- and 6-year-old children, they were within the physiological norm.
Respiratory pulse rate data indirectly indicate a low oxygen level in the body or fatigue in frequently ill boys of 4 and 6 years old.
The girls in the surveyed group had BMI slightly below normal values, which indicates a lack of weight. In boys, BMI indicators corresponded to normal values, but were within the lower limit of normal.
The value of the vital index in the surveyed frequently ill children was significantly lower than the physiological norm for this age - by 13% - 20% for boys and 16% - 40% for girls.
The indicator of Stange's test was reduced in all subjects by 53%, and Genchi's tests, also in all frequently ill preschoolers, by 38%. Serkin's test data were below normal and were obtained only in two 6-year-old girls.
Functional tests by Shtange and Genchi showed that frequently ill children showed a decrease in the time of holding their breath, which indicates a decrease in the function of external respiration. Frequent respiratory diseases limit the physical activity of children and even inhibit the physical development of the child's body.
Conclusion. The functional state of the external respiratory system in frequently ill children is characterized by a decrease in VC, especially in boys and girls six years old. Respiratory pulse rate data for all subjects indirectly indicate a low oxygen level in the body or overwork. A significant decrease in the body mass index was found in girls 4-6 years old and a significant decrease in the vital index in all subjects.
The indicators of the Stange test and the Genchi test in all frequently ill preschoolers were significantly lower in all subjects. The decrease in the function of external respiration in the subjects makes it possible to recommend a course of health-improving physical education with elements of respiratory gymnastics as means of preventive medicine and effective means of increasing the physical capabilities of frequently ill children.

The relevance of this topic is due to the environmental crisis, which requires its solution in the near future [1, 2]. An attempt to participate in solving environmental problems was made by the participants of the 50th World Economic Forum (WEF), held in 2020 in Davos (Switzerland). Three thousand people from 117 countries are planned to participate. Representatives of business structures, entrepreneurs feel the measure of their social responsibility before society, therefore, they consider it necessary to invest part of the capital in improving the environment. The main topics that are touched on in the field of ecology are climatic changes, in particular global warming, natural disasters, a significant reduction in biodiversity, destruction of ecosystems, man-made and environmental damage, disasters that can lead to irreversible processes on our planet, and, consequently, even to her death.
Goal:
Study of the results of the World Economic Forum in the field of ecology and consideration of the proposed ways to solve environmental problems in relation to our country and the world community.
Methods:
As research methods were used: note-taking, abstracting, analysis. The objects of the research were environmental problems and their consideration at the World Economic Forum in Davos.
Results:
Russia has an environmentally friendly fuel - gas. New gas pipelines to China and Europe are a very important contribution of Russia to the global environmental agenda. In addition, Russia has the largest forest areas that are the lungs of our planet. However, the domestic economy has yet to prepare for the emerging climate challenges. We have to admit that the representatives of our country and other states did not make sound scientific and practical proposals regarding climate change, as well as the digital transformation of the modern economy and society.
Conclusion:
Environmental problems are widely discussed at various forums, including economic ones. Businessmen and heads of state offer different directions in solving urgent environmental problems. In our opinion, no breakthrough statements, opinions, assessments, like a year ago, were made at the anniversary WEF in 2020.

Relevance. Means of electronic warfare, which are sources of high-frequency electromagnetic waves, are subject to constant modernization, and are also dangerous objects due to significant chronic damage to employees and the population who find themselves in the coverage area.
Goal. The aim of the work was to build a tree of events of the impact of excess electromagnetic radiation on a person and calculate the probabilities of various consequences.
Methods. Data were collected on the adverse health effects of exposure to electromagnetic fields. The analysis included both data on systematic observations of personnel associated with the equipment under discussion, and descriptions of single exposure events, for example, in emergency situations. On the basis of mathematical processing of the obtained data, we built a tree of events of the adverse consequences of the action of electromagnetic radiation of ultrahigh frequencies.
Results. It was found that the most likely consequence of the excess of electromagnetic radiation is asthenovegetative syndrome (the probability of occurrence is about 12%). Asthenic syndrome occurs in about 4% of cases. The likelihood of special injuries such as internal and external burns, oncological diseases, infertility is extremely small, since they can occur only in the event of accidents and gross violations of safety measures.

Relevance: The development of new systems for the delivery of nicotine to the body by tobacco campaigns is expanding the market boundaries. So, relatively recently, INT - products from heated tobacco and ENDS - electronic nicotine delivery systems appeared. For these products, an active marketing policy is carried out, which, firstly, is aimed at a teenage audience, and secondly, carries false information about the effect on the body. This is what helps to increase the sale of products. So, for example, according to manufacturers, it is often mentioned that these devices are safe to use, and also help to quit smoking by reducing the intake of nicotine and other hazardous compounds in the body.

The purpose of this work is to study the explosiveness of electronic nicotine delivery systems and their effect on the human body.
Research methods: in the preparation of this work, a large number of scientific articles, studies were considered, as well as joint work was carried out with the departments of "propaedeutic dentistry" and "disaster medicine and life safety" VSMU named after N.N.Burdenko, in the process of which students of MBOU were interviewed LYCEUM №7 8 and 11 grades. The survey showed that more than 50% of children have tried tobacco products, or are still using it. Also, according to statistics, 70% of people trying to quit smoking using vapes and e-cigarettes return to smoking standard cigarettes, and 50% use both ENDS and cigarettes. In addition, there is no clear regulation for the composition of liquid for electronic cigarettes, as a result of which the manufacturer can add various impurities and harmful chemical compounds, and the device of such products implies the presence of a heating device, a battery, which is a reason for fire and explosion hazard. In Russia alone, in the period from 2015 to 2017, there were 2035 emergency calls due to the explosion or ignition of vapes and electronic cigarettes. There are also known cases of death and severe injuries by users.

Result: The question of the explosiveness of ENDS and the consequences of its use was studied.

Conclusion: we would like to note that it is necessary to conduct more educational work, including in schools, raising awareness about the principles of operation of electronic nicotine delivery systems, possible failures in their work, as well as about the effect of the substances used on the body.

Purpose: to involve the population in the problem of possible reintroduction of the virus and the appearance of new outbreaks of the disease.

Methods: systematic and statistical analysis of scientific literature, abstracting, note-taking, analysis of data on the epidemiological situation and the incidence of smallpox in the population of the world, analysis of official data on currently available variola virus strains.

Results: Potential leakage of variola virus samples from official research institutions in the United States and Russia. This can lead to epidemics and pandemics due to the lack of immunity against the virus in more than half of the population. Most countries in the world do not have an adequate supply of vaccines. Vaccines of a new generation are being actively developed.

Conclusions: there is a potential threat of infection with variola virus for the population in the world, therefore it is necessary to consider the issue of resuming vaccination and revaccination with smallpox vaccines of a new generation.

Relevance: Today, there are many risk factors that contribute to the formation of cancer. One of them is the ecological situation.

Purpose: To reveal the relationship of the incidence of malignant neoplasms with the environmental situation in the Tula region and work in hazardous industries.

Methods: Analysis of statistics on the occurrence of cancer and changes in the number of cases in 2012-2017 both in the Tula region as a whole and in some of its areas. An analysis of the incidence of malignant neoplasms (MNO) was carried out.

Results: In the course of the work, it was revealed that malignant neoplasms were more common in men. The main age groups of patients are from 45 to 50 years old and from 60 to 75. Cancer of the gastrointestinal tract, respiratory and endocrine systems predominated among the respondents. 47.2% of respondents are not and were not employees of a carcinogenically hazardous organization, 33.3% work in these organizations, and 19.4% were employees.

Conclusion: The incidence can be influenced by the environmental hazardous industries to increase the likelihood of cancer in the population.

Relevance. One of the most significant manifestations of post-traumatic stress syndrome in combat veterans is aggression. In addition, veterans often have depressive disorders, chronic pain, and problems with the cardiovascular system. In addition, recent studies show that such people often have family problems and difficulties in social life.
Goal. The aim of this study is to identify functional disorders associated with post-traumatic stress syndrome in combat veterans.
Methods. In this study, we conducted a survey of 16 combat veterans. In our sample, there was not a single veteran who displayed violent (criminal) behavior. None of them were convicted or involved in compulsory treatment. The questionnaire was filled out anonymously and included questions about the types of aggressive behavior that are characteristic of a person.
Results. It was found that the types of aggressive behavior among combat veterans are different. Conventionally, all types of aggressive behavior can be divided into two groups: autoaggressive behavior (aggression directed at oneself) and heteroaggressive behavior (interpersonal aggression). It was revealed that social status, education and the presence of negative events in the past, even before participation in hostilities, play an important role in the formation of a particular type of aggressive behavior.

Relevance. Noise pollution is the noise resulting from anthropogenic activity and disrupting the vital activity of not only humans but also other living creatures. In our time, due to growing urbanization, people face this problem every day, which has an adverse impact on the physiological systems of the body and leads to the development of many diseases.
Goal. To study the problems of noise pollution from motor vehicles and the impact of noise on the human body in the city of Voronezh.
Methods. Study of the data of measurements of noise levels (maximum Lamax. And equivalent LAeq), which were carried out during day, evening and night time, the morbidity data for the city of Voronezh "Center for Hygiene and Epidemiology in the Voronezh region». Carrying out statistical analysis of data, calculating the correlation coefficient, making charts and tables. Creation of a noise pollution map.
Results. A decrease in noise levels exceeding hygienic standards was detected in the dynamics of noise pollution. Decrease in morbidity rate by diseases of systems influenced by noise was revealed. Calculation of correlation coefficient established a direct correlation between the rate of morbidity of diseases of cardiovascular system, hearing organs, mental and nervous disorders and noise level. According to the monitoring data, the streets with the highest noise level were identified. With the help of Scribblemaps program a noise pollution map was created.
Conclusion. We observe a decrease in the level of traffic noise in the city of Voronezh from 2015 to 2017 and against this background, a decrease in the rate of incidence of mental disorders, diseases of the ear and spine, cardiovascular system and nervous system. There are still high levels of traffic noise, exceeding the hygienic standards in many streets of Voronezh.

Relevance. The widespread use of electronic devices leads to an increase in the electromagnetic load on the body and can cause changes in the state of health, which is especially important in childhood and adolescence. The child is exposed to additional EMF radiation due to Wi-Fi, as well as tablets, smart boards and other wireless devices. The effects of EMF on the brain of a child from a mobile phone are especially dangerous.
Goal. To assess the impact of electronic devices on the health status of medical students.
Methods. The main studied contingent were students of the Voronezh Medical University (100 people). The studies were carried out simultaneously. The created questionnaire included questions related to the goals and frequency of use of electronic devices, the impact on health. A personal dosimeter "Mera" was used to control the load from the electromagnetic radiation received by the body. The processing and analysis of the obtained material was carried out using standard Microsoft Excel 2007 software packages.
Results. As a result of the study, it was revealed that 100% of the surveyed respondents use electronic devices on a daily basis. 83% of students cannot be more than 3 hours a day without gadgets; students are insufficiently informed about the operation of devices emitting an electromagnetic field (EMF). After analyzing the screen time on the phone for one day and 7 days (week), it was determined that the average value for the time of use per day was 6 hours; in just a week - 44 hours 57 minutes. After using gadgets 42% of students reported headaches and 65% - drowsiness and fatigue. Unreasonable anxiety was observed in 15% of respondents, 9% of students experienced apathy after using gadgets, 24% - a state of sudden aggressiveness, 35% - noted their irritability. A significant positive association (r = 0.79) was found between the use of electronic devices and decreased vision.
The subjects received the highest EMP power at cellular stations, WiFi access points, while the level did not exceed 200-300 nW per cm2, this is less than one μW.
Conclusion. The overuse of modern electronic devices by students significantly alters their quality of life and social well-being. The resulting changes are most often negative in nature and negatively affect the state of the body. Taking into account the identified features of using various electronic devices and assessing their impact on health, it is necessary to search for the most effective forms of organizing healthy lifestyle attitudes among young people, aimed at forming a culture of using electronic devices.

Relevance. Respiratory tract diseases are very common diseases, therefore, early diagnosis of lung diseases is relevant. Breathing is the main life process that is interconnected with all systems and organs of the human body. The conditions of educational activity, social status, lifestyle of students distinguish them from all other strata of the population. Strengthening the educational process and insufficient physical activity negatively affect the functional capabilities of the body of students.
The aim of the research is to study the parameters of the students' external respiration system using a computer spirometer Spiro-Spectrum.
Methods. Using a computer spirometer "Spiro-Spectrum" (LLC "Neurosoft", Russian Federation, Ivanovo), the parameters of external respiration were determined in 40 volunteer students of the Faculty of Medicine and Biology of Voronezh State University (25 girls and 15 boys).
Results. It was found that the indicators of VC, FVC, FEV1 of the examined students corresponded to the age norm, and the indicators of PIC and MVL were below the norm.
Conclusion. Assessment of indicators of the respiratory system of student youth testifies to the wide variability of individual parameters of external respiration of students. The MVL index according to our research is below the norm, which may reflect a decrease in the limiting capabilities of the external respiration system of the examined students.

Relevance: the quality and safety of food products is one of the fundamental factors of the body's health. In addition to standard food products, manufacturers in retail chains sell functional products, the systematic use of which has a positive effect on human health.
Purpose: to study the attitude of medical University students to the features of functional nutrition as an element of health saving and disease prevention.
Methods: General scientific, sociological using questionnaires, analytical. The work was carried out with 60 students of the Voronezh state medical University of the following faculties: medical-preventive, pediatric and curative.
Results: Functional products fully meet the quality and safety requirements according to N29-FZ, TR CU 021/2011, TR CU 023/2011, TR CU 029/2012, GOST R 52349-2005, etc.and are specially enriched with trace elements and specialized substances "classic" food products.
Only 16.7% of respondents follow the principles of healthy nutrition among the studied students, which forms the agenda for more active promotion of a healthy lifestyle. When studying the attitude of students to functional nutrition, it was found that many medical students do not know about functional foods and their health benefits, but a fifth of the respondents who do not use functional foods are ready to add them to the diet when they receive proven evidence of the impact on health of functional foods.
Conclusion: Most medical students do not adhere to the principles of healthy nutrition. Every third student violates the" regime " of nutrition. Less than half of the respondents have an idea of functional nutrition, and only a quarter of respondents add these foods to their diet. There is a need to cooperate with the media in promoting healthy nutrition, including the use of functional products.

Relevance. There is a growing concern among health workers about smoking among adolescents. Despite the legal ban on the sale of tobacco products to minors, the addiction continues to spread among children, even of primary school age. The motives leading to smoking are varied, one of them is the desire to reduce body weight or maintain it at the required optimal level.
Goal. This study examined the relationship between tobacco smoking habits in adolescents and young people, both boys and girls, from nine to nineteen years old and the expectation that smoking helps to reduce body weight or maintain it at a constant desired level.
Methods. The survey was conducted on the Internet. Young people were asked to answer a series of questions about smoking. After that, the results of the survey were analyzed using the methods of mathematical statistics.
Results. The study showed that among female smokers over the age of twelve, a larger percentage of respondents said they agreed with the thesis that smoking helps to control body weight and stay lean. This pattern is less obvious among non-smoking girls and boys, as well as among smoking boys.

Relevance: The demographic situation reflects the main trends taking place in the social and economic sphere and can serve as an indicator of the development of the country as a whole, as well as of individual regions. Voronezh Region is a constituent entity of the Russian Federation that occupies the European part of the country. This region has favorable conditions for people living: a temperate climate, the development of industry and agriculture, the provision of social facilities.

Purpose: The purpose of this study was to study the demographic structure of the population of the Voronezh region.

Methods: To achieve this goal, an analysis of literary sources was carried out, statistical processing was carried out

Results: When analyzing the data for 2011-2019, it was revealed that in the Voronezh region there is a decrease in the birth rate, while the birth rate in the region remains below the average values ​​for the Russian Federation. The demographic situation is worsening, as there are processes caused by the excess of the death rate over the birth rate. In the region, the prevalence of the female population over the male is traced, moreover, more male children are born than female ones. There is a trend towards an increase in the proportion of the population of retirement age. The number of the urban population, as well as the migration activity, is increasing.

Conclusion: Appealing to the results of our study, we can conclude that there is a natural population decline in the Voronezh region.

