Vol 11 (2022): Materials of the XVIII International Burdenkov Scientific Conference on April 14-16, 2022

Relevance. Pelvic presentation childbirth occurs in 3-5% of full-term pregnancies. The frequency of abdominal labor with pelvic presentation is 60-70%. The high risk of possible complications during abdominal childbirth dictates the search for safe and effective methods of correction of pelvic presentation of the fetus, therefore, today, external rotation of the fetus on the head (NPP) is increasingly heard in foreign and domestic literature.
The purpose of the study. To assess the feasibility and safety of NPP on the head during pregnancy closer to full term.
Materials and methods. A single-stage cross-retrospective study included 90 patients for the period 2020-2021, of which 30 patients with pelvic presentation who had an attempt at NPP (the main group), 30 pregnant women with pelvic presentation of the fetus who had a plan of delivery through the natural birth canal, 30 women - childbirth in the head presentation of the fetus (control group). All groups met the criteria for inclusion and exclusion from the study.
Results. The attempt of external rotation of the fetus to the head was successfully completed in 93.3% of pregnant women of the main group, in 6.7% it was not possible to change the presentation of the fetus as a result of the rotation. In 7.1% of cases of successful attempts to turn the fetus on its head, the fetus returned to its original position after 2 days. None of the above clinical cases required an emergency caesarean section. An analysis of the possible reasons for the unsuccessful attempt to turn revealed the following: the body mass index in this group of women was significantly higher compared to the patients who managed to turn, respectively 23.6 ± 4.4 and 30.5± 2.1 kg/m2 (p=0.035). The analysis of the outcomes of childbirth showed that in the main group 92.9% of cases were delivered through the natural birth canal, the remaining 13.3% - by caesarean section (p<0.05). NPP per head is quite effective and useful, as it allows to reduce the percentage of cesarean sections by 3.0 times (13.3 and 40.0% (p<0.05)), reduce the frequency of birth injuries (3.8% and 66.7%) by 18 times (p<0.05) and reduce perinatal morbidity (26.4 and 46.2%) by 1.75 times (p>0.05).

Relevance. The development of medical digital technologies goes in a number of directions: prevention, determination of diagnostic parameters, control of the course and effectiveness of treatment, consulting support and patient support. Mobile healthcare (mHealth) is a new direction in the IT field, focused on both the doctor and the patient. Digitalization, transition to electronic document management, development of telemedicine are the key tasks of the national project "Healthcare".
The purpose of the study. Develop a mobile application for pregnant women that allows you to quickly assess your health status. Basic requirements: simplicity of the interface, the possibility of autonomous operation without Internet access, concise design, compliance with current clinical protocols.
Materials and methods: object-oriented programming in the Java IDE integrated environment, current clinical protocols of the Russian Society of Obstetricians and Gynecologists (ROAG)
Results: a mobile application for pregnant women has been developed that allows for rapid self-diagnosis of abnormalities during pregnancy, psychological state, and health status. The software package includes three blocks: "My health", "My pregnancy", "My psychological state". The results of testing in each of the blocks determine the need for consultation with an obstetrician-gynecologist, a general practitioner, a psychologist of a women's consultation.
Conclusion: the introduction of mobile applications into the work of outpatient services, in particular women's consultations, will significantly increase the availability and quality of medical care, significantly reduce the financial costs of medical institutions for unreasonable appeals. The predominant use of software components that do not require Internet access allows the population of remote areas to receive reliable and up-to-date information about their health that meets all current clinical recommendations.

The purpose of the study: To study the possibility of the effectiveness of ultrasound as the most accessible method of identifying the causes of menstrual disorders.

Relevance: Human papillomavirus (HPV) is the most common viral infection of the genital tract in the world. The peak period of infection for both women and men begins shortly after they become sexually active. The introduction of the virus into the body occurs when the integrity of the tissues is violated. HPV infects stem cells of the basal layer of the epithelium. The introsomal form of persistence determines the leading role of HPV in the pathogenesis of cervical cancer. The increase in morbidity, the high prevalence of unprotected sexual intercourse among young people, as well as the high mortality rate from cervical cancer determine the need to find new approaches to solving this problem, including the development of new methods for diagnosing HPV carriers.The purpose of the study: to identify and study the features of the phenomenon of arborization of cervical mucus in female carriers of the human papillomavirus.Materials and methods: microscopy of 100 native preparations of cervical mucus using the techniques of crystalloscopy and tachymetry at the Research Institute of EBM VSMU. N.N.Burdenko The obtained results were subjected to statistical processing in the software packages STATISTICA (StatSoft Russia 4.0) and Microsoft Office 2010.Results: during microscopy of cervical mucus preparations taken from female HPV carriers, a change in a number of crystalloscopic indicators was noted: the indices of structurality and crystallizability; the dependence of the degree of crystallization on the pH of the separated cervical canal was revealed; higher tachymetric indicators were established.Conclusion: the revealed changes in the crystalloscopic and tachymetric patterns may indicate a change in the physico-chemical parameters of cervical mucus in women infected with HPV.

Relevance. The human CDKN2A gene encoding the p16INK4A protein is located at locus 9 of the chromosome, which is subject to a high mutagenesis rate. Several tens of missense mutations have been described, accompanied by the replacement of one amino acid residue in the p16 INK4A polypeptide chain, as a result of which the binding activity of the protein against CDK4 is reduced. At the same time, the effect of amino acid substitutions on the binding affinity of p16INK4A with its dominant CDK6 ligand requires further clarification in light of the critical role of the p16/CDK6 complex in the regulation of mitotic activity in eukaryotic cells. In the present work, the biological consequences of replacing arginine at position 87 of the polypeptide chain with tryptophan are considered in the context of the affinity of the p16INK4A mutant type for CDK6. Target. Analysis of changes in the binding affinity and interaction interface of the R87W mutant type p16INK4A protein with the predominant cyclin-dependent kinase CDK6. Materials and methods. Structural and functional consequences of replacing arginine with tryptophan at position 87 of the p16INK4A protein polypeptide chain in the context of the formation of a molecular complex with cyclin-dependent kinase CDK6 were analyzed using structural bioinformatics and computer biology methods. Results. It was found that the replacement of the R87W amino acid residue is accompanied by changes in the secondary conformation, physicochemical properties of p16INK4A, and also in the interface of its interaction with CDK6. The predicted ΔG values ​​of binding and dissociation constants of p16/CDK6 ≈ -9.94 kcal/mol and ≈ 5.12e-08 M, respectively, while the predicted values ​​of ΔG binding and dissociation constants of the mutant type p16R87W/CDK6 ≈ -9.49 kcal/mol and ≈ 1.10 e-07M respectively. Conclusion. As a result of the pyrimidine > pyrimidine transition at position 21971100 of human autosome 9, which corresponds to the E2 exon of the CDKN2A gene, a missense mutation occurs, the essence of which is a nonsynonymous replacement of cytosine with thymine in the coding chain of the gene, as a result of which the complementary nucleotide adenine appears in the template chain . Thus, the elongation of the primary transcript is accompanied by the formation of a single tryptophan-coding codon UGG. Ultimately, R87W is replaced in the polypeptide chain of the p16INK4A protein, leading to changes in its secondary conformation, physicochemical properties, and energy profiles of the interaction interface with CDK6. The results of this in silico study demonstrate a decrease in the binding affinity of the R87W mutant type tumor suppressor p16INK4A to the cyclin-dependent kinase CDK6, illustrating the importance of conservation of the amino acid context in the region of the pre-loop turn of the ascending α-helix 3 of the ankyrin repeat in light of the inhibition of the G0/G1 and G1/S transitions by the p16INK4A protein.

Relevance. The use of air ambulance is the most important component of medical support, which, first of all, determines the effectiveness of medical care provided to various groups of the population.
Goal. To analyze the history of the development and application of aviation in medicine, as well as to try to justify further opportunities and ways to improve the air ambulance service in the Russian Federation.
Methods. There was a review and study of the literature that was devoted to this topic, the study of materials from the university archive, as well as the integration of information from historical sources about the development of air ambulance in our state from the beginning of the XX century to the present.
Results. In our country, the development of the air ambulance service was mainly through the introduction of specialized sanitary transport used during military operations and in peacetime in various emergencies. During the Second World War and in the post-war period, air ambulance was successfully used both for evacuation and for the provision of qualified medical care. The main advantage of the technical means used in this case was the ability to take patients out of the emergency zone with simultaneous monitoring of their condition and the possibility of carrying out the necessary resuscitation measures, including during flight, that is, on board these vehicles. The analysis of samples of transport, which was used in the past and is currently being used, showed their high efficiency, as well as the need for their use during emergencies. The use of this service has its advantages and disadvantages, which determine the expediency of using it in emergency situations of various kinds.
Conclusion. The use of sanitation during medical evacuation made it possible to significantly increase the effectiveness of providing medical care to the wounded and injured in emergencies of peacetime and wartime, thereby saving a large number of lives.

Relevance. It is well known that bad habits shorten life expectancy. One of the most harmful and widespread in the Russian Federation is smoking. This has been proven by numerous studies, but people continue to inhale the dangerous combustion products of tobacco and cause irreparable harm to their bodies. Nicotine is incredibly dangerous for a teenager, because important physiological changes occur at this age. The body has not yet formed and therefore is vulnerable to toxins that act on it more strongly than on an adult, the child quickly gets used to it. Most smokers get acquainted with cigarettes during adolescence, so it is important to conduct educational work among students in grades 5-9.
Target. Analyze and prepare material that can later be used to combat smoking among students of educational institutions.
Materials and methods. The review and analysis of the literature on this topic made it possible to study the materials and studies of Internet resources.
Results. Smoking has a detrimental effect not only on individual organs and their systems, but also on the physical and mental development of a teenager's body in general.
Conclusion. Smoking is perceived by adolescents as a habit associated with a strong deterioration in health in the distant future, at the moment causing almost no harm to them. This is an erroneous opinion, which is stated in the work.

Relevance. The city of Voronezh is a rapidly growing, highly developed city. In this regard, the health of the population is considered one of the most important indicators, which, first of all, depends on the quality of the environment.
Continuous monitoring of the state of atmospheric air makes it possible to assess the risk to health among residents, including carcinogenic. In the presented article, the influence of the atmospheric air of a large city on the level of oncological morbidity of the population, the composition of the air in various districts of Voronezh, and an assessment of the carcinogenic risk were analyzed.
Target. Identification of the carcinogenic effect of atmospheric air and assessment of the risk of oncological diseases in the city of Voronezh.
Methods. Study of available documentation and literature;
Analysis of archival sources on the selected topic;
Obtaining official statistics
Results. Toxicants with the highest possible risk of affecting the population were identified and ways to minimize their impact on a living organism were determined. Also, the largest enterprises of the city of Voronezh were identified, in the emissions of which these carcinogens are present.
Conclusion. Given the peculiarities of the composition of pollutants and the proximity of industrial enterprises to residential areas, it is necessary to carry out systematic monitoring and measures to reduce emissions into the atmospheric air.

The influence of social and biological factors on the mortality of children under one year old living in the conditions of the DPR, an ecologically unfavorable region, which has also been subjected to military influence in the last 8 years, has been studied; the need for a clear organization of preventive and therapeutic measures. The work used statistical materials of statistical collections of the Republican Center for the Organization of Health Protection, Medical Statistics and Information Technologies of the Ministry of Health of the DPR for the period 2014‒2021, practical material of the sanitary and epidemiological service of the DPR; survey was carried out. The leading role of the influence of biological factors in the early periods of life has been established - this is gender, the nature of feeding, the number of abortions. Of the social factors, the main ones were determined by the level of per capita income, the culture of the mother, military operations. Despite the uniformity of the influence of these factors, the level of infant mortality in the main and control groups was different - the highest values ​​of infant mortality were determined in settlements with more intense hostilities and environmental pollution, which suggests the possibility of an indirect effect of these factors on the health of this age group. . Conclusion: the analysis of infant mortality has shown that factors of both a biological and social nature have a rather pronounced influence on its level. The role of the latter was decisive in almost all periods of the first year, while biological factors were the main ones in the neonatal period.

The presented article reflects the features of the NVNPP operation, its technical parameters of new power units. The main damaging factors in emergency situations at this power facility were determined, the levels of organization of radiation control and ways to minimize the impact of ionizing radiation both on the NVNPP employees and on the population of adjacent areas and environmental well-being were identified. The features of first aid in an emergency and the organization of evacuation measures to safe areas are noted. Adequate maintenance of the normal operation of radiation-hazardous facilities, which is the NVNPP, is impossible without the creation of a specific control system, which includes, in addition to a number of organizational measures, specific tasks to determine the level of safety in the operation of new nuclear reactors at the NVNPP. In addition, the procedure for ensuring the radiation safety of the population and personnel in the event of an accident at the NVNPP, as well as the procedure for evacuating the population, is revealed. Special attention was paid to objects that are subject to environmental monitoring and environmental control, laboratory control methods, as well as the ARMS system - an automated system for monitoring the radiation situation, and references were made to legal documents regulating activities in the field of radiation safety at NVNPP.