Purpose
The purpose of the work was to study the prevalence of senile asthenia, cognitive dysfunction and the risk of falls in patients with a geriatric profile on outpatient admission.
Methods
- questionnaire
- KBTFF tests for equilibrium, walking speed and chair lifting test
- statistical analysis of all obtained data.
Results
In the analysis of the obtained data, it was determined that most of the patients who took part in the study needed a geriatrician consultation to develop an individual prevention program, namely, changing the mode of physical activity, the need for cognitive training and, possibly, the correction of drug therapy.
Conclusions
Based on the results of a brief battery of physical activity tests, senile asthenia was detected in more than half of the examined. Preasthenia - in a quarter. These patients need a geriatric consultation. In assessing cognitive impairment, it was determined that with a cut-off point of 4 points, according to the mini-KOG test, more than 75% of patients need in-depth counseling. It is necessary to provide patients with access to information about the risks of the formation of geriatric syndromes and their prevention measures.

Актуальность. Метод перкуссии почек по Ф.И. Пастернацкому был открыт в 1907г. Данная работа приурочена к 175-летию с момента рождения великого ученого.

Цель. Рассмотреть основные этапы создания метода перкуссии почек по Ф.И. Пастернацкому и осветить историю жизни ученого.

Методы. Обзор литературы, посвященной данной тематике. Консолидация полученной информации из исторических источников о жизни Ф. И. Пастернацкого и данных о методе перкуссии почек из учебников для медицинских ВУЗов.

Результаты. В результате данного исследования были подробно освещены многие интересные аспекты жизни великого русского врача, этапы создания метода, а также все стороны и нормативные критерии, которые по сей день соблюдаются при выполнении перкуссии почек по методу Ф.И. Пастернацкого.

Заключение. Профессор Ф.И. Пастернацкий внес неоценимый вклад в развитие медицины в России. Его деятельность оказала большое влияние на многие поколения врачей. Раскрывается значение сохранении памяти ученого и важности его методики по сегодняшний день.

Background. Reducing mortality from cardiovascular diseases, provided for by the national project "Zdravoohranenie", is one of the most priority tasks of domestic medicine. Myocardial infarction (MI) is one of the most common and dangerous cardiovascular diseases with a high mortality rate. One of the ways to reduce mortality in MI may be to increase patients ' adherence to treatment. Currently, there is no clear understanding of the impact of psychosocial factors on treatment adherence in these patients. Aim. Study of the influence of psychosocial, gender factors and the degree of coronary artery damage on treatment adherence in patients with myocardial infarction (MI). Methods. A comprehensive assessment of the treatment adherence of 40 inpatient MI patients (average age 60.45±1.63 years) of both sexes was performed. The number of patients' adherence to treatment was assessed using questionnaires from the KOP-25 questionnaire. Levels of anxiety and depression were determined on the HADS. The level of patients' awareness of cardiovascular diseases was assessed by means of a questionnaire. All patients underwent complete clinical examination, including coronary angiography (CTA). Results. Depending on the degree of adherence to treatment, 3 groups of patients were identified: 1st - with high, 2nd – with medium, and 3rd - with low. The 1st group included younger and more educated patients with a high level of awareness. In the 2nd group of older patients, there was a lower level of awareness, in the 3rd group, which did not differ in age from the 2nd group, the level of education and awareness was even lower. Levels of anxiety and depression increased from group 1 to group 3 without reaching the subclinical level. According to the severity of myocardial damage, there were no pronounced differences between the groups. Conclusion. In inpatients, a high degree of adherence to treatment was found only in 12.5% ​​of younger patients with a high level of education and awareness, low rates of anxiety and depression. With increasing age in the 2nd and 3rd groups, a decrease in the level of education and awareness decreases with treatment, a slight increase in the level of anxiety and depression.

Relevance. Patient adherence to treatment is a significant problem in modern medicine, requiring the study of factors influencing it.

The aim of the study was to assess the adherence to therapy of patients with essential hypertension of different age categories, depending on their use of information technologies.

Methods. In the course of the work, 109 patients with hypertension were interviewed using the Morisky-Green questionnaire. To determine the extent to which patients use modern information technologies in the treatment and diagnostic process, their own questionnaire was developed. Anxiety-depressive disorders were assessed using the HADS hospital anxiety and depression scale.

Results. The study revealed the relationship between patient adherence and indicators reflecting the level of anxiety and depression with the number of drugs taken. Results were also obtained on the degree of use information technology for patients, including the method of making patient appointments and their impact on patient adherence to treatment.

Conclusion. Patients using information resources before visiting a doctor showed greater adherence to treatment than patients who do not use or rarely use information technology. With regard to the method of making an appointment with a doctor, the greatest adherence to treatment was revealed in the group of patients who sought help from relatives. A direct correlation was also determined between the patient's age, the level of anxiety-depressive disorders and adherence to treatment.

Abstract Relevance
.
Patients with coronary heart disease (CHD) older than 60 years are characterized by the development of senile asthenia syndrome (SA), which leads to an increased risk of complications and increased mortality. Reduced renal function also plays a significant role in reducing muscle strength, balance disorders, and increasing the risk of falls.

Objective: to study the frequency of SA syndrome and renal dysfunction in inpatient patients with IHD, to assess the impact of age, gender, comorbidities, glomerular filtration rate (GFR) on the severity of these indicators.

Methods. To identify SA syndrome, patients were surveyed using three questionnaires: Fried, "Age is not a hindrance"(Pirogov Russian national research UNIVERSITY, RUDN) and the SA criteria in the Study of Osteoporotic Fractures – SOF-index. GFR was determined using the CKD-EPI formula. Patients were divided into 3 age groups: 1st-middle age, 2nd – elderly, 3rd-senile.

Results. 40 patients (men – 19, women – 21) with IHD were examined: stable stenocardia – 17 people, unstable-13 people, with primary myocardial infarction (MI)– 8 people, repeated MI-2 people. aged 50 to 86 years (average 69.8±9.3 years).Group 1 included 6 people, group 2-24 people, and group 3-10 people. SA syndrome was detected in 50% of the examined patients, preaste-NII (PA)-in 37.5%, not detected in 13.5%. in group 1, SA syndrome was diagnosed in 66.6%, in group 2 in 91.1%, and in group 3 in 100% of patients. The prevalence of SA in women was revealed. Impaired renal function - in 20% of patients without SA, in 26.6% with PA and in 65% with SA. Hypertension (GB) in group 1 was observed in 66%, in group 2-in 79.0%, in group 3-in 100% of patients. Type 2 diabetes mellitus (DM) was more common in group 2 (20.0%) and group 3 (35.0%) compared to group 1 (16.6%). Calculating GFR allowed us to determine the stages of chronic kidney disease (CKD). In patients without SA, CKD C3-C4 was detected in 20.0%, with PA-in 26.7%, with SA - in 65.0%.

Conclusion. In various forms of IHD, the presence of PA and SA worsens with age, the PRO-phenomena of IHD are more severe in them, functional disorders of the kidneys also increase due to age and an increase in the degree of SA. Correction of SA and renal function may improve the prognosis of patients with IHD.

Diabetes mellitus is a predominantly metabolic disease. Against the background of this pathology, there is a risk of developing atherosclerotic vascular damage in the lower extremities, which is a factor in disability in patients with type 2 diabetes .
Objective: to Analyze laboratory data, complaints, symptoms, and perform additional diagnostic manipulations to clarify the clinical diagnosis.
Methods: viewing medical records, collecting anamnesis, analyzing data from the initial examination and studying laboratory and instrumental research methods on the basis of the Stationary unit No. 2 at the Otrozhka station. Processing the results obtained using the Student's t-test.
Results: a blood Test showed that 18% of patients with insulin resistance have increased levels of total cholesterol and LDL, which is a factor in the appearance of vascular atherosclerosis. According to the results of the study of the USDS of the lower extremity arteries, 27 patients with insulin-dependent diabetes show the initial stages of vascular ischemia.
Conclusion: type 2 Diabetes is one of the main factors of disability in people due to complications that occur against the background of the leading pathology. This complication is an atherosclerotic lesion of the iliac arteries. According to statistics, 88% of patients with this complication undergo surgical treatment. This suggests that there are not enough diagnostic manipulations to detect such complications in a timely manner.
Key words: type 2 diabetes mellitus; complications; atherosclerotic lesion

Atrial ibrillation (AF) is a heart rhythm disorder that is most common in clinical practice. An increase in the average life expectancy of a person leads to an increase in cardiovascular diseases, including AF. It was reported that the presence of chronic heart failure (CHF) increases the risk of AF by 5 times. There are currently no well-defined markers of AF progression. Therefore, the identification of such markers in patients with CHF is reasonable and relevant.

Relevance: Glucocorticoids, being both drugs and natural hormones of the adrenal cortex, have not only the necessary pharmacological effect, but also contribute to the development of changes in the endocrine system of the body. As a result of such transformations, exogenous Itsenko-Cushing's syndrome may develop. Therefore, the task of modern medicine is the timely prediction and correction of this condition.

Objective: To analyze the prevalence of Itsenko-Cushing's drug syndrome among patients of the rheumatology department, depending on the nosological form, duration and scheme of taking synthetic glucocorticoids.

Methods: Hypothetical-deductive method, comparison, probability-statistical methods, generalization.

Results: In total, the rheumatology department received treatment: in 2017 - 1468 people, in 2018 - 1433 people, in 2019 - 1389 people. Including nosologies in which glucocorticoids are used for a long time: with a diagnosis of systemic lupus erythematosus - 57, 48 and 65 people, respectively, rheumatoid arthritis - 365, 320 and 334 people, respectively, systemic vasculitis - 24, 35 and 24 people, respectively, systemic scleroderma - 61, 48 and 56 people, respectively. Itsenko-Cushing's drug syndrome was determined in 56.4% of patients receiving glucocorticoid therapy for systemic lupus erythematosus, in 34.2% with rheumatoid arthritis, in 58.1% of patients undergoing treatment for systemic vasculitis and in 57.4% with systemic scleroderma.

Conclusion: One of the important problems of modern medicine is the Itsenko-Cushing drug syndrome. The use of glucocorticosteroids for a long time or in high doses leads to the development of serious complications. This phenomenon requires comprehensive accounting, analysis and prediction of the likelihood of adverse consequences and, as a consequence, the appointment of modern therapy in order to prevent and promptly correct possible complications.

Relevance: In connection with the norms of the Ministry of Health, no more than 15 minutes are allotted for the initial admission of one patient to a district therapist, pediatrician, general practitioner, as well as narrow specialists - a neurologist, otorhinolaryngologist, gynecologist, ophthalmologist [1]. During this period of time, it is necessary to collect as much information as possible about the patient, record his complaints, collect anamnesis, and conduct an examination. One of the ways to solve this problem is to interview the patient through a questionnaire.

Objective: To find out the positive and negative aspects of using questionnaires. Determine how much time saves the questionnaire, compared to the classic survey. Identify the most qualitative and fastest way to conduct a survey when a patient is admitted to a hospital.

Methods: Statistical analysis, direct observation, empirical description, generalization.

Results: This method of interviewing is effective for the work of novice doctors or residents who may get confused in the patient's testimony or forget points that need clarification. However, despite the aforementioned plus, the questionnaire is not suitable for all patients; its use is most relevant for people aged 18-55 with a satisfactory state of health.

Conclusion: The study showed that the questionnaire is a convenient tool in the doctor's work for collecting the most complete anamnesis and complaints, but is not suitable for all patients. We also found out that the method we have chosen allows the doctor to meet the time specified by the norms of the Ministry of Health.

The urgency of the problem of enterovirus infection (EVI) is due to the ubiquity, high frequency of occurrence, clinical polymorphism of EVI and high contagiousness, which makes it possible to classify this disease as a high-risk group. The aim of the study was to study the epidemic and clinical and laboratory features of isolated and combined forms of enterovirus infection in children. A retrospective analysis of 100 case histories of children with various forms of enterovirus infection was carried out according to the data of the infectious diseases department of OGBUZ "KB No. 1" in Smolensk for 2017-2019. On the basis of clinical and laboratory data, various clinical forms of EVI (exanthema, herpangina, enteritis, myalgia, meningitis) were identified, and features of the course of combined forms of EVI and serous meningitis in children were noted. From 2017 to 2019, there was a trend in the course of EVI in the form of combined forms of this disease, which is due to their more severe course and, as a result, an increase in indications for hospitalization. Key words: enterovirus infection; herpangina; exanthema; enterovirus meningitis; children

Relevance: Adenovirus infection (AI) is characterized by pronounced catarrhal phenomena, often leading to the development of complications from the ENT organs and respiratory tract. Especially susceptible to the disease are young children, in whom AI can occur in a severe form and for a longer time [1].
Objective: to study age-related features of clinical manifestations of AI in children.
Methods: 38 children with confirmed AI were monitored, selected by random sampling and were hospitalized in the CSTO No. 2 medical center IN 2019. To study the clinical features of AI, patients were divided into two groups depending on their age. The first group – children from 1 month to 3 years (20 people), the second group – children older than 3 years (18 people). Inclusion criteria: positive results of PCR of nasopharyngeal smears on adenovirus DNA in the absence of ARVI markers of other etiology (respiratory screen).
Results: AI occurs mainly in a moderate form-89.5% of children, severe was registered only in 10.5%. Severe feverish intoxication syndrome was significantly more often detected in children over 3 years of age (33%) compared to children under 3 years of age (15%). The leading clinical symptom of AI is rhinopharyngitis, which is equally common in the compared groups (95% and 100%, respectively), but with a significantly longer course in young children (6.8±0.4 and 3.0±0.8 days, respectively). Rhinopharyngoconjunctival fever (RFC), as the most typical form of AI, occurred in the group of children under 3 years of age only in 1 child (5%), while in the group of children over 3 years of age, this form was detected in almost every third patient (27.8%, p<0.05). Lymphadenopathy with an increase in mainly submandibular and cervical lymph nodes was observed in more than half (76.7%) of patients over 3 years of age and in 25% under 3 years of age (p<0.05). In most of the hospitalized patients, AI proceeded with the development of complications. In young children, obstructive bronchitis prevailed in the structure of complications-31.6%, less often stenosing laryngotracheitis of the 1st degree (25%) and catarrhal otitis (5.2%). Bacterial complications were more often registered in children over 3 years of age: purulent tonsillitis in 25% and urinary tract infection in 5%.
Conclusion: In young children with AI, catarrhal syndrome prevailed with damage to both the upper and lower respiratory tracts and the development of grade 1 respiratory failure, while in older children, lymphoproliferative and feverish intoxication syndromes were more pronounced.

Relevance. Despite the success of modern medicine, acute intestinal infections (ACI) remain a common pathology in the practice of doctors of various specialties. These diseases are found everywhere, are caused by a variety of pathogens, some of them are highly contagious and are not always easily controlled, which is why their timely diagnosis is so important. Molecular biological methods such as polymerase chain reaction (PCR) are considered promising methods for early detection of intestinal pathogens. The use of this technique in many regions of Russia has expanded the range of detected pathogens of AKI, including viral diarrhea (VD). To date, the pathogenicity of many virus families has been confirmed for humans: rotaviruses of groups A, B, C, noroviruses, astroviruses of serotypes 1-8, adenoviruses of types 40, 41, enteroviruses, etc.
Goal. To study the structure and clinical and epidemiological features of viral diarrhea in adult patients for timely diagnosis and use of adequate therapy.
Methods. A retrospective analysis of 245 case histories of patients of the 2nd infectious (intestinal) Department of the Voronezh regional clinical hospital (VOKIB) who were treated in 2018 was performed.inclusion Criteria: the presence of a clinical picture of acute intestinal infection and laboratory confirmation of the viral nature of the disease. In addition to traditional bacteriological and serological methods, PCR was used to determine the etiology of the disease.
Results. During the analysis of medical histories, it was revealed that viral diarrhea accounted for 45.5% of patients with laboratory-verified AKI. The etiological structure of VD was dominated by noroviruses (45.7 %) and rotaviruses (44.9%), adenoviruses made up 5.7 %, astroviruses – 3.7% of patients. The group nature of the disease and mixed infections occurred in a small part of patients (17.9% and 10.2%, respectively). VD in adults did not have a certain seasonality and was recorded year – round: rotavirus infection is more common in spring and summer, norovirus infection-in autumn and winter. The topological diagnosis in the vast majority of patients was gastroenteritis (84.9%), which led to exicosis in 53.1% of cases, and fever was absent in 65.7% of patients. Respiratory syndrome were detected in adults is quite rare (15.6 per cent). The clinical course of the disease had a mostly favorable outcome regardless of age and premorbid background. There were no significant, diagnostically significant changes in General clinical analyses. Most of the patients received antibiotic therapy (86.5%) prescribed in the emergency Department.
Conclusion. The introduction of molecular genetic methods (PCR) into the complex of examination of patients with AKI allowed us to significantly expand our understanding of the frequency of VD in adults and optimize a differentiated approach to the appointment of adequate therapy.