Relevance: Fats are the main source of human thermal energy and a necessary part of a balanced human diet. At the same time, fats consumed by humans are not chemically pure substances, but are a fatty mixture that varies greatly in its composition depending on the type of products and ingredients used in the preparation. And the unbalanced systematic use of components of a fat mixture with food by a person can lead to the development of a number of diseases such as disruption of the gastrointestinal tract, diseases of the cardiovascular system, etc. Therefore, products with a large amount of fat require special control and regulation of consumption by the population.

Purpose: to evaluate the fatty acid composition of fat-and-oil products sold in retail outlets in the Voronezh region according to its layout on the shopping malls.

Methods: laboratory, chromatographic, analytical, hygienic.

Results:

On the "Golden shelves" of retail chains there are products in the average price range. The cheapest samples of fat-and-oil products are located on a shelf that is above eye level at arm's length. The main differences in the fat composition among the compared samples were found in goods located on shelves at arm's length and on the lower shelves. A sample of butter contains PUFA in the amount of 0.29 g / 100g of the product, MNFA and NLC - 21.6 and 47.71 g / 100g of the product, which differs from the fat composition of both samples from the top shelf and samples from the "Golden Shelves". In the samples of margarine and spreads selected on the shelves at arm's length, PUFA is contained either at the same level - 8.78-8.89 g / 100 of the product, or in an amount 2 times higher than the PUFA content in the samples of spread and margarine from the upper shelves - 12.29-15.53 g /100 of the product. There was also an increased content of trans-isomers of fatty acids, rather than in the images from the upper shelves (0.48-1.26 g/100g of the product and 0.07-0.23 g/100g of the product, respectively).

The data of the conducted research can be used to make additions to the regulatory framework governing the conduct of risk-based supervision during scheduled inspections by officials of the Rospotrebnadzor Department.

Relevance: Vaccination as a way to fight infections has proven to be effective. To date, immunization against COVID-19 is a very controversial issue. The world is divided into two fronts - defenders and opponents of vaccinations. The proportion of the vaccinated population of the Voronezh region as of January 20, 2022 amounted to 55.4%. The paper addressed the issue of one of the topical methods of combating a new coronavirus infection - vaccination. To assess post-vaccination reactions, a survey of 671 residents of the city of Voronezh was conducted from June to September 2021.

Purpose: To evaluate the frequency of post-vaccination reactions after immunization against COVID-19.

Materials and methods: general scientific, hygienic, epidemiological, sociological using a questionnaire.

Results: According to the results of the study, it was found that in 48.81% of those who were immunized, post-vaccination reactions were not observed. The most common symptoms for the introduction of immunobiological preparations were weakness, soreness at the injection site and body aches (93.45%, 92.26% and 64.29%), followed by reactions at the injection site - 38% and an increase in body temperature up to 380C (36.61%). Significantly more often, pain at the injection site was noted with the introduction of the first dose of the drug, an increase in body temperature to 390C during repeated vaccination. Significantly more often, the duration of symptoms was observed in the first two days in relation to the 3rd-7th days after immunization (p=0.0003, CI 1.06-1.98, χ2-20.64). It was established that when vaccinating "Sputnik V" and "KoviVak" there were observed - pain at the injection site, weakness, body aches then, when using the drug "EpiVacCorona" - pain at the injection site, weakness, fever. The duration of symptoms of 1-2 days was observed after immunization with Sputnik V and KoviVak, after vaccination with EpiVacCoron, the duration of symptoms was 3-7 days. This study once again proved the importance of vaccination.

Conclusion: According to the data obtained, out of 671 people who took part in the survey, 336 were vaccinated. Of these, 48.81% did not experience post-vaccination reactions, and 51.19% had the most pronounced weakness, soreness at the injection site, and body aches. It is noted that the similarity of post-vaccination symptoms and their duration during vaccination with Sputnik V and CoviVac, in contrast to immunization with EpiVacCoron.

Distance learning has become an integral part of the education of modern schoolchildren due to the epidemic situation. The online learning format has its advantages: comfort, accessibility, individual approach, an increase in the duration of a night's sleep, an increase in academic performance and, as a result, an increase in motivation to study. But distance learning can also have a negative impact on the health of students: spending time at an electronic monitor increases 4-5 times, which entails a load on the visual apparatus, the musculoskeletal system, leads to sleep disorders, increased physical and mental fatigue. There is a violation of metabolic processes and a decrease in the body's resistance to infectious agents, which leads to increased access to doctors and a waste of health resources. 114 schoolchildren took part in our study. A quarter of schoolchildren noted a deterioration in their health. There was a significant decrease in motor activity, an increase in BMI, an increase in complaints of headaches, a decrease in visual acuity. 17% of schoolchildren believe that their health has improved. It is impossible not to note an increase in the duration of night sleep and an improvement in academic performance, which can have a positive effect on psychological health. Distance learning undoubtedly has both its positive features and a negative impact on the health of schoolchildren. To reduce the negative impact of online learning on the health of students, it is necessary to develop hygienic preventive measures in the current situation.

The article presents the results of a study to study the prevalence of tobacco smoking among medical workers of public health organizations in Simferopol. Anonymous survey of 75 respondents was carried out. The questionnaire included questions on the demographic and socio-structural characteristics of the sample, determining the causes and intensity of smoking, as well as individual attitudes towards tobacco smoking and the role of health workers in the prevention of tobacco use. Every fourth of the respondents (25.3%) has a commitment to this bad habit. The distribution of smokers by age groups was: 20-29 years old - 36.8%, 30-39 - 31.6%, 40-49 - 26.3%, 50-59 - 5.3%. The dependence of the prevalence of tobacco smoking on gender differences and the level of education has been established. The number of smokers is dominated by men (68.42%) with specialized secondary education. The average smoking experience of employees of treatment-and-prophylactic organizations is 11 years, the intensity of smoking from 10 to 20 cigarettes per day was found in 42.87%, over 20 cigarettes - 20%. The main motives determining smoking behavior are habit as a ritual; a tool that allows you to cope with negative emotions and stress, as well as a way to maintain performance. Low motivation of medical workers to quit smoking was revealed, which requires more active preventive work to correct addictive behavior.

Annotation. The article analyzes the medical support of those injured in man-made accidents on the territory of the Voronezh region. The specificity and classification of man-made accidents are considered, aspects of this type of emergencies that complicate the provision of medical care are identified. The features of the organization of medical support for those affected by man-made accidents, the types of medical care provided and the conditions for its provision are given.