Relevance: Purulent meningitis in children is currently the most severe pathology among acute infectious diseases. Despite advances in Pediatrics, the mortality rate remains at a very high level, which can only be reduced by optimizing diagnosis and treatment.
Objective: to study laboratory features of purulent meningitis in children.
Methods: 19 children aged 15 days to 17 years, selected by random sampling, were hospitalized in BUZ VO "obkb No. 2" under observation. Inclusion criteria: the presence of clinical manifestations of meningitis and laboratory data of cerebrospinal fluid confirming purulent meningitis. The main outcome of the study is the analysis of laboratory features of purulent meningitis in children. Information from patients ' medical records was used to determine the study outcomes.
Results: neutrophilic pleocytosis 1369±28.01×106/l was detected in all children, the protein level increased to 1.6±0.32 g/l. in 42.1% of patients, a decrease in glucose level was registered. In 73.7% of patients, the level of lactate in the cerebrospinal fluid (CPF) increased to 5.39±1.17 mmol/l and in 79% of children - LDH to 84.9±17.04 U/l. Changes in the hemogram were represented by leukocytosis of 16.17±17.04×109/l of neutrophilic nature, an increase in ESR of 36.5±4.39 mm / h. In 100% of cases, at the height of the disease, there was an increased CRP of 194±35 and PKT≥2 - ≥10. The blood lactate level was elevated in 78.9% and amounted to 4.88±0.5 mmol/l, the serum LDH level-in 52.6% to 617.75±26.6 U/l.
Conclusion: All children with purulent meningitis had an inflammatory nature of the peripheral blood and an increase in CRP and PCT. The level of decrease in CSF glucose correlated with the height of pleocytosis, reflecting the severity of the bacterial process. In most cases, high LDH and liquor lactate were recorded, which characterize the severity of CNS damage.

Relevance: The body state of adolescents in correctional facilities differs significantly from national indicators. The main reasons for the health violation of convicts are insufficient knowledge of sanitation and hygiene, pre-social lifestyle and low general cultural level. According to a number of sources, the indicator of significant diseases in this category of convicts increased: hepatitis B and C, tuberculosis, HIV, sexually transmitted infections (STIs) and others. Outbreaks of infections occur mainly in conditions of unsanitary conditions and overcrowding of the prison population, therefore, persons in prison are a high-risk group.

Work objective: the analysis of the prevalence of infectious diseases among adolescents in a closed penitentiary institution.

Methods: studies were conducted at the Federal State Healthcare Institution "Medical and Sanitary Unit No. 61 of the Federal Penitentiary Service of Russia". The study group included 76 adolescents aged 14 to 19 years. The median age was 17.7 years. Urban residents – 44 people (57.9%), rural residents – 25 (32.9%), homeless – 7 (9.2%).

Results: the structure of chronic infectious diseases in adolescents of the study group was distributed as follows: 1 (1.3%) – lymphadenopathy, 1 (1.3%) - frequent tonsillitis, 1 (1.3%) – chronic bronchitis (against the background of smoking), 1 (1.3%) – HIV-infected. Over the past year, there have been no outbreaks of acute respiratory viral, acute intestinal and other outbreaks within the institution.

Discussion: Chronic infectious diseases in adolescents in the study group were found in only 4 cases (5.3%). Over the past year, there have been no outbreaks of acute respiratory viral infections, acute respiratory infections and other outbreaks within the institution, which indicates the early detection of isolated cases of acute infectious diseases, the timely isolation of sick people and properly organized anti-epidemic measures.

Conclusion: The hypothesis that the long stay of adolescents in a closed-type institution creates favorable conditions for the spread of dangerous infections (HIV infection, tuberculosis, hepatitis B, C, etc.) was not confirmed in our study, which indicates a relatively favorable medical prognosis for juvenile convicts who were in a penitentiary after the end of the established period compared to adult criminals. The absence of outbreaks of acute infectious diseases in a closed institution and in conditions of increased crowding indicates the well-organized work of medical personnel, timely isolation and adequate anti-epidemic measures carried out in this institution.

Relevance. Morbidity indicators, today, are leading in characterizing the health of the population. The deterioration of the health of the younger generation, in particular of students, contributes to a significant reduction in life expectancy, and also entails economic losses [3].
The goal is to analyze the statistical data on vaccination / revaccination rates of the student population for the period 2015 - 2019. on the example of a student polyclinic (BUZ VO VGKP No. 1) in Voronezh.
Materials and methods. A statistical analysis of the official reporting data of VGKP No. 1 was carried out, relative indicators were calculated, the following values ​​were calculated: t - Student's test. Differences in values ​​were considered significant at p <0.05.
Research results. By 2019, there is a downward trend in vaccination and revaccination rates against many infectious diseases (influenza, revaccination against measles, rubella). A study and analysis of the outpatient records of patients of the AHEC # 1 was carried out for vaccination, revaccination of students for 2018 - 2019. During the study, 300 outpatient patient records were studied (150 - for the period of 2018, 150 - for the period of 2019, respectively). Statistical data were processed using the Student's t-test with the calculation of the mean, standard deviation, differences were considered significant at p≤0.05. It was noted that 32% of students refuse vaccination in favor of using other drugs for preventive purposes, and 26% of students do not know about the need for revaccination against many diseases in accordance with the national calendar of preventive vaccinations. It was also revealed that
Conclusions. During the study period (2015 - 2019), it is worth noting that the rates of vaccination and revaccination of students decreased (in most cases due to medical indications and mistrust of vaccination as a specific method of preventing infectious diseases).

Actuality: In recent years there has been a tendency to increase gerpeticescoy infection. In Russia, about 20 million people suffer from various forms of herpetic infection [1].
Purpose: the Purpose of our study was to study the features of the course of infectious mononucleosis in patients depending on their age.
Methods: the Study was conducted on the basis of BUZ VOKIB Voronezh in 94 patients with infectious mononucleosis who were treated in the period from 2015 to 2019. The clinical and laboratory examination included a clinical examination, routine studies of peripheral blood, and biochemical parameters. The diagnosis was confirmed by ELISA and PCR.
Results: the study showed that the course of infectious mononucleosis varies depending on the age of the patient. So in older patients, after a decrease in temperature, the subfibrile temperature persists, the size of the tonsils and lymph nodes normalizes more slowly, and hepatomegaly persists for a long time. The initial level of white blood cells varies from lymphopenia to leukocytosis, in contrast to younger patients. Initially overestimated levels of Alat and thymol samples are preserved for a longer period of time.
Conclusion: the Data obtained suggest that full recovery after infectious mononucleosis depends on the patient's age. Younger patients experience more complete clinical and laboratory remission. This requires mandatory follow-up of older patients on an outpatient basis in order to reduce the patient's risk of developing chronic mononucleosis.

Relevance: changes in the current socio-cultural norms, in particular the characteristics of sexual behavior, are reflected in the epidemiology of sexually transmitted infections (STIs). The significant role of behavioral factors in the spread of STIs indicates the importance of improving the formation of precautionary behavior.

Purpose: to assess the level of awareness of first and fourth year medical students on prevention and risky sexual behavior in relation to sexually transmitted infections.

Methods: an anonymous survey was conducted 200 students of the Voronezh State Medical University named after N.N.Burdenko (VSMU named after N.N.Burdenko), studying at the 1st and 4th courses. The test consisted of 27 questions, affecting the nature of the sexual behavior of each respondent and awareness of sexually transmitted diseases.

Results: 1st year students are less informed about STIs and correct sexual behavior than 4th year students.

Conclusion: promotion of a healthy lifestyle. life at the pre-university (school) level and educational work on STI issues among junior students of the university are important factors in the formation of correct sexual behavior.

Relevance: Responding to sexually transmitted diseases (hereinafter STIs / STDs) should be a global priority. STIs negatively affect the quality of life, sexual and reproductive health of people, as well as the health of children and newborns. These infections indirectly contribute to the sexual transmission of HIV infection and lead to changes at the cellular level that lead to the development of some types of cancer.

Objective: To identify the level of awareness of students of medical and non-medical universities on the issue of sexually transmitted diseases, as well as to develop and provide the population with recommendation materials on this group of diseases.

Methods: Statistical analysis, full induction, generalization.

Results: Briefly describing the main outcome, it can be argued that the majority of the surveyed students have a general idea of ​​what sexually transmitted diseases are and how to avoid them. However, some aspects of this issue, affecting specific information on the diseases themselves, as well as the principles of sexual hygiene are not so embedded in the minds of the masses, which can negatively affect the health of the population. Also, with a sufficient degree of reliability, it was revealed that students of medical schools are better versed in the issues of this topic.

Conclusion: Summing up the results of the work, we can conclude that the awareness of students about STDs is at an average level or even lower, and, of course, it needs to be increased.

Every year in the Voronezh region, more than 6 thousand people apply for bites from wild or domestic animals. At the same time, rabies is regularly detected in 22-25 species of wild and domestic animals in our area. The aim of the work was to study the clinical and epidemiological features of human rabies according to the medical histories and protocols of pathoanatomic studies of the corpses of all 4 patients with rabies over the past 14 years, as well as to analyze the reasons for the failure of post-exposure prevention of rabies in patients. The rabies clinic had typical symptoms in all patients. Rabies disease in all four patients can be explained by a combination of several factors: dangerous localization of bites in all patients, complete lack of anti-rabies care in half of patients, late treatment for anti-rabies care in 1 patient (25%), antisocial lifestyle combined with alcoholism in 25% of patients. Timely access to anti-rabies care and strict adherence to the rules and vaccination regimen, in our opinion, would prevent the death of these patients, even with dangerous localizations of bites, which were observed in 3 out of 4 of our patients.

Objective: to compare the pharmacological and clinical efficacy, the feasibility of using various therapies, including fixed and non-fixed combinations of diuretics, ACE inhibitors and ARA II, in relation to hypertension combined with MS. Methods: 136 women with first or second degree arterial hypertension were selected for implementation. A set of examinations was carried out at all stages of the study, including a biochemical blood test and an ECG. Results: During the analysis of the effect of therapy, it turned out that the use of a combination of eprosartan and indapamide was comparatively better than the combination of eprosartan and hydrochlorothiazide, perindopril and indapamide in reducing the blood pressure level in women with arterial hypertension of I and II degrees and metabolic syndrome in both age groups. When using a non-fixed combination of drugs, the percentage of patients who reached cut-off BP values ​​was quite high. Conclusions: the clinical effects of some drugs are more pronounced in reducing SBP, while the effects of others - in reducing DBP. However, at the same time, it cannot be denied that the non-fixed therapy is superior to the fixed one in a specific group of subjects - women 40-49 years old.

Relevance: Antibiotic resistance takes a significant place in infection
urinary tract, in particular with exacerbation of urolithiasis, therefore
it is necessary to study the structure of causative agents of urinary tract infections,
features of the appointment of antibacterial drugs and their rationality
use.
Objective: to assess the feasibility of prescribing antibacterial drugs in patients with
exacerbation of urolithiasis.
Methods: retrospective analysis of case histories of patients admitted to
urology department BUZ VO "VGKBSMP No. 10" with a diagnosis of urolithiasis for
2019 year.
Results: an analysis of 150 case histories of patients who were admitted in 2019 was carried out
in BUZ VO "VGKBSMP No. 10" with a diagnosis of urolithiasis and had positive
the results of bacteriological culture of urine. Species structure of urinary tract infection
pathways are represented by E. Coli - 37%, Klebsiella pneumonia - 17%, Enterococcus faecalis - 16%,
Enterococcus spp. - 12%, S. saprophyticus - 6%, Pseudomonas aeruginosa - 4%, Proteus mirabilis -
4%, Enterobacter 2% and S.epidermidis 2%.
For the isolated strains of E. coli, there is a high level of resistance against
ampicillin and ciprofloxacin - 61% each, respectively, while maintaining sensitivity
to amikacin - 87%, gentamicin - 75%, nitrofurantoin - 86%, cefepime - 61% and
meropenem - 100%.
Klebsiella pneumonia is characterized by resistance to ampicillin - 100%, ciprofloxacin
- 78%, nitrofurantoin - 93% and ceftazidime - 64%. Highest level
sensitivity of Klebsiella pneumonia is typical for meropenem - 86%.
The isolated strains of Enterococcus faecalis had resistance to ciprofloxacin - 77%,
levofloxacin - 75% gentamicin - 75%. This pathogen retained sensitivity
to nitrofurantoin - 88%.
As antibiotic therapy, most patients with exacerbations
kidney stones received ceftriaxone - 86%, in a limited amount
ciprofloxacin - 9%. When assessing the indicators of a general blood test and a general urine test, it was noted that
29% of patients admitted to the urology department had no signs
inflammatory reaction, since they had leukocyte counts within normal limits. Of these
of patients 81% received antibacterial treatment, which does not correspond to clinical
recommendations for antimicrobial therapy for urinary tract infections.
Conclusion: For the rational appointment of antibacterial drugs, it is necessary to take into account
the structure of pathogens, the level of resistance to antimicrobial drugs and indicators
inflammatory reaction in patients with exacerbation of urolithiasis.

Annotation:
Relevance: the problem of sepsis is global in nature. Even with early diagnosis and timely treatment, mortality reaches 6 million people. In this regard, the search for new methods of therapy, easy and cheap to manufacture, can change the statistics towards reducing the incidence of severe sepsis and mortality from it.
Objective: to study the effect of intravenous administration of ionized fluids with different oxidation-reduction potential (ORP) on morphological changes in kidney and liver tissue in staphylococcal sepsis.
Methods: an experiment in which rabbits with staphylococcal sepsis were injected with ionized fluids with different ORP. Subsequently, using microscopy of the liver and kidneys of animals, the effect of these fluids on the course of the pathological process in the tissues and, as a consequence, on the morphological changes in organs was studied.
Results: as a result of the experiment, it was proved that a liquid with a positive ORP has a favorable (antimicrobial and anti-inflammatory) effect.
Conclusion: ionized liquid with a positive potential can be used in the complex therapy of sepsis.

Relevance: The pathology of the cardiovascular system has remained an urgent problem for many years, due to which the quality of life of patients and its duration decreases. Undoubtedly, atherosclerosis is one of its components. The inflammatory theory of atherogenesis is gaining more and more popularity in the modern world.
Purpose: In our study, we tracked the relationship between lowering cholesterol and LDL cholesterol levels while taking statins under conditions of an inflammatory response.
Methods: The study involved 70 people with coronary artery disease, some of whom at the time of the study also suffered from acute respiratory viral infection. Results: After a fourteen-week course of taking rosuvastatin at a dosage of 10 mg / day in patients with coronary heart disease with acute respiratory viral infection with isolated hyperlipidemia, there was a significant decrease in cholesterol levels (-10.3%) in men and (-9.3%) in individuals female, while with combined hyperlipidemia by 8.1% and 7.8%, respectively. The decrease in cholesterol and low density lipoproteins was (–33%) and (–38%) in women with isolated and combined hyperlipidemia, and in men (–27%) and (–39%), respectively.
Conclusion: Our study demonstrates the hypolydemic effect of the therapy under ARVI conditions.

Currently, there is a trend towards a constant increase in the prevalence of infectious diseases. One of the main places in the structure of infectious morbidity and mortality is occupied by pneumonia. Reducing the mortality rate from this disease is one of the urgent problems of Pediatrics. Along with the correct choice of antibacterial therapy, much attention is paid to the timely and reasonable administration of bronchodilators and other symptomatic medications in the treatment of children with pneumonia.
Goal. Evaluation of the rationality of prescribing bronchodilators and corticosteroids in the treatment of acute community-acquired pneumonia of moderate severity in children.
Material and methods. A retrospective analysis of 100 case histories of patients aged 1 to 17 years who were treated at the Regional children's clinical hospital No. 2 in 2019 with a diagnosis of acute community-acquired pneumonia of moderate severity was performed. We took into account patient examination data, results of additional examination methods, drug therapy, treatment effectiveness, and duration of hospitalization.
Results: the Majority of children (83%) were under the age of 14 years, in this age group, obstructive syndrome occurred in 3 children (3.6%). Among patients older than 14 years, the incidence of bronchial obstruction was significantly higher and amounted to 76.5% (13 children), p<0.05. Among all patients with bronchial-obstructive syndrome was dominated by the boys – 13 children (81.3 per cent). Treatment of bronchoobstructive syndrome included the administration of bronchodilators (ipratropia bromide/fenoterol) to 11 patients (68.8%), inhaled glucocorticosteroids – 5 children, including one child receiving combined therapy with these drugs. Children without bronchial obstruction syndrome in 73% (62 children) received therapy with bronchodilators (ipratropia bromide/fenoterol), in 5% budesonide (4 children), 10 patients were prescribed combination therapy with these drugs. Treatment of 15 children included the use of systemic glucocorticosteroids (dexamethasone) and bronchodilators (aminophylline). The duration of hospitalization of patients with the presence and absence of bronchoobstructive syndrome did not differ, and the average duration was 12 days.
Conclusion. The clinical picture of acute community-acquired pneumonia of moderate severity included the development of bronchial obstruction syndrome in only 16% of patients. However, 91% of children received therapy with the inclusion of bronchodilators (ipratropia bromide / fenoterol) and inhaled glucocorticoids (budesonide), which does not fully comply with clinical recommendations.