The relevance of our work is due to the fact that in large cities there are many 
economic facilities that are dangerous for the population, and the timely provision 
of medical care is important for saving lives. The purpose of our work is to study 
the features of medical support for those affected by man-made accidents in the 
Voronezh region. To achieve it, methods of analysis and synthesis of scientific 
publications and literary sources on the topic under consideration were used.

Tasks. 
To study the specifics of man-made accidents. 
Consider the organization of medical 
support for those injured in road traffic accidents in the Voronezh region. 
To analyze statistics and assistance to victims of man-made accidents.

To achieve the goals and objectives set before us, such materials and research 
methods were used as:
1) collection and analysis of material in the field of the specifics of 
man-made accidents;
2) collection of information on the websites of the Ministry of Internal 
Affairs and the Ministry of Emergency Situations of Russia for the Voronezh 
region in the field of traffic accidents and analysis of these data;
3) collecting information on hospital websites and contacting hospitals 
using communication tools to analyze information on the number of beds in 
certain departments.

Conclusions:
1) The organization and implementation of medical support for those injured 
in man-made accidents form one of the most important sets of measures for the 
general medical support of the population of the Voronezh region.
2) The activities of this complex are aimed at ensuring the timely provision 
of the necessary medical care to the injured in the required volume, the prevention 
of complications and the speedy restoration of their health.
3) The effectiveness of medical support for the injured depends on the advance 
preparation of the medical service for actions during the emergency period, the 
professional preparedness of medical workers and interaction with emergency services.

The article presents basic information about the level of physical activity in the life of students, as well as its subjective assessment of their own health status. The study was carried out using the anonymous questionnaire method. It was held on the basis of three higher educational institutions of the city of Voronezh with the participation of students of I, II, III courses. In a comparative analysis, it was found that the majority of medical university students assess their own state of health as "satisfactory" (50.8%), while their peers from technical universities - VSTU and VSUIT - gave a higher assessment of their level of physical health. Thus, the answers "good" and "excellent" prevail, amounting to a total of 73.3% for the technical university and 59.4% for the university of engineering technologies. It can be noted that there are significant differences between the level of motor activity of students of three educational organizations with different profiles of education. The best indicators of physical activity were recorded among respondents from VSTU, while these indicators are much lower among VSMU students. This is due to the fact that physical activity is largely determined by the availability of time free from training sessions, which can be used for physical exercises and other types of activity.
In order to solve the problem of lack of physical activity of students, it is advisable to make adjustments to educational programs, improve the infrastructure of educational institutions and plan physical education activities that allow students to lead an active lifestyle.

The article shows a scheme of the effectiveness of the use of various antithrombotic therapy in patients with myocardial infarction in the focus of the postinfarction period. Relevance. Myocardial infarction is one of the causes of disability and decline among the population of developing and export countries. For the prevention of secondary thrombotic complications and myocardial infarction, often fatal for patients with an early post-infarction period, lifelong maintenance therapy with antiplatelet agents. For this reason, the expected effectiveness of such therapy in patients with suspected post-infarction period. Objective: to evaluate the effectiveness of antithrombotic therapy with acetylsalicylic acid in combination with clopidogrel and ticagrelor in patients with acute non-ST elevation myocardial infarction in the identified postinfarction period. Materials and methods. For the study, 54 patients aged 58 to 74 years who had acute subendocardial myocardial infarction without ST segment elevation and without a pathological Q tooth, who were present in the postinfarction period, were identified. The patients were divided into two groups of 27 people. Patients from the first observation group were treated with acetylsalicylic acid 75 mg/day and clopidogrel 75 mg/day, in the second group - acetylsalicylic acid 75 mg/day and ticagrelor 180 mg/day (90 mg divided into two doses per day). To evaluate the effectiveness of therapy, the VerifyNow test system and the flow cytometry method with the determination of P-selectin expression were used. Results. It was found that aspirin monotherapy is not a sufficiently high-quality method for the prevention of cardiovascular complications. From the above results, it follows that both treatment regimens have a pronounced antithrombotic effect. However, the combination of acetylsalicylic acid and ticagrelor in general showed a more rapid decrease in P-selectin expression and PRU, resulting in a significantly greater effect. 1 patient from the first group and 2 patients from the second group were weakly receptive to the proposed choice, which subsequently occupied a special place in individual therapy and drugs. Conclusion. Thus, it was found that clopidogrel and ticagrelor are quite effective drugs in the context of the ongoing early post-infarction phase, which was manifested in a more pronounced use of control of platelet system parameters. It was noted that combination therapy with ticagrelor and acetylsalicylic acid has a more pronounced effect than therapy with clopidogrel and acetylsalicylic acid. However, the features of the features and the presence of mechanisms of resistance of patients to the approach to the use of these drugs should be strictly individualized.

The economy, environmental factors, as well as modern conditions for the development of students - adversely affect their health. The trend of growth in the number of students who need specialized medical and psychological assistance, more sparing organization of the educational process is revealed. Students from all over the world have an increased risk for health reasons. This conclusion was obtained as a result of a contradiction existing in the system of higher professional education. It consists in optimizing the educational process of higher education institutions in order to maintain the health of students and simultaneously increase the intensity of the educational process in order to increase the level of knowledge of students. Every year, the number of reliable and thorough studies of social health factors in groups of children and adolescents increases, while a small amount of relevant information remains regarding the health of students. The reason for this is the lack of statistical indicators and the limited research opportunities in this group. The studies available to date, in relation to this problem, give alarming results. This indicates that the health of students, as well as the development of technologies that promote prevention and health protection, are, at the moment, insufficiently studied.

Relevance: for a long time studying the appointment of coraxan to patients with coronary heart disease, it was found that this drug significantly improves the quality of life of the patient and health indicators. Purpose: a real reasonable assessment of the effect of coraxan on HRV parameters in patients combining COPD with exertional angina. Materials and methods: the study was carried out according to all the requirements of the ethical committee, and also approved by it. Inclusion criteria and exclusion criteria were included - in two cases, patients gave informed voluntary consent. The main complex of studies was carried out on the basis of the "Voronezh Regional Clinical Hospital No. 1", amounting to 150 people. Both anamnestic and conservative methods, as well as hardware ones (“ETON”) were used. Conclusion: Thus, we have built a model that allows us to evaluate the effect of Coraxan when it is used in the treatment of patients with coronary artery disease after CABG and in conditions of conservative therapy with positive practical application.