Relevance: Currently, most countries have implemented regulatory requirements for drug monitoring using global standards. The system for monitoring the movement of drugs (MD) for medical use is the basis for ensuring the identification of pharmaceuticals worldwide and creates a global and secure structure for a complete traceability system at all levels of packaging [1]. Globally harmonized drug tracking systems play a key role in the fight against counterfeiting. More and more regulators are demanding the use of unique identifiers that must be encoded into the secondary packaging media and linked to the corresponding information in the database. Regulators are increasingly recommending or requiring the use of global standards to implement these traceability requirements. Adopting requirements for a harmonized approach across countries using global standards enables these regulators to effectively address counterfeit drug issues and ensure cross-border traceability. In accordance with the current situation, the Ministry of Health of the Russian Federation made a decision to implement data monitoring for drug circulation, using drug labeling with Data Matrix barcodes [2].
Purpose: The purpose of our study is to consider the problems at the stage of introducing the drug labeling system in the retail network of pharmacy organizations (JSC).
Methods: This study was conducted by interviewing pharmaceutical workers actively interacting with the drug monitoring system.
Results: The results of a survey of pharmaceutical workers in Voronezh of various forms of ownership clearly show that today, in 26.99% of cases, employees are not familiar with the regulatory documents of the introduced project, in 46.6% of JSCs there is no technical support, 74.6% of respondents had difficulties in working with the innovation, of which 41.26% find it difficult to answer what ways of solving this problem they see.
Conclusion: In the course of our research, we identified shortcomings of the introduced program "Marking" at the stages of training specialists, software and hardware.

Relevance: Poisoning with nasal decongestants occupies a leading place among drug poisoning in children, therefore it is important to study the structure, clinical features of drug poisoning with the subsequent development of prevention methods.
Purpose: to study the structure and clinical features of nasal decongestant poisoning in children of the Voronezh region.
Methods: retrospective analysis of case histories of children admitted to the hospital with drug poisoning in the period 2016-2018.
Results: 127 case histories of patients were analyzed, of which 73 people (57.5%) were admitted with drug poisoning. Poisoning with nasal decongestants was observed in 15 children (20.5%), mainly at the age of 1 to 3 years (86.7%). The main drug that caused the poisoning was naphazoline in 13 patients (86.7%). Intranasal route of drug intake was observed in 5 people (33.3%), oral - in 10 people (66.6%). Moderate poisoning was observed in 7 children (46.6%), severe poisoning also in 7 patients (46.6%), extremely severe poisoning in 1 child (6.6%). The oral route of administration of the drug led to a more severe course of poisoning in children (p <0.05) with the development of severe bradycardia in 9 cases (60%). Therapeutic measures included gastric lavage, infusion therapy; 1 child (6.7%) needed atropine. All children were discharged with recovery.
Conclusion: analysis of the structure of poisoning in children is necessary in order to develop preventive measures to reduce their number and prevent poisoning.

One of the main methods for studying molecular evolution is multiple alignment of protein and nucleic acid sequences with subsequent construction of a philodendrogram. Such an in silico analysis reflects the qualitative changes in biopolymers, their dynamics and evolutionary patterns; in a number of cases, it seems possible to identify a common ancestor. At the same time, the evolutionary process is characterized by the conservatism of structures that are critical for the implementation of key biological acts. However, the issues of conservatism of biological macromolecules are complex and controversial. One of the main difficulties associated with this category is which of the considered structures should be considered conservative, and how much its monomeric composition should maintain molecular authenticity during evolution. According to one of the opinions, a protein molecule that is 29% similar to its ortholog can be considered conservative. From this point of view, of particular interest is how conservative are the abstractly taken proteins of the human proteome and their orthologues in a much more ancient organism. One suitable candidate for such a phylogenetic analysis is the unique ancient fish Latimeria chalumnae. Goal. Comparative analysis of evolutionary conservatism of amino acid sequences of polypeptide chains of some proteome structures of humans and living fossil fish Latimeria chalumnae. Methods. All peer-reviewed amino acid sequences of coelacanth proteome proteins (n ​​= 18) and their human orthologs were taken from the UniProt database, including proteins involved in the functioning of the redox chain, carriers of reducing equivalents; α and β-chains of hemoglobin; components of ATP synthase and others. Each sequence and its ortholog were aligned in pairs using the EMBOSS Needle software. Results. Subunit 1 of cytochrome C oxidase - 85.2%, subunit 3 of cytochrome C oxidase - 80.1%, triose phosphate isomerase - 71.4%, cytochrome b - 70.7%, chain 1 NADH-ubiquinone oxidoreductase - 65.3% subunit 2 cytochrome C oxidase - 64.5%, chain 4 of NADH-ubiquinone oxidoreductase - 62.7%, glycohydrolase of ADP-ribose - 60.9%, chain 5 of NADH-ubiquinone oxidoreductase - 58.7%, parvalbumin alpha - 56.8% , chain 3 NADH-ubiquinone oxidoreductase - 56%, subunit A of ATP synthase - 52.8%, α-hemoglobin chain - 50.3%, β-chain of hemoglobin - 47.6%, 4L chain of NADH-ubiquinone oxidoreductase - 46 , 9%, chain 2 of NADH-ubiquinone oxidoreductase - 46%, chain 6 of NADH-ubiquinone oxidoreductase - 35.9% and protein 8 of ATP synthase - 24.7%. Conclusion. The analyzed sequences were 18 proteins of the human proteome and their orthologues from living fossil fish Latimeria chalumnae. It was found that the most conservative structure of those considered is the subunit 1 of cytochrome C oxidase, while the least homology is characteristic of protein 8 of ATP synthase.

Relevance. Currently, there are many different approaches to the study of changes and restructuring of the human body during embryonic development. One such approach was proposed by the Russian biologist Alexey Severtsov, calling it “the theory of phylembryogeneses”. This theory is considered one of the most advanced in this matter, which is based on the knowledge gained about human development in the embryonic period.

Goal. To consider the theory of phylembryogeneses by A. N. Severtsov on the example of the development of the human cardiovascular system in the embryonic period, and also to trace the relationship with the development of structures and the occurrence of pathologies of this system, classifying them using the theory of the russian biologist.

Methods. Research of literature on this topic. Analysis of the results obtained.

Results. Applying knowledge about the development of the cardiovascular system in human embryonic development, we were able to confirm the Severtsov's theory of phylembryogeneses, and also classified the pathologies of this system of the human body by the time of their occurrence, based on the theory taken as a basis.

Conclusion. The development of the structures of the cardiovascular system of the human body is subject to the theory of phylembryogenesis, proposed by A. N. Severtsov.

Today, despite the advances in medicine in the diagnosis and treatment of cancer, it remains one of the most common causes of death. And often cancer is localized in the colon (1 million cases per year in the world). Clinical cases of colorectal cancer in world practice are characterized by the difficulty of its diagnosis, which complicates the appointment of timely treatment, as well as predicting the dynamics of the disease associated with the spread of tumor metastases throughout the body. In colon cancer, the tumor is detected late, because in such a hollow organ as the intestine, it must increase to such a size that the first symptoms appear, forcing a person to see a doctor. This happens already in the late stages of tumor development, when it grows deeply into the surrounding tissues. The aim of the study was to establish the dependence of the metastatic potential on the depth of tumor invasion and localization. Methods used: general scientific methods of analysis and synthesis, statistics. Results: The analysis of pathological studies of the Central Pathological Laboratory of the Ministry of Defense of the Russian Federation for 2018 was carried out to establish the nature of the dependence of the metastatic potential of a cancerous tumor on the depth of its invasion, as well as on its localization. A direct relationship was established between the metastatic potential of a colorectal cancer tumor on the depth of its invasion into the intestinal wall (with the degree of invasion of T4, metastases spread with a greater probability than with T3: 35.7% and 28.5%, respectively).

Currently, a special place in surgical practice is occupied by the treatment of patients with hernias of the semilunar (spigelial) line, which can be subcutaneous, interstitial and preperitoneal, and account for 1% of all external abdominal hernias. The difficulty of diagnosis spigelian hernias can lead to serious complication is infringement of hernia and requires emergency surgery. Therefore, the study of the typical and variant anatomy of the anterior abdominal wall, including the spigelial line, is of great importance in improving the diagnosis and treatment of patients with external abdominal hernias.
Objective: To study the features of the sexual, typical and variant anatomy of the semilunar (spigelian) line.
Methods: 42 unfixed corpses of persons of both sexes without signs of pathology of the anterior abdominal wall were studied. There were 20 (47.6%) male corpses and 22 (52.4%) female corpses. At the autopsy, topographical and anatomical dissection of the spigelial line was performed, and the width of the aponeurotic stretch was measured from the end of the muscle fiber of the transverse abdominal muscle to the lateral edge of the rectus abdominis muscle at level d.bicostarum, the umbilical ring, and d. bispinarum.
Results: The width of the spigelial line at the level of d. bicostarum averaged 0.8±0.5 cm, the umbilical ring-1.9±0.7 cm, d.bispinarum – 1.3±0.8 cm, as a result of which four clusters were identified that correspond to the established forms of the spigelial line: tapering down (9.5%), uniform width (19%), tapering up (28.6%) and wide in the middle (42.9%). The form of the spigelial line, tapering downwards, was found only in men, and the spigelial line, tapering up, was significantly more often observed in women (83.3%). It was found that the uniformly wide spigelial line was significantly more common in persons of brachymorphic body type (75%), and the mid-wide form of the spigelial line was more common in persons of mesomorphic body type (66.7%). Forms Spigelia line tapering upward and downward, were absent in individuals brachymorphic body type. At the same time, form tapering to the top Spigelia line was found without significant differences in individuals mesomorphic (41,6%) and brachymorphic (58,4%) body types, and narrowing down form spigelius lines – persons with dolichomorphic body type (75%).
Conclusion: The obtained data may allow us to more accurately predict the location and type of spigelial line hernia, as well as better plan the tactics of surgical treatment.

The paper presents a comparative characteristic of the structural formations of the testes of dogs, the morphological and functional features of which, despite the availability of material for research, have not been studied. 2. Purpose. Therefore, the aim of the study was to establish seasonal and age differences in the processes and structure of the testes. 3. Methods. To study the age indices of the testes, 12 animals were used at the age of 15 days, 5 and 12 months (4 animals in each group), in which the diameter of the convoluted seminiferous tubules (50 for each animal) and the diameter of the nuclei of Leydig cells (100 measurements ) and the area of ​​the nuclei was calculated from the diameter. For the study of seasonal characteristics, 8 animals (4 in winter and 4 in summer) were used, in which the primary pachycin spermatocytes and early (round) spermatids were counted on cross-sections of convoluted seminiferous tubules (50 tubules for each animal). 4. Results. In dogs 12 months old, the seminiferous tubules, which contain all spermatogenic cells, predominate. The morphometric indices of the diameters of the convoluted seminiferous tubules were statistically significantly higher in dogs at the age of five and 12 months compared to those at half and five months of age. In the summer period, the average number of pachycin spermatocytes was 44.6; the number of round spermatids theoretically should be 178.4, but in fact 108.4 spermatids were detected. 70 spermatids died, which is 39.2% of the theoretically possible number of spermatids. 5. Conclusion. In dogs aged 12 months, the most pronounced signs of spermatogenic and hormonal activity of the testis were revealed, which is confirmed by morphometric and karyometric indicators. The number of dying spermatogenic cells significantly increases in dogs in summer (39.2%), while the efficiency of spermatogenesis decreases to 60.8%. Establishing the activity of the established processes of spermatogenesis will allow using these data in the selection of individuals for breeding.

Relevance.

When testing solids from the perspective of the strength of materials theory, the properties, structural specificity of objects and their deformations are evaluated by the texture of the fracture surface. Studying the specificity of the long tubular bones destruction, we decided to investigate the properties of a compact substance as a composite material under various tension methods for standard samples of tibial diaphysis in the age range of 20-60 years, which corresponds to the characteristics of brittle-plastic deformation of the studying object.

Purpose.

Development of forensic criteria for the diagnosis of long tubular bones destruction under various types of external effects based on the analysis of fracture morphology.

Methods.

Modeling of damage to standard bone samples using standard devices - a pendulum tabletop copra (for an impact reproduction) and a tabletop hydraulic press (for pressure reproduction), researching of the nature and specificity of bone tissue destruction under conditions of a combination of deformations by the methods of osteoscopy, light microscopy, stereomicroscopy and scanning electron microscopy.

Results.

It was studied in 32 experiments the characteristic of bone tissue destruction in the compact substance of the tibia under impacts and pressure on bone samples, comparative studies of damage to bone samples were performed with practical objects - fractures from the materials of practical forensic medical examinations. Significant differences in the structure of the fracture surface were revealed in the ranges of the ratios of the cross section and the length of the working span of the samples 1 / 20-1 / 14 (group I), 1 / 12-1 / 8 (group II) and 1/6 (group III). In samples of groups I and II, local fractures with triangular fragments were formed, the size of which were decreased as the length of the working span of the sample decreased. In group III, the destruction is cross-zigzag, fragments-free. Under pressure, the fracture shape was in the form of a "brush" or "hole burst", on impact it acquired a jagged shape. On impact, their disposition in the walls of osteons and intersteonic spaces was chaotic, under pressure - only in intersteonic areas. In the rupture zone, microcracks were concentrated around the Haversian canals of osteons and resorption cavities in the form of bundle clusters. In the rupture zone, they spread along the course of destruction, had the appearance of sinuous formations mainly on the tops of the ridges. In the first group, in the rupture zone, microcracks took a ladder-like shape, in the second, they were concentrated tightly along the edge of the rupture, in the third, single short micro-fractures were formed.

Conclusion.

The revealed morphological criteria of bone damage allow solving expert problems of the external effects reconstruction according to the characteristics of a fracture in order to specify the level of external effects and the rate of impact or pressure of an object, which is necessary when performing forensic studies in case of an car-accident and falling from a height.

Relevance: In 10-25% of cases of acute cerebrovascular accident (CVA), one of the components of clinical manifestations are symptomatic epileptic seizures, which aggravate the course of the underlying disease and cause a significant decrease in the quality of life of patients. [1] Also in the acute period of stroke there is a risk of developing a clinical picture of epileptic seizures and the appearance of epileptiform activity on the EEG in patients with epilepsy by history, the incidence of which, according to domestic and foreign authors, ranges from 2.8% to 8.6%. [2]

Purpose: to study the incidence of symptomatic epileptic seizures and seizures in the acute and acute period of stroke.

Methods: analysis of case histories, systematization of the information received.

Results: the nature of changes in the biopotentials of the brain and the presence of epileptiform activity on the electroencephalogram of patients with hemorrhagic and ischemic stroke, the location of the lesions of brain structures reflected on X-ray computed tomography were studied and analyzed. We have found that clinically expressed epileptic seizures in most cases are not reflected in the form of epiactivity on the EEG, and the frequency of coincidence of ischemic foci and epileptiform activity in ischemic stroke is higher than in hemorrhagic stroke.

Conclusion: during the study of the case histories of patients for 2019, who had acute symptomatic epileptic seizures in the acute period of stroke, a relationship was revealed between the localization of the ischemic focus on the CT scan and the location of epiactivity on the EEG.

Cognitive anxiety is an emotional experience associated with the performance of cognitive tasks; this is one of the most common fears of young people in the learning process, which can both reduce the effectiveness of the task and stimulate. Multiple surveys of students demonstrate that future exams or demonstration of the performance of cognitive tasks may have an adverse effect on the psycho-emotional health of students. The aim of the research is to study and analyze changes in the bioelectrical activity of the brain under the influence of cognitive anxiety in students during the examination session. Research methods. The experimental series consisted of two stages: 1) psychometric research (assessment of the levels of anxiety, depression and propensity to aggression); 2) registration of EEG of background activity with open, closed eyes and when performing cognitive tasks to shift attention to emotional visual stimuli. We studied the data of psychometric tests BPAQ, HADS and the characteristics of the power of the alpha-band rhythm in the frontal leads of the brain zones and indicators of the time of sensorimotor reactions when performing cognitive tasks to shift attention to emotional (threatening) visual stimulation in elementary students of the medical university. Results. The shift of visual attention to threatening information is accompanied by a relatively higher level of activation of the frontal zones of the brain on the right. It has been shown that people with intense right-sided frontal cortex activation demonstrate: a decrease in the ability to regulate emotional reactions, a shift in attention to stimuli with negative content. Conclusion. Thus, the frontal asymmetry of the EEG spectral power in the α-rhythm range can be used as one of the promising biomarkers of psychoemotional stress manifestation.