Relevance: the actual problem of medicine as a science has always been the adherence of patients to the treatment prescribed by a specialist, because the effectiveness and speed of restoring the health of the person who applied for help has always depended on the exact and most strict execution of medical prescriptions [1]. The XXI century has made its own adjustments in this area of interaction between a doctor and a patient.
The purpose of the study: to assess the adherence of patients of different age groups to therapy at the outpatient stage, depending on the degree of their use of information technology
Materials and methods: The study was conducted using our own questionnaire on the use of information technologies by a particular patient in combination with the Morisky-Green questionnaire designed to assess patients' adherence to treatment, as well as the HADS anxiety and depression scale. Statistical processing was carried out using the Microsoft Excel program. All patients gave informed consent to participate in the survey.
Results: analyzing the data obtained using the Morisky-Green questionnaire, three groups were identified among the respondents: compliant (18 people), non-compliant (31 people) and the least committed to treatment patients (11 people).
After processing the data obtained using the HADS anxiety and depression scale, it turned out that the average level of depression and anxiety in compliant patients was higher than the corresponding indicators in non-compliant and least committed to treatment patients.
The results of their own questionnaire: 17 people give their preference to the Internet in the search for information, 35 respondents searched for information about their disease before visiting the attending physician, patients use technical devices with Internet access on average 4.5 ± 0.8 hours a day, and directly from the Internet, patients participating in the study consume information on average 3.8 ± 0.6 hours a day.
Conclusion:
1. Based on the analysis of the above data, we can say that the patients who are most located and trust the knowledge obtained from virtual environments have an average age of 39.8 ± 4.1 years, since representatives of this age category are more socialized, as a rule, actively use the Internet in everyday life to communicate with their family members, colleagues and consumption of entertainment content.
2. Patients who use Internet resources as a source of information immediately before outpatient admission are more committed to the prescribed treatment than other respondents, at the same time they are characterized by a significantly higher level of anxiety and depression, which can negatively affect the treatment and recovery process.

Relevance.The rapid spread of COVID-19 and the high incidence of diabetes mellitus (DM) in Russia make it relevant to study DM as a risk factor for COVID-19 severity and mortality.

Objective.To determine the incidence of DM as a comorbidity in COVID-19 in the Russian population, to determine the influence of DM on the severity and mortality in COVID-19, to evaluate the effect of metformin in patients with DM on mortality from COVID-19.

Materials and Methods.We analyzed 386 medical records of patients hospitalized between 02.02.2020 and 21.03.2021 with COVID-19. Comorbidities and DM therapy were recorded. Patients were divided into 2 groups according to the presence or absence of DM. The duration of hospitalization, frequency of transfer to intensive care unit (ICU), mortality, data of laboratory and instrumental studies were analyzed. DM patients were divided into 2 groups: the first did not take metformin, the second took metformin - the duration of their hospitalization, ICU length of stay, COVID-19 mortality were estimated.

Results.Structure of comorbidities: 64.8% of patients had arterial hypertension, 40.9% had obesity, 22.5% had chronic kidney disease, 21.0% had DM, 10.9% had coronary heart disease, 10.6% had chronic respiratory disease, and 10.4% had atrial fibrillation. Hospitalization duration was 15.17±21.43days in the group without diabetes vs 13.68±5.85days with diabetes (p=0.633), ICU length of stay 7.9%vs13.6% (p=0.114), outcomes (9.5% died without diabetes, 14.8% with diabetes, p=0.168) were not statistically significantly different. Patients with diabetes had lower saturation on admission (94.30±3.5vs93.15±4.58, p=0.005), higher C-reactive protein (71.55±61.89vs106.09±83.24, p<0.001), they required respiratory support more frequently (p=0.027,39.35% of patients without diabetes vs56.7% with diabetes received it: 32.8%vs45.7% - oxygen therapy, 0.65%vs2.5% - noninvasive ventilation, 5.9% vs8.6% - invasive ventilation), administration of biological agents (18.0%vs28.4%, p=0.039) and acticoagulants (90.5%vs97.5%, p=0.044). 

No statistically significant differences were found between the groups of patients not taking metformin and those taking it: length of hospitalization (14.06±4.86vs13.09±6.25, p=0.232), ICU length of stay (16.7%vs7.5%, p=0.262), outcomes (mortality 22.2%and7.5%, p=0.089).

Conclusion.DM has no effect on the severity and mortality of COVID-19. This result was associated with more aggressive therapy in DM patients. Treatment of DM with metformin was not associated with a reduction in mortality from COVID-10.

Relevance. This article discusses the prevalence of concomitant diseases in patients with COVID-19, carried out a statistical analysis and identified the most common pathologies. Purpose: to identify the prevalence and type of concomitant diseases in patients with COVID-19.
Materials and methods: statistical and mathematical analysis, generalization, comparison. Results: During 6 months of 2021, 678 patients with the main diagnosis of COVID-19 underwent inpatient treatment at the VUZ VO VGKB No. 20. Among them, 2 groups were distinguished: men and women. The number of men in the total number of patients was 42.48%, women - 57.52%. In the course of further research in each group, patients were divided into 7 age categories. Among all groups of patients, the prevalence of comorbidities was determined: hypertension, coronary heart disease, diabetes mellitus, etc.
Conclusion: It is necessary for the doctor of the therapeutic department to correctly and timely identify comorbidities, as well as to know which of them occur quite often and at what age. The most common are hypertension and type 2 diabetes. Therefore, the diagnosis of comorbidities is essential for the proper management of patients with COVID-19.

Relevance. Chronic lower limb ischemia (CLLI) is associated with a two-fold increase in the risk of mortality, mainly from cardiovascular disease. Progression of coronary heart disease (CHD) and CINK stage 2B according to Fontaine-Pokrovsky leads to the development of large cardiovascular events in the hospital and long-term periods, can lead to the development of critical ischemia of the lower extremities, as well as amputations in the absence of treatment. The main goal in the treatment of these patients is to preserve the lower extremities and reduce cardiovascular risk, in particular, reduce the number of myocardial infarctions (MI). To date, there is no single point of view in choosing a strategy for the treatment of patients with stage 2B CLCI, in whom conservative therapy was ineffective, in combination with concomitant significant damage to the coronary arteries. Purpose. To evaluate the results of treatment in patients with CLII stage 2B in combination with coronary artery disease. Materials and methods. On the basis of the National Medical Research Center for Surgery named after A.V. Vishnevsky, the results of treatment in 92 patients with CLII stage 2B in combination with coronary artery disease were analyzed. Patients were divided into 2 groups: group 1 - PCI and lower limb artery stenting (LEA) and group 2 - PCI and open surgery for LA. Among 92 patients, 70 (76%) were men. The mean age of the patients was 65.7 ± 7.7 years. Angina pectoris II-III FC according to CCS occurred in 72 (78.2%) patients, painless form of myocardial ischemia - in 20 (21.8%). Single-vessel coronary artery disease (narrowing over 50%) was diagnosed in 23 (25%) patients, two-vessel lesion in 34 (36.9%), and three-vessel lesion in 35 (38%) patients. In 72 (78.2%) patients, a unilateral lesion of the ANC was diagnosed, in 20 (21.7%) - bilateral. Results. At the hospital stage, no MI, stroke, or deaths were observed in both groups. In the long-term period, the results were evaluated in 76 (82.6%) of 92 patients: group 1 - 37 (48.7%) and group 2 - 39 (51.3%) of 76 evaluated patients. In group 1, 2 (5.4%) patients out of 37 experienced 2 (5.4%) MI and 1 (2.7%) death due to pneumonia. In group 2, 1 (2.5%) of 39 had a non-fatal MI. There were 5 (12.8%) deaths in total: 2 (5.1%) MI, 1 (2.5%) oncology, 2 (5.1%) complications after COVID-19. Conclusions. 1. X-ray endovascular and combined strategies for the treatment of patients with CLCI in combination with coronary artery disease showed their safety and effectiveness. When performing 198 interventions in 92 patients (average 2.1 operations per 1 patient), no severe cardiovascular complications were observed. We suggest that timely PCI in patients with CLCI helps to avoid major cardiovascular complications.

Objective: To study the features of the cardiovascular system in patients with systemic lupus erythematosus

Purpose: To draw the attention of society to the history of Voronezh TСDM

Methods: analysis and study of materials and articles on the history of the centre

Relevance. Nowadays, there is a high probability of occurrence of emergency situations at economic facilities. This implies the need to inform the population and employees of these facilities about the consequences of possible accidents, the procedure for dealing with them.

Goal. Systematization of information about emergency hazardous facilities located on the territory of the city of Voronezh; study of the damaging factors of emergencies at economic facilities; study and analysis of ongoing measures to ensure industrial safety.

Methods and Materials. The study, analysis and generalization of literature, qualitative and quantitative processing of information obtained from the structure of the GOCHS in the Voronezh region.

Results. We have identified the main causes contributing to the occurrence and development of accidents; the factors on which the scale of the accident depends have been identified; the zone of possible fatal damage from suspected accidents has been established.

Conclusion. Based on the analysis, it was found that in order to reduce the danger in the event of an accident of various origins, it is necessary to provide enterprises with PPE, clear planning of the notification system and the order of action of the organization's forces, as well as close inter-organizational interaction.

The article presents an assessment of the state of the atmospheric air of the city of Voronezh for a ten-year period (2011-2020), identifies the main air pollutants, highlights the main factors affecting the state of the atmosphere, and presents the results of assessing the risk to public health from exposure to atmospheric pollutants.

In December 2019, an epidemic of a new coronavirus infection COVID-19 began. In the process of evolution, the infectious agent mutates with the acquisition of new properties, which causes an undulating course of the epidemiological process with the involvement of the child population in the epidemic process. The aim of the study was to identify the clinical and epidemiological features of the new coronavirus infection COVID-19 in children of the first year of life during the epidemic rise of the “3-4 waves of COVID-19”. Under observation were 49 patients with laboratory-confirmed by PCR method of a new coronavirus infection COVID-19 at the age of 1-12 months, who came, as a rule, from family foci of infection. The main manifestations of the disease were predominantly subfebrile temperature in 87.7% of the observed, dry cough in 73.5% of cases and moderately severe catarrhal phenomena like nasopharyngitis in 41% of children. Pneumonia (CT-1 lesion area) was diagnosed in 46.9%. It was not accompanied by clinical signs of respiratory failure and a drop in saturation. The severity, to a greater extent, was determined by metabolic disorders, which were marked by a long-term persistence of an increase in the values ​​of blood lactate, LDH, CPK, GGTP, ALT and AST. The increase in CRP was infrequent 26.5%, was insignificant and quickly returned to normal within 10 days.

Federal State Budgetary Educational Institution of Higher Education «Samara State Medical University» of the Ministry of Healthcare of the Russian Federation

The Chair of Infectious Diseases and Epidemiology

Scientific Heads: Ph.D., Associate Professor Konnova Tatiana Vitalevna, Ph.D., Associate Professor Konstantinova Elena Aleksandrovna

Annotation. Relevance. Tularemia is an acute zoonotic disease characterized by a wide distribution, the presence of natural foci, and periodic epidemic outbreaks. Natural foci of tularemia are distinguished by their persistence, longevity, and the ability to manifest themselves after many years of epizootic and epidemic well-being. The main ways and factors of human infection are contacts with infected animals, consumption of food and water contaminated by rodents. Less commonly, infection occurs during the processing and threshing of grain crops. The susceptibility of people to the causative agent of tularemia is 100%.

Purpose: updating the criteria for diagnosing rare highly contagious human epidemic diseases using the example of a clinical case of tularemia diagnosed in September 2021.

Materials and methods. Preliminarily, according to the literature, 16 clinical cases of tularemia that occurred in the Russian Federation and abroad over the past ten years were considered. Two cases of tularemia diagnosed in Samara in 2021 were also studied. Both patients were infected in the Komi Republic.

Results. The largest number of patients were aged 40 to 50 years, and 4 children under the age of 18 also fell ill. One patient was over 60 years of age. Patients underwent a standard general clinical examination, serological examination to detect antibodies to the causative agent of tularemia, ultrasound of the lymph nodes. In children with tularemia, compared with adults, prolonged febrile fever, inguinal lymphadenitis, and micro abscesses were more common. In patients over 18 years of age, abscessing cervical lymphadenitis, exudative pleurisy with serous hemorrhagic effusion, and myocardial dystrophy were more common. In clinical blood tests, leukocytosis, and an increase in ESR were observed. In biochemical blood tests, an increase in C-reactive protein was observed.

Conclusion. A special role in the diagnosis of tularemia is given to a thorough collection of epidemiological history and serological tests. Timely and properly selected antibiotic therapy, considering sensitivity to antibiotics, will help prevent complications of this disease.

Keywords: tularemia; highly contagious disease; lymphadenitis.

Aim: a comparative analysis of the composition and characteristics of the microflora of the pathological discharge of the tonsils in patients who are to undergo surgery for paratonsillar abscess (analyses in 2021), and compare the data obtained with the situation in 2013, based on archival materials.

Methods: the results of microflora inoculation of swabs from the tonsils of patients performed before surgery to open a paratonsillar abscess, as well as tests for antibiotic resistance, were analyzed. The data were provided by the laboratory of the clinic "Center for Modern Pediatrics", for the period from September to December 2021. Next, a comparative analysis of the composition of the microflora in patients with archival data for 2013 was carried out (based on the materials of the thesis of A. I. Yartsev).