The increase in the frequency of depressive disorders among young people studying at universities is a clear trend in recent years. This is due to the strengthening of informational and moral and psychological pressure.

Goal. This study analyzes the frequency of depression in cadets of military educational institutions, in addition, discusses the relationship of the occurrence of depression with adverse events in the past.

Methods. 351 cadets of the first and second years of study were interviewed. Depression was identified on the basis of the Beck scale, in addition, respondents noted adverse events that happened to them over the past year. The performance of cadets was also taken into account in the form of an average mark for the exams of the winter session.

Results. As a result of the study, it was found that the level of depressive disorders in higher military educational institutions is quite low (7.8% and 6.2%). The first and second year cadets did not show significant differences in the incidence of depression. The available cases were related to mild depressive disorder. Depression has been shown to be significantly associated with financial hardship, as well as personal illness and injury. An analysis of the relationship between depressive disorders and the academic performance of cadets allowed us to reveal a significant inverse relationship between depression and exam scores.

Objective: to study impairment of cognitive functions and anxiety-depressive disorders among patients with neurosurgical and neurological profile.
Methods: Cognitive assessment using a range of tests such as the Mini Mental State Examination (MMSE) and the Montreal School of Cognitive Assessment (MoCA). The level of depressive disorders regardless of the etiology of depression, stage and phase of the disease was determined using the Self-Questionnaire of Depression (Patient Health Questionnaire, PHQ-9). To measure the severity of anxiety, a test for the presence of generalized anxiety disorder (Generalizes Anxiety Disorder-7, GAD-7) was used by the patient's self-report method [2]. And also, we analyzed the patient records.
results: the results of our study were statistically processed. According to the MMSE test, 5 people (16%) have no cognitive impairment. 3 patients (10%) scored the sum of points characteristic of subject disorders. In the remaining 22 people, the values of this test correspond to dementia of varying severity. According to the MoCA test, the mean values were 17.4 ± 0.9, which indicates the presence of cognitive impairments. In 24 subjects on the PHQ-9 test, depression of varying severity.
Conclusions: this group of patients is at risk for the development of cognitive impairments and anxiety-depressive disorders due to the formation of endogenous intoxication after traumatic brain injury. The data obtained can be used to prevent possible complications and improve the rehabilitation of patients with a similar pathology.

The study is devoted to the problem of non-compliance with the medication regimen in patients with paranoid schizophrenia. Non-compliance of patients leads to a more severe course and exacerbation of mental illness, an increase in cases of repeated hospitalizations, as well as the formation of psychopathological disorders resistant to pharmacotherapy. Special attention was paid to the influence of various factors on the patient's purchase of medicines prescribed by the attending physician as part of the treatment of a patient diagnosed with paranoid schizophrenia.

Objective: to Identify risk groups for non-compliance and determine the factors that have the greatest impact on its formation.

Methods: the survey of patients and processing of information collected during the survey were used. The results were interpreted using a statistical method.

Results: during the analysis of the observations revealed a group of patients who do not always comply with a doctor's prescription, as well as factors, to varying degrees negatively affect adherence to therapy related to the individual patient and the associated physician and the patient at home and on the database selected for collecting information of the medical institution microsocial environment; among them are the high duration and severity of the disease, conflict relations in the family, low social and material level, subjectively high assessment of the patient's mental state, the patient's age is more than 40 years, low level of access to the HDP, etc.

Conclusions: The study identified risk groups for non-compliance with prescribed medication and key factors that negatively affect compliance.

Relevance. Every year in the world there are 300 thousand newly diagnosed patients with Parkinson's disease, the total number of patients in the world is 3.6 million. Currently, Parkinson's disease is characterized not only by motor manifestations, but also by the development of non-motor disorders: in patients, there is also a deterioration in psychological health, in particular, an increase in anxiety, which affects the patient's attitude towards his disease and the treatment.

Purpose: To determine the level of anxiety in patients of both sex groups with Parkinson's disease and syndrome.

Methods. The study was conducted with the participation of patients with Parkinson's disease and syndrome who applied for an outpatient appointment and were undergoing inpatient treatment at the Department of Neurology. The object of the study was the respondents' responses to testing for anxiety on the Taylor scale. All patients were divided into subgroups by gender to assess the effect of this aspect on the level of anxiety. Statistical research was carried out using Microsoft Office Excel. In addition, a separate analysis of patients' responses to questions characterizing their experiences and aspects causing anxiety in connection with their disease was carried out.

Results. Patients with Parkinson's disease and syndrome have a high level of anxiety in 65%, the rest (35%) have an average level of anxiety with a tendency to a high level. When analyzed in a subgroup, most of the women: 90% have a high level, 10% have an average level with a tendency to high. In men, the percentage ratios differently: 30% have a high level and most, 70%, have an average level with a tendency to high.

Conclusion. Based on the data of the general analysis, it was found that the majority of patients with Parkinson's disease have a high level of anxiety. Gender subgroup analysis data show that women are more likely to increase anxiety levels than men. An increase in anxiety can be explained by 2 reasons: the patient's response to a progressive chronic disease, and a deficiency of monoamines, this requires additional research in the dynamics in the future.

Relevance: Post-stroke depression has a significant negative impact on the quality of life of stroke patients and also reduces their neurorehabilitation potential. Transcranial magnetic stimulation is a non-invasive therapeutic method that affects the excitability of neurons, which has a modulating effect on the imbalance of nervous processes, helping to reduce the severity of depression.
Objective: to evaluate the effectiveness of rhythmic transcranial magnetic stimulation in the rehabilitation of patients after ischemic stroke, followed by the development of post-stroke depression in the acute, early and late recovery periods.
Methods: analysis of case histories, testing using the Hamilton scale for assessing depression, and statistical analysis of data.
Results: before the start of therapy with rhythmic transcranial magnetic stimulation, the average value on the Hamilton scale in the experimental group was 16.88 ± 0.74 points, in the control group - 15.24 ± 0.85 points. The severity of post-stroke depression did not depend on the age of the patients. After rhythmic transcranial magnetic stimulation in the experimental group, the mean value on the Hamilton scale decreased to 10.08 ± 0.67 points, in the control group it was 13.12 ± 0.77. There was revealed a significant statistical significance of the differences between the two groups according to the Hamilton scale.
Conclusions: according to the results of the study, transcranial magnetic stimulation had a positive effect on the course of post-stroke depression and contributed to its regression.

The prevalence of anxiety disorders is high among people, especially those living in large cities. Anxiety disorders reduce the quality of life, ability to work, social activity, but other areas of functioning are affected. Lack of knowledge about various treatments for a patient's condition can lead to uncontrolled drug use, alcoholism, feelings of guilt and the risk of suicidal behavior.

The aim of the study is to analyze the effect of body-oriented therapy on the patient's condition in the treatment of anxiety disorder.

Research methods. The study involved respondents with a confirmed anxiety disorder. Participants from the Tyumen district, the Tyumen region, the city of Tyumen in the day hospital of the outpatient-polyclinic service of GBUZ TO "OKPB". The age of the participants ranged from 19 to 28 years old. The analysis was carried out in the form of: questionnaire Ch.D. Spielberg - a study of personal anxiety, Ch.D. Spielberg - A Situational Anxiety Study. The effect of psychotherapy after a month gave its results, namely a decrease in anxiety and fear in some indicators, a decrease in physical stress and an improvement in the quality of sleep.

Results. The study involved individuals with a diagnosed anxiety disorder. Participants from the Tyumen region, the Tyumen region, the city of Tyumen in the day hospital of the outpatient-polyclinic service GBUZ TO "OKPB". The age of the participants ranged from 19 to 28 years old, the respondents were 24 people. As a result, it turned out that at the end of the month, the experimental group's general condition improved, namely, sleep improved, the feeling of anxiety and fear decreased according to some indicators and physical stress decreased.

Conclusion. Survey data showed that body-oriented psychotherapy can help manage anxiety disorders and improve the well-being of patients.

Relevance. Local wars and armed conflicts have arisen and are emerging both in the past and in the present. They pose a threat to the health and life of citizens, cause significant economic damage and are accompanied by medical and social losses. This requires paying special attention to the quality of training of doctors, because it is this profession that has always allowed the possibility of working in extreme conditions.
This makes it necessary to pay special attention to the training of persons who take part, both in the provision of medical assistance to the victims and in the elimination of the consequences. It is the profession of a doctor that has always allowed for the possibility of working in extreme conditions.
Purpose. To study the features of training students of medical and military medical universities of the country for emergencies in peace and wartime.
Methods. exploratory, descriptive, work was carried out with the narrative material that was collected and structured, including with the help of materials from the VSMU museum complex.
Results. Today in Russia there are 6 military medical universities: the Military Medical Academy named after S.M. Kirov, Institute for Advanced Training of Doctors of the Ministry of Defense of the Russian Federation, Volga Research Medical University, Samara Military Medical Institute, Saratov Military Medical Institute, Tomsk Military Medical Institute, where, based on the latest achievements of medical science, research and development of effective methods of treating surgical consequences of emergency situations. A special place is occupied by the Military Medical Academy. CM. Kirov, which is rightfully considered the main higher military medical educational institution, the main research institution of the Ministry of Defense of the Russian Federation. The Military Medical Academy is actively involved in the introduction of new modern technologies into clinical practice for the treatment of severe wounds and injuries, as well as their consequences.
Conclusion. The training of future doctors is based on the achievement of the main goal - the ability to solve the most difficult problems in the provision of surgical care both in peacetime and in war. The training is conducted under the guidance of competent teachers with in-depth knowledge and, in some cases, experience of working in areas of armed conflict.

Maternal mortality due to termination of pregnancy occupies one of the leading places in the structure of significant socio-economic problems. Thus, approximately 70% of mothers belonged to the group of low-income, unemployed, without housing, as well as negatively related to a healthy lifestyle. Most of them are residents of rural areas (66%). It is established that the woman herself is responsible for her decision. It comes primarily from the ability to provide for the child, and this directly depends on the conditions for maintaining motherhood in the country. In many countries, sexual activity before marriage is unacceptable, and as a result, legislation restricts "infanticide" by unmarried young girls. Despite the availability of information in our time, many people do not know how to use contraceptives, as well as where to buy them. Most refuse to consult with specialists on this issue, as a result of which later they have to face more serious problems and make important decisions: whether to perform an abortion or not. Goal. Analysis of the demographic situation in the Russian Federation and research of the direct causes and problems that push girls to have abortions. Methods.Study of statistical data reflecting the demographic indicators of abortions in the Russian Federation. Results.In the Russian Federation, since 2016, there has been a demographic crisis: in 2016, 688,117 abortions (26.18%) accounted for 2628,696 pregnancies, while at present, 567,180 abortions (12.33%) accounted for 2166,180 pregnancies. It can be concluded that the percentage of abortions decreased by 13.85%, but the birth rate also decreased significantly. Conclusion. Analyzing the indicators among the subjects, it is clear that the first place in the number of abortions is occupied by Tuva (34.5%), as well as the Sakhalin region (32.2%), the smallest – Ingushetia (6.2%), Dagestan (7%), Moscow (8.5%).

Relevance. To achieve a positive effect of state programs, their planning and management must take into account the current and projected medical and demographic specifics of the region, since it significantly affects the development of the economy and social sphere, including the labor market, active life, the volume of social assistance, and the cost of preventing and treating diseases. The purpose of the study is to place emphasis on the implementation of the state program of the Voronezh region " development of healthcare. Methods: when performing this work, we analyzed the information contained in the Report on the implementation of the state program of the Voronezh region "health Development". Results: it is necessary to pay close attention to the classes of diseases that have a high mortality rate of the population, especially citizens of working age, and to increase the number of measures to prevent abortions. It should be borne in mind that migration activity is associated with an increased risk of the spread of acute infectious diseases. Conclusion: high values of mortality rates of residents of the region of working age due to coronary heart disease may indicate problems in the provision of primary medical care, as well as unconvincing educational and preventive work. The increase in the number of late first births requires the use of assisted reproductive technologies. The increase in migration activity should be accompanied by a targeted medical examination of newcomers to detect acute infectious diseases, detect the presence or absence of vaccinations, as well as the feasibility of applying quarantine to them.

The theme of war will never become outdated and will always remain relevant. The study of the experience of those years, the fate of ordinary people is not only of practical significance, but also has an invaluable educational effect on subsequent generations.
The purpose of the work is to trace the life of an ordinary person during the war on the basis of archival sources and the memories of close relatives of N. L. Grevtsev himself.
Method of research. The work mainly used information from the archive of the Ministry of defense of Russia, in terms of awarding medals for years of combat path to a serious injury to the arm and its amputation. Most of the work is based on the memoirs of his sons and daughters, to whom, at their request, he told about his military past. When writing this article, the author used the descriptive method, as well as the historical-comparative method and the method of decoding archival sources.
Results: N. L. Grevtsev's Life path, overshadowed by the war, was difficult and thorny, but later life was successful and happy, he raised worthy sons and daughters, planted many trees and built a house. It must be remembered that it was our great-grandfathers who brought Victory as close as they could.
Conclusion: the Publication of new archival sources, their analysis and study should provide new material not only for historical research, but also be used for Patriotic work in higher education.
Keywords: Great Patriotic war; Grevtsev N. L.; human destiny

Relevance. Method for measuring pressure with elements of auscultation according to N.S. Korotkov was opened in 1905, and approved by WHO 30 years later, in 1935. This work is timed to coincide with the 115th anniversary of the discovery and the 85th anniversary of the approval of this technique.
Goal. Consider the main stages of creating a method for measuring blood pressure with elements of auscultation according to N.S. Korotkov and illuminate the history of the scientist's life.
Methods. Review of literature on this topic. Consolidation of the information received from historical sources about the life of N.S. Korotkov and data on the method of measuring pressure from textbooks for medical universities.
Results. As a result of this study, many interesting aspects of the life of the great Russian doctor, the stages of creating the method, as well as all aspects and regulatory criteria that are still observed when measuring pressure according to the method of N. Korotkov.
Conclusion. Pressure measurement with elements of auscultation, discovered in 1905, is the basic method used in examining patients today - the days of new diagnostic methods. The significance of preserving the memory of the great figure N.S. Korotkov and the importance of its discovery in modern realities.

In recent years, medical science has taken a huge step forward. However, despite all this, many diseases remain, which are still an urgent problem for the whole world. A striking example of this is urolithiasis. The incidence of urolithiasis in the world is more than 3% and is increasing every year. For the Russian Federation, the ICD problem is quite urgent. In 2013, 161,241.5 cases of diseases were recorded in the Russian Federation per 100 thousand population.
The Voronezh region is characterized by a similar trend.
Purpose: to analyze the incidence of urolithiasis in Voronezh and the Voronezh region, to compare the incidence with other regions of the Russian Federation.
Methods: analysis of statistical data from official sources of the Ministry of Health of Russia, journals on urology, public health and health care, Russian and foreign dissertations and abstracts, official statistics of the Ministry of Health of the Russian Federation.
Results: In the study of primary morbidity in 2016, the highest level was noted in Moscow (11104) and the Moscow region (8744). And also a large number of cases were registered in Voronezh (3230) and Lipetsk (3295) regions. The dynamics of morbidity in the Voronezh region is similar to that in the country. According to the data for 2013, 10 districts are leading in terms of the average long-term incidence rate of the ICD population. The largest number of cases was recorded in Buturlinovsky, Kantemirovsky and Olkhovatsky districts. Also in the risk category are Rossoshansky, Podgorensky, Talovsky districts. They are followed by the Kalacheyevsky and Repyevsky districts, and the Borisoglebsky and Petropavlovsky districts with the highest incidence of ICD complete the list. The situation has changed somewhat in recent years. When studying the data for 2016, 13 municipal districts were assigned to the territories of "risk". Studies of the average values ​​of the incidence rate in 2016 showed that the highest rate was in the Kamensky (545.84), Buturlinovsky (401.12) and Repyevsky (374.85) districts. Kantemirovsky and Verkhnekhavsky districts have indicators slightly lower - 312.16 and 301.53, respectively. The Podgorensky (272.44), Olkhovatsky (251.5) and Anninsky (231.49) districts are also classified as at risk. The list includes districts in which the indicators are lower, but also falling into the risk zone according to the ICD: Paninsky (231.83), Pavlovsky (223.27), Gribanovsky (145.33). The list is completed by the Nizhnedevitsky district with an indicator of 119.30 and the Semiluksky district - 166.46. The average incidence rate in Voronezh is 177.18.
Conclusion: The presented statistical data indicate an increase in the number of patients with urolithiasis both in the Russian Federation as a whole, and in individual districts of the Voronezh region.