Results: Staphylococcus aureus becomes the most common pathogen (total 36 cases, 40.1%), while in 2013 its frequency was only 16.6%, and the most common pathogens were Streptococcus viridans (30.5%) and Staphylococcus epidermidis (25%). In the same study, Staphylococcus epidermidis was isolated from 4 patients (4.4%), but Streptococcus viridans was isolated from 22 patients (24.7%), i.e. the occurrence of opportunistic flora decreased, and Staphylococcus aureus increased significantly.

Conclusion: the microflora that causes paratonsillar abscesses has changed since 2013. In the first place in terms of the number of cases, was Staphylococcus aureus. This can be attributed to its increased antibiotic resistance (strains resistant to several antibiotics exist in every age group). There are also new pathogens (Moraxella catarrhalis, Pseudomonas aeruginosa), which also have antibiotic resistance.

Abstract: the research topic is relevant due to the fact that the intestinal microbiome participates in the metabolic and epigenetic process, is actively involved with them in protective and coordinating functions. Human health, in turn, is connected with the biome. With dysbiosis, a violation of biome functions leads to pathological processes. The microbiota and the immune system constantly interact - with the dependence of the second on the first. Purpose: to determine the effect of various lactic acid products in combination with different bacterial groups on human immunity, analyze it, compare it. Methods: outpatient charts were copied, a questionnaire was conducted with parallel anamnesis, an examination with anthropometry and a laboratory examination - both at the beginning and at the end of the ten-day period of consumption of lactic acid products. Results: the formation of the body's immune system occurs under the dominant influence of the microbiota, as well as the microbial-tissue complex formed by it in the intestine. They also constitute the first line of defense (non-specific). It is the close connection of the immune system with the intestinal microflora that determines the degree of immunity of the body to infectious / non-infectious environmental influences. The level of resistance and the state of the intestinal microflora essentially determine the health of the body. Studies have shown an important positive role of lactic acid products in stimulating and maintaining intestinal microflora, and hence immunity. Conclusion: there is no doubt that the balance of the human intestinal microflora is of crucial importance for health and well-being. The consequence of probiotic therapy and suppression of conditionally pathogenic microbiota is an increase in the number of fecal bacteria (lacto- and bifido-) and the return to normal metabolic activity of the gastrointestinal microbiota. When intestinal epithelial cells interact with probiotic microorganisms, the resistance of cells against pathogenic viruses and bacteria increases. Summing up the presented data, it should be noted: knowledge about the human microbiota, the actions of probiotics has grown significantly recently, and food and drugs with them are already everywhere nearby in everyday life. One of the most important channels for optimizing the intestinal microbiota is their competent use. This in turn leads to the prevention of diseases and a healthy person.

Relevance

To date, COVID-19 continues to be one of the most pressing health problems since the end of 2019. The clinical picture of all infectious diseases has its own characteristics in the child population. Most often, asymptomatic and mild forms were the predominant variants of the disease in the structure of the morbidity of children with a new coronavirus infection. Currently, severe forms with the development of respiratory distress syndrome, multiple organ failure, and isolated deaths are also detected.

Goal

To analyze clinical and laboratory data on the course of a new coronavirus infection in children under the conditions of the COVID-19 pandemic.

Materials and methods

On the basis of the regional infectious diseases hospital in Voronezh, a study of the clinical features of the course of a new coronavirus infection was conducted in 352 children, whose diagnosis was established after the detection of SARS-CoV-2 virus RNA in a smear from the throat and nose by PCR.

Results

The disease most often occurred in 81.8% of children in mild and moderate forms. The most common symptoms were hyperthermia and cough. Febrile temperature was observed in 47.1% of patients, subfebrility in 28.4%, hyperthermia in 14.2%. Over the course of each subsequent wave of the pandemic of a new coronavirus infection, the incidence of children with cough has increased significantly, to 91.2%. There was a tendency to increase the percentage of nasal congestion and rhinorrhea from 10.7% and 8.5% in the first wave to 57.6% and 42.3% in the third wave, respectively. Decreased sense of smell, taste disorders and clinical symptoms of gastrointestinal tract damage were most common in the second wave. According to computed tomography of the chest organs, there was an increase in the frequency of detection of pneumonia from 46.3% in the first wave of the pandemic to 69.3% in the third wave. Clinical signs of respiratory failure, decreased blood saturation developed in 11.8% of children of the third group. During the first and second waves of infection, there was a significant increase in the number of platelets during clinical recovalescence – 230 [180; 270]×109/ l vs. 280 [215; 340]×109/l. Thrombocytopenia, as an unfavorable diagnostic sign, was detected in 15.3% of the third group. Biochemical blood tests showed an increase in the level of transaminases, lactate, CK, LDH, C-reactive protein, ferritin. The children were treated according to modern clinical guidelines.

Conclusion

Throughout the observation, children of all ages were ill, the predominant age group was children of primary school age, regardless of gender. Basically, the disease occurred in mild and moderate forms, but gradually there was an increase in the number of severe forms.

           Коронавирусная инфекция (COVID-19)  вызвала не только глобальную пандемию, но и указала на неподготовленность систем здравоохранения, и меры были приняты под давлением неотложных обстоятельств. Вспышка инфекции начавшаяся в марте 2020 года, все еще продолжается в Кыргызстане, и по состоянию на 2021 год было подтверждено более 86000 случаев заболевания и 1 426 летальных исходов. В настоящее время существуют различные методы, каждый из которых имеет свои плюсы и минусы как в лабораторной надежности, так и в диагностической интерпретации. Ситуация с используемыми методами и их специфическими применениями постепенно развивается по мере того, как болезнь становится серьезной мировой проблемой, и прилагаются значительные усилия для решения текущих проблем.

Abstract. Relevance. In December 2019, a new coronavirus causing severe acute respiratory syndrome (SARS-CoV-2) emerged in China. A number of studies have shown that people living with HIV (PLHIV) with well-controlled disease have no risk of more severe COVID-19 outcomes than the general population. However, there is also evidence to the contrary.
Objective: Study the course of a new coronavirus infection COVID-19 in patients with well-controlled HIV infection using antiretroviral therapy.
Materials and methods. Case histories of 31 patients with COVID-19 were analyzed, of which 14 people had well-controlled HIV infection (group №1), and the remaining 17 people with COVID-19 did not have antibodies to HIV (group №2). All patients were hospitalized at the centre of the Voronezh regional clinical hospital N 8 or the Voronezh Regional Clinical Center for the Prevention and Control of AIDS for the period from April 2020 to September 2021.
Results. Among patients of both groups, such clinical manifestations of a new coronavirus infection as fever, cough, shortness of breath, sore throat, myalgia, headache, nasal congestion, anosmia, diarrhea were equally often observed. The stages of viral pneumonia according to the results of CT in patients of both groups were also comparable. Changes in laboratory parameters in both groups were also similar: leukocytosis, increased levels of CRP, ESR and D-dimer occurred with the same frequency. A small sample of patients does not allow us to reliably determine the mutual influence of HIV infection and COVID-19, however, this study did not reveal an increased risk of severe course and adverse outcomes of COVID-19 in PLHIV with well-controlled HIV infection compared with a group of patients without HIV infections.
Conclusion. The results of the study demonstrate that PLHIV with well-controlled disease are not at risk of worse outcomes of COVID-19 compared to the HIV-free population, which is generally consistent with the literature data.