The article is devoted to the traditions of A.V. Suvorov, which are the basis of the whole military hygiene system, in which attention was paid to all aspects of the life of officers. An attentive and caring military commander, who had completed nine years of military service, from a simple soldier to a Generalissimo, paid great attention to both the life and health of a soldier. At that time, due to unfavorable hygienic conditions, there was a huge morbidity and mortality. Suvorov could not put up with this. Upon arrival in the regiment, he immediately engaged in the arrangement of the hospital and sanitary part of it. They were drawn a whole military-hygienic system, which reflected all aspects of civilian life: recreation, work, clothing, shoes, housing. Cleanliness of the body and linen, work without exhaustion, healthy food, boiled water - the precepts of Suvorov, which the officers had to strictly observe. Teaching soldiers to hard work, he said that work is more important than laziness, military training should always be, even in the guard house it was forbidden to play checkers [1, p. 48].
A.V. Suvorov raised the system of training troops to a height at which it did not stand at that time in any country in the world. The principles of A.V. Suvorov included moral and strong-willed training, education of patriotism to the Motherland and the military-hygienic system, which has not lost its role at the present time. Created by A.V. Suvorov, "the True art of good morals" is still relevant today.

Relevance: Issues related to the birth rate and mortality of the population of the Russian Federation do not lose their relevance from year to year. In this regard, it is necessary to study the current situation in the Voronezh region on the example of students of the Voronezh medical university.

Goal: Studying the attitude of students of the Voronezh medical University to the issue of childbearing and the factors that determine it.

Methods: Drawing up a research plan and program, developing an anonymous questionnaire, conducting a survey (Google Forms) among students of Voronezh medical University, processing and analyzing the results obtained using Microsoft Office Excel, formulating conclusions and practical significance of the study.

Results: The study is based on data from an anonymous survey of 238 students of Voronezh medical University. The age of the respondents ranged from 18 to 27 years.

Among all respondents, 9,3% of men and 20,6% of women indicated that the birth of a child is planned in the next 2 years. Later than two years – the response of 44,1% of men and 55,6% of women. 23,2% of men and 14,9% of women did not think about this question. Almost a quarter of men (23,2%) and 8,3% of women expressed their reluctance to have children regardless of the timing.Conclusions: Regional policy should be based on three vectors: 1. financial assistance to students, increased funding for such an item of expenditure as a scholarship; 2. creating optimal conditions for combining education and upbringing of children, possibly forming special training programs for students with children; 3. informing students about existing programs to support families with children.

Relevance. The problem of over-the-counter dispensing of drugs has been one of the most urgent in the pharmaceutical industry for many decades. At the legislative level, this problem has not been fully studied, and, therefore, cannot be clearly regulated.
Goal. To study the features of dispensing OTC drugs and their consequences in the territory of Voronezh.
Methods. Search, descriptive, content research, a survey of medical workers was carried out on the basis of pharmacies and medical institutions.
Results. At present, more than 20 federal chains, from 5 to 7 small private pharmacy chains are located in the city of Voronezh, and 1,069 pharmacy points are currently registered in the directory of the Internet portal "My Company". As a result of the study, which was carried out with the help of a questionnaire, the following was found out: 85% of 155 people have no idea what drugs are dispensed with a prescription and which without a prescription; 15% of respondents know which drugs are on the list of dispensed drugs only with a doctor's prescription.
Conclusion. The main problem with the dispensing of OTC drugs is the weak medical and pharmaceutical education of the population by the employees of the pharmacy organizations themselves. As a result of a survey of pharmacy workers, it was found that 55% of employees know the rules for dispensing drugs from pharmacies and strictly follow them. The rest of the pharmacy workers do not delve into the procedure for dispensing drugs and have no idea that drugs with the same active ingredients in the state register of drugs have a different order of dispensing from pharmacies.

Public-private partnership in the field of health care is the interaction of one and the other sectors with the aim of implementing socially important projects and the subsequent provision of quality medical services to the population. Purpose: to support the organization's approaches to public-private partnerships in healthcare in the Russian Federation with arguments and to show the positive dynamics of this interaction.Methods: Questionnaire questions were compiled and posted in Google forms, which allowed all participants to complete an online survey using electronic devices, not limited to time frames. The participants (objects) of the study were: students of VSMU named after N.N. Burdenko 1-6 course; workers and students of other professions. The results of the study tested our hypothesis: the possibility of using the results obtained to improve the work of medical institutions, both private and public, which will certainly affect the quality of medical services provided. As a rule, qualified medical care at a high level determines the high cost of providing these services. And this is one of the provoking factors for the interaction of private and public organizations. Conclusion: 86% of those who voted consider it necessary to have a public-private partnership. 76.1% consider it effective, which gives grounds for its further improvement. Most of the respondents believe that private clinics complement the work of government agencies. Nevertheless, 54.3% of the population seek medical help at private medical centers, of which 64.5% for diagnostics, 29% for treatment. Despite the advantage in choosing private clinics, 63.3% voted to reduce prices for medical services. Also, 73.9% of citizens believe that services under the compulsory medical insurance system should be available not only in state organizations, but also in private ones.

A large number of scientific publications on diagnosis and treatment are devoted to this nosology, as researchers are increasingly interested in finding universal verification of clinical diagnosis and creating optimal treatment standards. This is undoubtedly due to the high prevalence of DST among children and a significant risk of developing multiple organ complications.
Purpose: to conduct a survey in children of Belgorod to assess the frequency of phenotypic manifestations of polygenic connective tissue dysplasia.
Methods: survey of parents took place in the children's municipal polyclinics of the city of Belgorod with 01.12.2018 for 01.12.2019 years by random sampling. Based on the inclusion/exclusion criteria, the main group included 800 children, 2 questionnaires were excluded by age factor.
Results: At this stage of the study, data from 798 children were analyzed, including 412 boys (51.62%) and 386 girls (48.37%). For the analysis of phenotypic manifestations, taking into account the age category, 798 children were divided into three groups: 1) 1-5 years; 2) 6-10 years; 3) 11-18 years. According to the data obtained, it is possible to judge the high prevalence of DST, so in the first age group the frequency of occurrence was 39 (13.8%), in the second 54 (19.6%) and in the third 82 (34.3%).
Conclusion: thus, the diagnosis of DST should be comprehensive, i.e. not only objective examination and data collection, but also the appointment of special molecular genetic studies to prevent complications and disability in children.

The modern Donbass is a broadly industrial region, in a state of depression of an ecological, socio-economic and political-psychological nature. For more than five years, the population of the DPR has been living in conditions of a civil war. War is the most primitive and cruel way of resolving conflict situations. The greatest casualties in this case are noted among the civilian population and, above all, among children. Infant mortality is a “public welfare barometer”. In our study, we evaluated and studied the influence of biological and social factors of influence, which are leading in our wartime conditions. The coefficients of "conjugation" were calculated when they were squared, and the coefficient of determination expressed as a percentage was determined.
The results of the study presented in the ranks made it possible to more clearly determine the place of each factor in general on infant mortality and in its main periods: neonatal and postneonatal. The level of education of the mother, her culture is the main factor determining the level of infant mortality in the early period and, in general, in infant mortality due to this particular period. Of the biological factors, the leading one is the number of abortions that preceded pregnancy with a given child. In the main early neonatal period, the following factors are identified as leading: the number of abortions and the culture of the mother.

Relevance. In 2020, the department of biology of Burdenko VSMU turns 90 years old. E. I. Pokrovskaya's contribution to the development of the Department and biology in the post-war years is of great importance for science and history.

Goal. Using the materials of the library fund, get acquainted with the life history and scientific activities of professor E. I. Pokrovskaya.

Methods. The paper uses a general scientific research method.

Results. The results obtained are of great importance for biology as a historical fact. Establishing the role of ticks and insects as carriers of infectious and parasitic human diseases has allowed the development of a number of preventive measures.

Conclusion. Familiarity with the scientific and research activities of the department's employees is an integral part of the educational process.

The article presents an analysis of the initial autonomic tone in children with both an enlarged thyroid gland and a normal thyroid gland. It was found that the thyroid gland affects the functioning of the autonomic nervous system. With the normal functioning of the endocrine organ, the balance of the sympathetic and parasympathetic divisions of the autonomic nervous system is maintained. The territory of the Khabarovsk Territory is an endemic zone of natural iodine deficiency, which causes a high prevalence of iodine deficiency states.

Relevance. Allergic diseases are one of the most common forms of chronic diseases in children. Their successful treatment largely depends on early diagnosis, which can be difficult, especially in young children. Given that oxidative stress is the basis of many diseases, it is possible to change some of its parameters in the presence of an allergic process in a child. Purpose. To conduct a study of indicators of oxidative stress and the activity of antioxidant systems in 48 children with various allergic diseases. Methods. Determined the levels of malondialdehyde and the concentration of dinitrophenylhydrazine derivatives as markers of oxidative stress, as well as the activity of superoxide dismutase, glutathione peroxidase, glutathione reductase and reduced glutathione to assess the functioning of antioxidant systems. Results. A significant increase in the parameters of lipid peroxidation and an imbalance of indicators of antioxidant systems, most pronounced in children with bronchial asthma, were recorded. The results obtained allow us to conclude that allergic diseases in children may be accompanied by the development of oxidative stress. Conclusion. This method can be used in the early stages of the disease.

Thyroid diseases are a serious problem in modern healthcare. The study of this pathology, the peculiarities of its clinical picture and variants of the course in children will improve the timely diagnosis of diseases and determine the prognosis.

Objective: to study the features of the course of thyroid diseases in children.

Methods: the study included analysis of medical records from 2017 to 2019, 91 children aged 1 to 18 years with thyroid diseases. In order to assess the characteristics of the course of the disease, a statistical analysis of the data obtained was carried out.

Results: 91 children aged from 1 to 18 years old were selected to participate in the study, among them 49 were girls and 42 were boys, 72 people were residents of the city and 19 people were residents of the region. The subjects were divided into three groups. Group I included 23 people with diffuse non-toxic goiter. Group II consisted of 10 people with diffuse toxic goiter. Group III included 22 people with autoimmune thyroiditis. During the work, it was revealed that the hypofunction of the thyroid gland was more often accompanied by obesity (r = 0.24, p <0.05), and children more often complained of increased fatigue (r = 0.651, p <0.05), headaches ( r = 0.267, p <0.05). Hypertriglyceridemia was more common in hypothyroidism (r = 0.243, p <0.05). With manifest thyrotoxicosis, an increase in the level of high-density lipoproteins was more often observed (r = 0.28, p <0.05). In patients with protein-energy deficiency, there was a decrease in the level of high-density lipoproteins (r = 0.26, p <0.05). Rhythm disturbances were more often observed in children with deviations in physical development (with protein-energy deficiency r = 0.31, p <0.05; with obesity, r = 0.28, p <0.05). There was a direct correlation between the level of cholesterol and the degree of obesity (r = 0.21, p <0.05).

Conclusion: The results of this study revealed the lack of specificity of the clinical picture of the manifestation of thyroid pathology. Thyroid function in diffuse non-toxic goiter and autoimmune thyroiditis is more often characterized by euthyroidism. The hypofunction of the thyroid gland more often contributed to the development of obesity and dyslipidemia in patients. With overt thyrotoxicosis, an increase in HDL levels was more often observed. In patients with protein-energy deficiency, there was a decrease in HDL levels. Rhythm disturbances were more often observed in children with disabilities in physical development.

Goal. To study the level of intestinal protein binding fatty acids in children with ASD. Materials and methods. The study involved 52 children aged 3 to 15 years with an established diagnosis of ASD, 20 of whom observed HD. Blood levels of I-FABP were determined by enzyme-linked immunosorbent assay. Statistical analysis was performed using Statistica 10.0 statistical software. Results. indicators of the level of intestinal protein binding fatty acids were distributed in the range of 1.63-209 PG / ml, the average value of 63.54 ± 48.5 PG / ml with age, there is a decrease in this indicator (r=-0.786).

The profession of a doctor is one of the most noble, humane and necessary professions in the world, but at the same time one of the most difficult, because the doctor is responsible for people's lives. Burnout syndrome (EBS) is defined as a state of physical, emotional and mental exhaustion, including the development of negative self-esteem, negative attitude to work, loss of empathy, compassion and understanding in relation to patients and their loved ones [1]. The problem of "emotional burnout" of doctors is relevant due to the fact that a significant number of highly qualified doctors are susceptible to this condition.

Objective: To study the possible causes and risk factors for "emotional burnout" in pediatricians.

Methods: A questionnaire was compiled for doctors, including questions about the age, work experience and specialty of the doctor, daily workload, actual time spent on various types of work, basic motivations and job satisfaction, signs of "emotional burnout" (23 questions in total). 126 doctors of different specialties took part in the survey - 77 pediatricians, 28 therapists and 21 surgeons. Statistical processing of the results was carried out using standard parametric methods.

Results: Many doctors are forced to combine basic work with additional work due to insufficient material support, incl. young doctors with less than 5 years of work experience. About half of pediatricians do not have enough time to spend with their families. The feeling of fatigue among pediatricians is more pronounced due to the fact that they have the opportunity to rest only during their annual leave. In the best situation, therapists and surgeons find time to rest. However, more than half of doctors do not want to leave their jobs after reaching retirement age, including about half of the pediatricians surveyed. Moreover, more than a third of pediatricians have already reached retirement age and continue to work, which significantly exceeds the number of doctors in other specialties. This fact can be explained by insufficient material support of doctors of retirement age, as well as a greater need to be needed by patients.

Conclusion: The results obtained indicate the presence of burnout syndrome in at least one third of pediatricians.

Physical development is an important indicator of human health. Social and medical support of adolescents in penitentiary institutions is an urgent problem.

Purpose: to analyze the main indicators of the physical development of adolescents who were in a closed penitentiary institution.

Methods: the characteristics and analysis of the physical development of 76 juvenile convicts serving sentences in the FKUZ MSCh-61 of the Federal Penitentiary Service of Russia, included in the study by the method of random sampling, are presented.

Results: The deviation of the indicators was in the form of a decrease in body weight: 10 people (13.2%); excess weight: 7 people (9.2%). Obesity was recorded in only one teenager (1.3%). According to the results of processing data on blood pressure, deviations were present only in 10 adolescents: a tendency to hypertension - 6 adolescents (7.9%); to hypotension - 4 people (5.3%). Heart rate per minute ranged from 62 to 88 beats per minute, and respiratory rate from 16 to 21 beats per minute. The values ​​obtained by us correspond to the age norms. Discussion. It was found that there was no relationship between the stay of the study group of 76 adolescents in a closed penitentiary institution and the possible development of pronounced deviations in their physical development.

Conclusion: despite the fact that more than a third of the adolescents in the study group led an asocial lifestyle (38.2%), we did not find any deviations in physical development significant for their health. Growth basically fit into the parameters of the average, deviations in body weight were found in less than a quarter of cases (23.7%). BMI had acceptable fluctuations. Despite the fact that the adolescents included in the study group were in a closed penitentiary institution, that is, they experienced chronic stress, the objective indicators of their somatic health did not affect in any way. The indicators did not go beyond the age norms.

In recent years, there has been a trend towards an increase in the share of viral infections in the structure of childhood diseases. Doctors more and more often observe a longer course of ARVI, accompanied by complications from the ENT organs and the respiratory system. At the same time, the age group of children remains the most vulnerable to the penetration of viruses: newborns, infants and preschool children, for whom it is extremely difficult to find the right drug. Purpose: This article discusses the features of the course of ARVI among vaccinated and unvaccinated children in the period from 2018-2019 in Yekaterinburg registered at the MAI Children's hospital No. 8

Methods: A study of the clinical course of ARVI was carried out, a comparative analysis.

Results: In the incidence of ARVI in 2019, the H1N1 and H3N2 viruses, RS and metapneumovirus were of the leading importance.

Psychological microclimate – the mood that has developed between the members of the team. The success of colleagues in any organization depends on it. Creating an optimal psychological microclimate in a medical organization directly depends not only on the individual characteristics of each member of the team, but, first of all, on the nurse-organizer. Its role in creating a favorable microclimate in the workplace is crucial. A nurse organizer should be able to listen to suggestions for improving the workplace and improving relations between her subordinates, as well as find compromise solutions to conflicts among employees. It is impossible to avoid conflicts in any group of people [1]. But it is possible to minimize the resulting omissions among subordinates. Possible interpersonal conflicts in the medical team are caused by individual characteristics of the individual and the nature of interpersonal relations in the team [2]. In the departments, an anonymous survey was conducted to find out the objective shortcomings of workplaces and identify interpersonal conflicts hidden from the eyes of the organizing nurse, where 24 employees took part. In questions concerning interpersonal relationships, the main points that employees could identify as negatively affecting the ability and desire to work in this team were highlighted. These include: distrust based on the unprofessionalism of a colleague, personal conflicts, passivity and irresponsibility when performing work tasks, short temper, unpleasant smell of a colleague, etc. In matters of an objective nature, such moments were: disorder in the workplace, the inconvenience of the workplace in terms of ergonomics, the aggression of patients and/or their accompanying persons, the desire of patients to pass away, due to the lack of self-service ability, etc. To optimize the comfortable microclimate, the staff highlighted the following points: the colors in the interior of the departments are warm and inviting, a comfortable workplace for nurses (chair, desk), confidential communication with colleagues, the opportunity to make an appropriate but important remark, a comfortable waiting area for a certain number of incoming and outgoing patients (with a sufficient number of seats). The nurses, organizers, recommendations were made to improve relations teams and a shared psychological climate at the workplace: − in the team to develop trusting relationships and the ability to win as a colleague and patient; − to enable professional growth and realization of potential of young employees [3]; − to improve psychological comfort nurses for full/almost complete satisfaction with the working area; - change the state of the department for a comfortable location of patients in it. Keywords: psychological microclimate; nurse-organizer; interpersonal relationships

Objective: to study the opinion of first-year students on the subject of their ideas about the appearance of a doctor.

Methods: survey of first-year students of medical and pediatric faculties with the help of a special form with ten questions in September and January 2018-19. Answers were analyzed, compared and described the results obtained.

Results: Anonymous survey of 70 students of medical and pediatric faculties, studying in the first year of the Voronezh Medical University in September 2018 and January 2019, was conducted.The questionnaire consisted of 10 questions and revealed general views of freshmen, yesterday's applicants, about their conditionally ideal physician image.

Conclusion: Becoming a good doctor is not easy. This lofty goal can be more effectively achieved after identifying students' initial ideas about their professional ideal, family characteristics, idols, orienting specialization. The presented results demonstrate good potential and correct orientation of future medical professionals.

Medical ethics is a science that studies the moral principles in the professional activities of medical professionals. The purpose of the study: to study the extent to which ethical norms and rules are currently being implemented by secondary medical personnel in their professional activities. Research method: statistical analysis of the results of a survey of patients communicating with secondary medical personnel in Bryansk. The study was divided into two groups – the average medical staff of children's and adult clinics was studied. It was found that the indicators between the two groups differ - in children's clinics, rudeness of secondary medical personnel is 3% more common than in adult clinics. The highest scores (4 and 5) on the politeness of nursing staff were given more by patients of adult clinics (79%), while patients of children's clinics – 63%. The same applies to professional responsibility: in adult clinics – 80%, in children's-63%. In conclusion, it should be noted that the identified "negative" indicators of secondary medical personnel indicate an incomplete study of their main legal act – the ethical code of nurses. The comparatively poorer results in children's clinics can be explained by the fact that parents of sick children who are subject to more stress and irritability due to the unhealthy state of their children were interviewed in this group.

The most important part of the modern health care system is nursing. Nurses are a huge human resource with real potential opportunities in the context of modernizing domestic healthcare. This article presents the results of a survey of nurses of the regional narcological dispensary. Analysis of a time-based study of the main types of functional responsibilities of outpatient nurses in the dispensary Department. This study may affect the organizational activities of a specialized drug treatment nurse. The purpose of this study is to improve the organization of nursing activities in a medical organization that provides specialized medical care. Proper organization of work of nurses contributes to high involvement in the treatment process, improving the quality of medical care and motivation for active professional development. Effective professional activity of nursing staff is aimed at meeting the needs of patients in affordable and acceptable medical care.

Relevance. An archival endodontic problem, in the etiology of which lies an iatrogenic cause, is the occurrence of microfractures, microcracks, in the root dentin after protocol interventions in the root canal system. Studying the etiology of tooth root fractures is an urgent problem that requires additional study.
Goal. Identification of factors provoking the occurrence of tooth root fracture.
Methods. To achieve this goal, we created an author's research design, which includes the following directions of methods: clinical studies, which included working with 36 patients, scanning electron microscopy, statistical studies using the X2-Pearson criterion.
Results. In the research results, I would like to note the different quality of root canal treatment with various types of instruments. Despite the high degree of technical feasibility of using the machine method of processing, the manual one turned out to be more gentle on the biological tissues of the tooth root.
Conclusion. Based on the research results, we can conclude that the machine method of root canal treatment is a better, more efficient, time-saving method. But, at the same time, trauma to the dentin of the tooth canal requires, in our opinion, additional measures to prevent the occurrence of root fractures. For example, in-root treatment with a root bond. The manual method of root canal treatment, as more economically available and biologically feasible, can be an option and is recommended for budget and pediatric practice.

Background:At present, there are a large number of sealing techniques, which has its own advantages and disadvantages. Very often in practice, dentists face such a problem as a post-sealing pain. The occurrence of a post-sealing pain is usually associated with a violation of the adhesive protocol or debonding, but we assume that this may also be due to the formation of pores in the layers of the packed composite material.Therefore, we identified the most optimal method of filling.

Purpose:To identify the regularity of pore formation in the layers of the filling material depending on the method of packing the composite material.

Methods:We examined 16 removed teeth (incisors, premolars, molars) that preserved their anatomical integrity, and divided them into 4 groups with each group having teeth of different group affiliation. Then we prepared the teeth for filling: opening the carious cavity, expansion, necrectomy, finishing the edges of the cavity, polishing. For each group we used different tools and filling materials: group I -composite + ironer, group II - liquid filling material + composite + ironer, group III - liquid filling material + composite + ironer + applicator, group IV -liquid filling material + composite + ironer + applicator + brush. In order to detect the presence of the voids between the filling material layers, we prepared dental preparations using a separation disk and a straight tip. To assess visually the quality of filling, all dental preparations were treated with a color indicator solution. The presence of pores was recorded using a microscope and a camera.

Results: During the study, we managed to establish that the number of pores was smaller in the preparations in which the maximum number of tools was used for packing materials.

Conclusion:The technique involving the use of an ironer, applicator, brush, leads to a better result, namely: reducing the formation of pores, which prevents the excessive development of polymerization stress.

Relevance
Very often, the carious process is localized on the contact surfaces of the teeth, as in the places of the greatest accumulation of plaque and in the low availability of interdental spaces for full hygiene. That is why the question of restoring contact points during the restoration of such teeth remains relevant. The goal of every dentist is to create the most accurate contact between the teeth in order to avoid injury to the marginal gum, for the correct distribution of the chewing load in the dentition.
goal
To prove the convenience, efficiency and economic feasibility of using an individual matrix ring in the daily work of a dentist by examining this technique in a dental appointment. Assess the quality of the subsequent restoration and the accuracy of the restoration of the contact surface.
Methods
In this work, in the process of treating caries on the medial surface of tooth 1.6, we used the method of making an individual matrix ring using a ready-made metal matrix ring and a liquid rubber dam.
results
The method for solving the existing clinical situation turned out to be simple and convenient to use, it made it possible to restore the contact point with maximum accuracy without additional time consumption and the need to use expensive matrix systems.
Conclusion
The technique of using an individual matrix ring in case of restoration of a contact point is an affordable alternative to using standard matrix sets. This method is simple, convenient and provides high-quality and accurate modeling of the contact point, minimizes the number of errors associated with the presence of insufficiently tight contacts between the teeth or their incorrect orientation relative to the tooth crown. Moreover, this technique does not require the use of expensive matrix systems, is easy to implement and saves time.

Cytobacterioscopic research methods have been known for more than 100 years, but they became widespread in dentistry in the 80s. The value of this method lies in the non-invasiveness of its application, and the results obtained make it possible to adequately visualize desquamated epithelial cells, assessing the degree of their maturity, bacterial and fungal flora. The aim of the study was to determine the state of the coccal and microbial flora, including the cytostatus of the oral fluid of the second-year students of the Faculty of Dentistry of V.G. N.N. Burdenko. Research methods. The rapid diagnostic method was used to assess the cytological and bacterioscopic parameters in the oral cavity of the students of the Faculty of Dentistry, taking into account the presence or absence of general somatic pathology. This technique made it possible to identify a violation of the microbiosis of the oral fluid even at a young age. Interesting, in our opinion, is the study of the state of the oral fluid according to the listed indicators in junior students. Results. The results of the study showed the relationship between the presence of general somatic pathology, including diseases of the digestive system, and the development of the fungal flora of the genus Candida and 4-5 mature cells of the prickly layer. There were single filaments of giant mature pseudomycelium and, in rare cases, single filaments of Leptotrics buccalis. In patients with endocrine pathology (hypothyroidism, small-nodular goiter, etc.), the cytobacterioscopic picture consisted of a large number of cells of the spiny layer of the epithelium and young filaments of pseudomycelium of the Candida fungus. Conclusion. According to the data of cytobacterioscopic examination of patients without somatic pathology, a minimum amount of pathological microflora is revealed. In patients with diseases of the digestive and endocrine systems, the amount of fungal flora, desquamated epithelial cells and the appearance of protozoa significantly increase. The obtained indicators can serve as a preventive diagnosis of pathology of internal organs.

An increase in the incidence of odontogenic diseases of the maxillofacial region leads to the search for new methods of treating this nosological pathology. The use of platelet-rich plasma obtained at a low centrifugation speed is an innovative technology today and has great success in dental practice, given that platelets contain growth factors (various proteins, cytokines and other bioactive factors) that play an important role in healing and bone formation. As a result, the severity of postoperative edema and pain is reduced, and the rehabilitation period is shortened, which is widely used in bone grafting and dental implantation. The aim of the study was to study the results of the use of platelet-rich fibrin for closing the bone cavity in the complex treatment of chronic odontogenic osteomyelitis of the lower jaw. Methods: on the basis of the Department of Maxillofacial Surgery of V.G. NN Burdenko treated odontogenic diseases of the maxillofacial area with platelet-rich fibrin. A-PRF has been used to close bone cavities after surgical treatment of odontogenic diseases of various etiologies. Results: The study of the qualitative composition of the microscopic view of the bone wound in patients with HCONCH revealed different groups of microorganisms. The use of OTF in the complex treatment of HCONCH made it possible to reduce the duration of inpatient treatment by almost three days. Disease relapses were not observed in our study. Conclusion: on the basis of the results obtained, it can be concluded that the beneficial effect of platelet-rich fibrin on the bone cavity and a decrease in its volume due to the improvement of local blood circulation and stimulation of bone regeneration in the area of ​​surgery.

Relevance. It is very important for a dentist to do his job efficiently, without spending a lot of time on it. Fortunately, the developed modern instruments allow us to simplify the treatment and at the same time improve the procedure for root canal enlargement.
Goal. The aim of this study was to review the literature on the use of the XP-endo Shaper (FKG Dentaire SA, La Chaux-de-Fonds, Switzerland) for root canal preparation, assessed using microcomputed tomography (micro-CT) technology, with an emphasis on intact wall analysis. channel.
Methods. I searched the Science Direct, SciELO and MEDLINE databases for articles published between 2018 and 2020 using the following keywords: micro-CT, intact walls, XP shaper, and XP-endo. Articles without abstract were excluded. Three entries were selected. Several studies are available on this topic.
Results. Studies published to date show that the XP-endo Shaper system performs well in terms of canal preparation, but leaves the walls intact.
Conclusion. However, the use of this unique instrument makes it possible to simplify and speed up the time of mechanical treatment of root canals, as well as reduce the risk of errors and complications, and preserve a larger volume of dentin. This makes canal treatment a fast, simple and safe procedure.

RELEVANCE: high-quality preparation of the carious cavity is the key to the successful treatment of caries and the prevention of its recurrence, in this regard, this work was carried out.
PURPOSE: To carry out a comparative characterization of the cytoarchitectonics of dentin during preparation using standard diamond burs and a high-intensity erbium laser PLUSER.
METHODS: The study was carried out by studying electron microscopy images obtained as a result of the preparation of extracted teeth with fissure caries using a PLUSER laser and diamond burs.
RESULTS: in the course of the work carried out, it turned out that preparation using a laser has a number of advantages, such as the cavity walls are smoother, there are no chips and microcracks, the angles between the bottom and the walls are rounded, the cavity shape optimal for the best retention of the filling is achieved, also when laser preparation does not require the use of anesthesia, it is painless, the resulting cavity is sterile, prevention of secondary caries is achieved, after laser preparation, enamel etching is not required. When using diamond burs, dentinal tubules are visible on the walls of the cavity, sealed with sawdust, the walls have an uneven surface, and the angle between the walls and the bottom is about 90 degrees.
CONCLUSION: A comparison of the methods of preparation of hard dental tissues using a high-intensity erbium laser PLUSER and using diamond burs was carried out, as a result of which the advantage of tooth preparation using a laser was revealed.

Today the number of dental-jaw anomalies is growing, the need for orthodontic treatment is naturally increasing. Treatment of an orthodontist dentist, like any other, can be accompanied by complications, the most common of which are: demineralization of enamel, multiple caries, gum recession, inflammation of periodontal tissues. The listed complications after orthodontic treatment negatively affect the aesthetics of a smile, in some cases they are accompanied by discomfort and pain. The aim of this study is to study the quality of life indicators in young patients after complications of orthodontic treatment with braces. An analysis of the quality of life of 28 male patients aged 19 to 24 years, who came to the dental clinic after complications of orthodontic treatment, was carried out using the SF-36 and OHRQoL questionnaires. The average indicators for this group of patients were compiled for each factor of quality of life. The study found that complications resulting from orthodontic treatment negatively affect the lives of young people, impede communication and are a negative psychological factor. Symptoms inherent in nosological forms and accompanying complications negatively affect the psychoemotional state of patients, especially young patients, proportionally reducing their quality of life. Thus, it is necessary to include preventive measures in the treatment plan, to give the necessary recommendations with their obligatory observance to prevent the negative consequences of orthodontic treatment.

Black elderberry is a promising object for study, since it has proven antioxidant, anti-inflammatory, hypoglycemic, GE-pathoprotective and anti-tyrosine kinase activity. This spectrum of activity is mainly due to the presence of a large number of flavonoids in the fruits and flowers of black elderberry. The purpose of this work was to study the recovery capacity of various water-organic solvents (glycerol, ethylene glycol, dimexide (DMSO), acetonitrile and ethyl acetate), followed by spectrophotometric determination of the antioxidant activity (AOA) of the obtained extracts. The DPPH spectrophotometric method was used to determine AOA. The method is based on the interaction of antioxidants with the stable Chromogen radical 2,2-diphenyl-1-picrylhydrazyl (DPPH). The obtained results allowed us to evaluate the dependence of antioxidant activity on the amount of flavonoids in the obtained water-organic extracts: the universality of extraction of flavonoids from black elderberry flowers by the studied extractants was revealed, since each of the studied solvents showed sufficient extracting ability. It was also found that aqueous solutions of solvents at concentrations of 20, 40, 60 and 80% extracted flavonoids better than absolute solvents, while the AOA of water-organic extracts takes fairly high values at any solvent concentration, and thus does not directly depend on the percentage of flavonoids.

Relevance. Dandelion officinalis is a widespread medicinal plant used as a choleretic and diuretic in both official and folk medicine. This is due to a number of biologically active substances that make up its composition. In order to increase the yield of these substances from raw materials, various pre-treatment methods are used: ultrasonic treatment, degreasing, and heat treatment. This paper examines the effect of pre-heat treatment of medicinal plant raw materials – an effective method for increasing the yield of various groups of biologically active substances.
Methods. Preliminary heat treatment of raw materials was carried out in a drying Cabinet in metal packaging and without it for one hour at temperatures of 40, 60, 80, 100, 120, 140, 160 and 180°C. To determine the optimal heat treatment time, we selected intervals of 30 minutes, 1 hour, 1.5 hours, 2 hours, 3 hours and 6 hours. In order to determine the optimal layer thickness, samples with a layer thickness of up to 1 cm, 1-2 cm, 2-3 cm, 3-4 cm, and 4-5 cm were heat-treated. Heat treatment of whole, cut and crushed raw materials was carried out.
Goal. To determine the effect of pre-heat treatment of raw materials on the content of hydroxycinnamic acids (HCC) in dandelion medicinal roots.
Results. Pre-heat treatment of raw materials significantly affects the content of PCC in dandelion medicinal roots. Heating to 40, 60, and 80 °C reduces the PCC content in the samples (up to 0.347%; 0.348% and 0.359%, respectively). At 140 °C, the thermal inactivation of enzymes is maximal, as evidenced by a 1.4-fold increase in the PCC content in the samples (0.657±0.082%). Using pre-heat treatment without packaging is inefficient. The optimal time for pre – heat treatment is one hour, and the layer thickness is 1 cm.
Conclusion. For further use as a method for intensifying the extraction of PCC from dandelion medicinal roots, it is proposed to use pre-heat treatment of crushed raw materials at a temperature of 140 °C for one hour in a package with a layer thickness of 1 cm.

Relevance: today, a Large number of foreign students who came from different parts of the world study at the Burdenko VSMU. At first, it is very difficult for them to get used to new living conditions. In this regard, successful adaptation of students from other countries becomes extremely relevant. It allows foreign students to quickly understand the essence of the educational process, affects the prospect of maintaining their number and the quality of training [1]. Changes in climate, time zone, mode and daily routine, diet, as well as meeting new people in one way or another affect the functional state, functional capabilities and abilities of students, and therefore, in terms of adaptation, the first year is the most difficult for them.
Objective: To determine the characteristics of the cardiovascular system response to physical activity in students of MIMOS Burdenko VSMU, as well as to evaluate the dynamics of students ' adaptation to new conditions using the obtained data.
Methods: the Research was conducted at The Department of physical culture and medical rehabilitation of the Burdenko state medical University using a combined Functional test of S. P. Letunov with dosed physical activity. The object of our study was healthy 1st year students of the faculty of MIMOS. The duration of the study was 4 months. Evaluation of the results of the work was carried out by studying the types of reaction, the degree of change in the indicators of the adaptation system (heart rate and BLOOD pressure).
Results: the study found that all subjects have a normotonic type of reaction, but for 2 out of 10 students, this type of reaction is hypotonic. Important criteria of the normotonic type are significantly increased Blood pressure, heart rate, Add decreases and the duration of the recovery period is within the limits of 2, 3, 4 minutes after the 1st, 2nd, and 3rd loads, respectively. This type of reaction is the most favorable and reflects the body's good adaptability to physical activity.
Conclusion: Thus, our study showed that foreign students of 1 year of study have features of the reaction of the cardiovascular system to physical activity-ADP, Add, heart rate do not have time to recover in the prescribed time. This indicates the tension of all body systems, in connection with finding it in the acute phase of adaptation. After 3 months from the date of the 1st wave of tests, the cardiovascular system's response to the load was normalized-the body adapted (due to living in one place for 4 months and regular physical training)

Target: According to current statistics, incidence of childhood cerebral palsy tend to increase. Сerebral palsy cannot be fully cured, but with effective rehabilitation techniques these children are able to recover some of their impaired physical skills, and to improve the living standards of patients, improve the development of everyday skills. The aim of this work was to analyse the effectiveness of different rehabilitation methods to improve the condition of children with cerebral palsy on the basis of the Regional rehabilitation centre «Sail of hope».

Methods: 60 children with cerebral palsy with motor impairments with varying muscle strength were monitored. The results of the rehabilitation programmes were reviewed. All patients were given a standard set of rehabilitation methods which includes therapeutic gymnastics, classical massage sessions and physiotherapy treatment. In comparison groups, besides the proposed methods, the simulators "Stender", "Spider" and Adele’s costume were used. The results of the course were evaluated on a six-point scale of muscle strength, a decimal visual analog pain scale, and on the scale of assessment of the severity of the exotic paresis (from the NIHSS stroke scale). 

Results: Our research has shown that positive trend as improvements in motor functions noted in groups wich used in the rehabilitation programme the simulator "Stender" and Adele’s costume. 

Relevance. More and more people with poor health are now found among the population of Russia. One of the urgent problems of our time is the restoration and preservation of health, which is not only of scientific and practical interest, but also contributes to the solution of social, demographic, economic and other social problems. Lifestyle creation involves the formation of a behavioral strategy, attitudes and values, norms and rules adopted in order for a person or group to comfortably exist in a social context [1]. The system of physical education in Russian universities considers the creation of favorable conditions for regular physical exercises of a health-improving and restorative orientation. From the list of various diseases, diseases of the respiratory system come to one of the first places. Scandinavian walking has useful properties for improving the body, preventing diseases of the respiratory system, as well as developing the functional capabilities of the respiratory system. To investigate the influence of Nordic walking classes on the respiratory system of students. Methods. To monitor changes in the functional parameters of the respiratory system, we used the following methods: measurement of chest excursion, functional breathing tests of Genchi and Stange. Results. As a result of the research carried out, the arithmetic mean values ​​were derived in the three groups participating in the experiment. Each group had its own kind of physical activity: one was engaged only in Scandinavian walking 2 times a week, the second - once in Scandinavian walking, and the second time in swimming, the third - in Scandinavian walking and athletics at the stadium (in the arena). Changes in indicators (chest circumference, Genchi and Stange tests) were observed in all groups, but the greatest increase in indicators was in the group that walked and swam in the pool. A more rapid development of the functional capabilities of the respiratory system occurs during Nordic walking and swimming in the pool. When practicing only Scandinavian walking, there is also a positive dynamics in the work of the respiratory system, but its rates are lower. For best results, you need to practice walking with poles for a longer time.

Relevance: the assessment of the dynamics of aerobic performance, as well as the influence of swimming and Nordic walking on the state of the functional indicators of respiration can become the basis for the development of the most effective training programs for students in order to increase physical performance, endurance and reduce the risks of morbidity.
Purpose: to identify and trace the dynamics of aerobic performance among second-year students involved in Nordic walking and swimming.
Methods: cross-sectional research design; objects of research - second-year students of VSMU named after N.N. Burdenko, engaged in Scandinavian walking and swimming; study of the dynamics of aerobic performance by calculating the maximum oxygen consumption (MOC) by a continuous method using the Astrand nomogram.
Results: using the Astrand method, according to the nomogram, the indicators of the maximum oxygen consumption of students were calculated before and after five months of Nordic walking and swimming. It was revealed that aerobic performance in the period from September 2019 to February 2020 increased, which shows positive dynamics, as well as an increase in the level of physical condition of students. Subjectively, the subjects noted that they received positive emotions from the course of physical exercises.
Conclusion: as a result of the work, it was revealed that Scandinavian walking and swimming increase aerobic performance, and also have a positive effect on the physical and emotional state of students, which makes it possible to include these types of physical activity in the compulsory program of the course of physical culture in order to increase their effectiveness.

Relevance: the physical performance of students is the most important condition for the development of all basic physical qualities. Efficiency is always ensured by the functioning of the same systems of the body, its level is influenced by the same factors, but the role of these systems and factors is different depending on the activities of the trainees, age, etc. [2,3]. This information is extremely necessary for adequate control of the functional state of the organism of students, since physical performance is an integral indicator of the functional state and functional fitness of the organism [1].
Purpose: to analyze the dynamics of physical working capacity of 2nd year students of VSMU, who go in for Scandinavian walking and swimming.
Methods:
1) Study the indicators of physical development;
2) Compare the received individual indicators of physical development with anthropometric indicators;
3) Assess physical performance using the PWC170 test;
4) Analyze the results.
Results: as a result of the study, we selected 2 groups of 2nd year students of VSMU; 11 boys and 19 girls involved in Scandinavian walking and swimming took part in the study. Anthropometric indices were measured in these students and the PWC170 (PhysicalWorcingCapaciti) test was carried out, based on the linear dependence of heart rate and power of the work performed, which made it possible to assess their physical performance.
Conclusion: Having analyzed the results obtained, we can say that Nordic walking and swimming have a positive effect on the physical development of students, and also contribute to an increase in physical performance.

Relevance: due to the fact that currently students are subjected to an enormous academic load, their active lifestyle is increasingly being replaced by a sedentary one. And as a consequence of this lifestyle, the number of chronic diseases of the cardiovascular, respiratory, musculoskeletal and endocrine systems is increasing. Therefore, this topic is very relevant.
Purpose: to reveal the effectiveness of Scandinavian walking and swimming lessons for individual indicators of adaptive potential among second-year students.
Methods: this article is devoted to the study of individual indicators of the adaptation process in second-year students who were engaged in Scandinavian walking and swimming during the academic semester, as part of practical classes at the Department of Physical Culture and Sports Rehabilitation in accordance with the schedule. Three groups of students were taken as a basis, who consistently attended practical classes during the study period.
Results: it was found that regular swimming and Nordic walking have a beneficial effect on such individual indicators as: blood pressure, heart rate, vital capacity of the lungs. As a key piece of evidence for the reasoning, work has been done that is presented in this article and proves the importance of Nordic walking and swimming.
Conclusion: in the course of the work done, the results were obtained, on the basis of which, it can be concluded that regular training in Scandinavian walking and swimming as part of practical training has a beneficial effect on the physiological parameters of the cardiovascular and respiratory systems and, as a result, the health of students in the whole.

Relevance: Physical performance is the ability of a person to perform a given physical activity with the lowest physiological costs and with the highest results. The Harvard step test is based on recording the heart rate after a planned physical activity (the faster the heart rate returns to its original values, the higher the body's endurance). With it, you can assess the level of physical performance, the rate of recovery of the body after exercise. An increase in the level of physical fitness is accompanied by an increase in the Harvard step test index. In turn, poor physical fitness manifests itself in the form of a decrease in the index of the Harvard step test, or in the inability to fulfill a given load during the Harvard step test. Purpose: Comparative analysis of the physical working capacity of 2nd year students of VSMU. N. N. Burdenko. Methods: 1) Harvard step test; 2) Use of specialized literature and Internet resources. Results: in the course of the study it was established that physical exercises used in the educational process are effective when these exercises are varied and regular. Conclusion: The introduction of stress tests allows you to monitor the effectiveness of regular physical exercise in practical physical education classes.

Structured annotation. 

Relevance. With the digitalization and computerization of modern society, mankind has faced many new problems related to health of human being. These problems are: a sedentary lifestyle, bulimia, eating disorders, migraines, increased physical and mental fatigue, provoking the development of metabolic syndrome. It has been proven that almost every second obese patient has metabolic syndrome. They also have a higher risk of diabetes type 2 developing. 

Purpose: to identify excess body weight and the risk of developing metabolic syndrome of medical students. 

Methods: The questionnaire method was used for the students' criteria for the diagnosis of metabolic syndrome. To determine excess body weight, the students were examined using the hardware-software complex “Medscaner Wellness”.

Results: It was found that 16 (26.6%) of the surveyed students met the criteria of MS diagnostics. Every 3^rd student from the MS risk-developing group noted that they have close relatives with cardiovascular diseases. Every 2^nd student indicated the presence of emotional stress and lack of inclination to a healthy lifestyle. During survey of the students from the MS risk-developing group, with the hardware-software complex “Medscaner Wellness”, it was revealed that they have first degree obesity or excess body weight. 

Conclusion: It was found that out of all the surveys, 6 students had a significantly higher risk of developing metabolic syndrone, which is associated with the peculiarities of their diet, lifestyle, and the presence of a hereditary predisposition. 

Purpose. Searching for the most effective remedy for correcting disorders of the oral microflora after eating. Methods. Conducting a dental examination of 36 people, interviewing, collecting plaque from the surface of the tongue and teeth before and after using the test agents, bacteriological sowing of the material, calculating and analyzing the results. Results. A study was conducted of the five most popular products that, according to the respondents, are capable of maintaining oral hygiene in the absence of the possibility of brushing their teeth. These remedies were: water, an apple, sugar-free gum, sugar-free black tea, and oral cleansing foam. The conditions for the sample of participants in the study were: normal acidity of saliva, normal oral hygiene, the absence of active carious processes, the absence of chronic somatic diseases, which made it possible to reduce the influence of factors that could interfere with the study. Control samples showed an accumulation of small rounded colonies of microorganisms measuring 1-2 mm in the amount of 700. The best result was shown by the use of water: after rinsing with water, the samples contained 20 small colonies and 17 medium-sized colonies. The use of tea resulted in the formation in the Petri dish of about 40 colonies with a diameter of 2-3 mm, as well as 80 small round colonies. When apple was used on a nutrient medium, about 800 colonies up to 1 mm in size and about 7 colonies of 5-7 mm in size, round and irregular, were found, respectively. The sugar-free chewing gum produced 30 irregular colonies and 100 small round colonies on the medium. The use of the foam to clean the interdental spaces resulted in the appearance of 10 colonies 12-3 mm in diameter in the Petri dish, as well as 30 rounded small colonies. As a result of the counting of colonies of microorganisms, after using the indicated means of affordable oral care, the most effective remedy was water. After rinsing, 17 colonies of medium size and about 20 small colonies were found.If it is not possible to maintain oral hygiene during the day, according to the data obtained, water can be called a remedy that can reduce the number of microorganisms in the oral cavity after eating, and, therefore, prevent the occurrence of caries. Water showed the best result. Rinsing with water can mechanically remove food particles from the oral cavity, which, during fermentation, can lead to the development of carious processes. It is important to understand that rinsing your mouth with water alone is not enough. To maintain the health of the oral cavity, it is necessary to undergo regular preventive examinations, professional hygiene procedures at a dentist to prevent the development of the disease.

Relevance. Significant prevalence of iron-deficiency anemia (IDA) and persistent growth of iron-deficiency conditions in young children are urgent problems of modern clinical and fundamental medicine. Objective: to study the pathophysiological aspects of the occurrence and development of IDA in young children. Methods. The study included an anonymous survey of 388 mothers whose children ranged in age from 1 to 3 years. The study was carried out on the basis of the health care institution "6th city children's clinical clinic" (Minsk) in 2019. Results. The significance of differences was estimated by the calculated Chi-square correspondence coefficient (χ2). The p<0.05 level was considered statistically significant. When analyzing the presence of IDA in children, it was found that in the group of mothers who noted the presence of IDA during pregnancy, 84 (31.11%) children also had IDA and 186 (68.89%) children did not have IDA; in the group of mothers who deny the presence of IDA during pregnancy, 7 (15.91%) children had IDA and 37 (84.09%) children did not have IDA; in the group of mothers who do not remember the presence or absence of IDA during pregnancy, 18 (24.32%) children had IDA and 56 (75.68%) children did not have IDA. The distribution of children with IDA by type of feeding in the first year of life was as follows: 18 (16.51%) children were breastfed, 73 (66.97%) children were artificially fed, and 18 (16.51%) children were mixed. Among children without IDA, the distribution by type of feeding in the first year of life was as follows: 54 (19.35%) children were breastfed, 60 (21.51%) children were artificially fed, and 165 (59.14%) children were mixed. Conclusion. When analyzing the data obtained, it was found that children whose mothers had IDA during pregnancy have a statistically significantly higher probability of developing IDA after birth (p<0.05). Children who are artificially fed have a statistically significantly higher probability of developing IDA compared to other types of feeding (p<0.001).

Relevance

The adaptation of students to the educational process is accompanied by a significant tension of the compensatory-adaptive systems of the body. In this regard, it seems relevant to study the indicators of heart rate variability (HRV) in medical students from different climatogeographic regions of permanent residence, obtained over a 24-hour observation period.

Purpose to conduct a comparative analysis of HRV indicators among students from different climatic and geographical regions when adapting to the temperate climate of the middle zone.

Methods

The study involved 59 students, who were divided into 2 groups depending on the climatic zone of permanent residence before coming to study. Group 1 included 29 people, 15 men (51.7%) and 16 women (48.3%) living in a temperate climate, in the 2nd 30 people (13 men (43.3%) and 18 women (56.6%)) who came to study from tropical and subtropical climatic zones. The study of HRV was carried out using 24-hour monitoring of the electrocardiogram using the Holter method (HM-ECG). The most temporal and spectral indicators of HRV, heart rate (HR), values ​​of the circadian index (CI) were analyzed.

Results

As a result of the analysis, we obtained data on the high stability of the average daily values ​​of heart rate, CI in students of both groups.

Comparison of the mean values ​​of the HRV time analysis indicators, reflecting the total autonomic regulation of the heart rate, did not reveal statistically significant differences in the indicators between the comparison groups, but showed the predominance of parasympathetic regulation in the group of students who changed the climatic zone of residence (SDNN 221.89 ± 124.68 msec, SDANN 204.15 ± 107.53ms, RMSSD 106.84 ± 19.60ms, pNN 50 17.79 ± 14.14%) compared to students permanently residing in a temperate climate (SDNN 192.465 ± 50.19 msec, SDANN 173.09 ± 49.51 msec, RMSSD 68.332 ± 44.2536 msec, pNN 50 20.69 ± 9.77%). The results of a comparative analysis of high-frequency parameters showed some predominance of the sympathetic influence of the autonomic nervous system in the group of students living in a temperate climate.

Conclusion

As a result of the analysis, we did not reveal any changes in HRV indicating the mobilization of the functional reserves of the body and the tension of the regulatory systems in students of both groups, the strengthening of the autonomous circuit of heart rate regulation indicates satisfactory adaptive capabilities of students in the process of acclimatization.