Relevance. As a result of an increase in the number of pathogenic microorganisms and their resistance not only to antibacterial, but also to antiseptic agents, the problem of pharmacotherapy of purulent-inflammatory processes is formed. Also, in the pathogenetic aspect of purulent-inflammatory pathology, the predominant role of the bacterial component should be highlighted. Moreover, in this case, the appointment of combined pharmacotherapy, including the appointment of both local and systemic use of medicines, is highly effective.

Goal. To study the features of the course of the wound process when using various combinations of pharmacological agents.

Methods. In the course of the scientific work, the material of foreign and domestic literary sources in the field of methods of modeling purulent wounds, methods of pharmacotherapy of this nosological group was analyzed, a chronic experiment on modeling purulent wounds and combined pharmacotherapy of this nosological group was conducted.

Results. The most positive dynamics of the wound process was observed in the combined pharmacotherapy of a purulent wound with the use of intra- hydrogen water, externally - Dioxomethyl-tetrahydropyrimidine + Chloramphenicol (Levomecol) (4 experimental group), where the disappearance of hyperemia, skin edema, the end of necrolysis, the appearance of granulations, epithelialization of the wound, reduction of discharge to scanty faster compared to the data of the 1st control group was observed.

Conclusion. A large volume of research literature on the modeling of purulent wounds in the experiment has been analyzed. The most optimal, accessible and sparing tactics of modeling purulent wounds in rats in the experiment was selected. The optimization of the pharmacotherapy of purulent wounds by the combined use of hydrogen water inside and local antibacterial agents is proposed.

The thesis presents a retrospective analysis of the case histories of 105 comorbid patients in the burn department in order to identify complications during treatment with apixaban.

The goal is to analyze the consumption of medicines and financial expenses using the ABC/VEN analysis system. Methods. ABC-VEN-analysis of drug consumption in the Gomel Regional Clinical Skin and Venereological Dispensary for the period of conversion to fight COVID-19 infection from 01.10.2021 to 20.11.2021 using an automated workplace of a clinical pharmacologist "Pharmsuite". Results. The list of medications used during the treatment of infectious patients amounted to 53 drugs. Amount of funds spent: 71,911.63 bel. rub. ABC analysis meets the requirements: A accounted for 79.6% of spending, B - 15.4%, C - 5%, which is an indicator of the most optimal and recommended allocation of funding. Intra-group ratio: Vital - 12.50%, 25.00%, From 62.50%; Essential - 7.32%, 12.20%, From 80.49%; Non-essential - 0.00%, 0.00%, From 100.00%. Money spent: Vital - 46,625.99 bel. rub.; Essential - 25,118.15 bel. rub.; Non-essential - 167.49 bel. rub. Conclusions. ABC/VEN analysis makes it possible to ensure the rational consumption of funds and the use of medicines with proven effectiveness. The distribution of funds and the use of medicines correspond to the most optimal regulatory values. In the treatment of severe pathology in a pandemic, doctors treat the prescription of drugs carefully, because non-core specialists are engaged in treatment.

Annotation. Currently, the study of the respiratory system using computed tomography has become in great demand due to the spread of a new coronavirus infection. Unfortunately, many people do not have sufficient knowledge about this research method and its possible negative consequences. Due to the lack of necessary information, some patients are ready to conduct this study not only without a doctor's appointment, but also simply for the purposes of a preventive method of research, not realizing at all that they receive a huge dose of radiation.

Relevance. In recent years, computed tomography (CT) has become increasingly common in the diagnosis of a wide variety of pathological conditions. Over the past two years, interest in this method has increased dramatically due to the emergence of a new coronavirus infection, most often affecting the respiratory system with the development of polysegmental bilateral pneumonia. CT has become the method of choice in the diagnosis of COVID-pneumonia [1]. Moreover, this research method finds a place in a number of specific areas of medicine, for example, in pulmonology, traumatology, urology and other fields. At the same time, CT is not a "harmless" procedure, if we take into account that this method refers to radiation and is based on different absorption of X-ray radiation by tissues. Ionizing radiation has stachostic effects that do not have a dose threshold of occurrence, but the probability of which is proportional to the total dose received over a long period of time [2]. Therefore, the choice of this research method should be strictly justified by the presence of indications that only a doctor can determine. Therefore, the population should be informed about the negative effects that can occur with uncontrolled use of CT.

The purpose of the work. Find out if patients are aware of the possible side effects of CT. And also to evaluate the frequency of CT without a doctor's appointment.

Materials and methods. The study involved 68 people who had ever undergone a CT procedure. Everyone was asked to take an anonymous questionnaire on this topic.

The results obtained. During the study, 40 people answered the question "Have you ever had a CT procedure without a doctor's appointment" in the affirmative, 3 respondents had CT performed five times, 2 - four times. Of all the respondents, CT was prescribed by a doctor only in 49% of cases.

At the same time, 87% of those who participated in the study are aware of the possible harmful side effects of this procedure. 85% know about the use of X-ray radiation in CT. Only 2 respondents are ready to carry out CT when the first symptoms of ARVI appear, however, 24% of respondents consider the use of CT to be acceptable for preventive monitoring of COVID-19.

Conclusions.

Based on the above, we can conclude that the majority of respondents are aware of the possible side effects of uncontrolled CT use, but not all of them understand that this harm is caused by the action of X-rays.

In addition, some respondents underestimate the degree of danger of possible side effects, as evidenced by the fairly frequent CT without a doctor's appointment, as well as the willingness to use this method for preventive monitoring of COVID-19.

Therefore, it is necessary to improve the quality of public awareness on this issue by conducting sanitary and educational work.

This article discusses the importance of positron emission tomography in the diagnosis of coronary heart disease and the interpretation of various results. The purpose of the study is to analyze the effectiveness of using this visualization method, its impact on the organ under study and the issues of the correct interpretation of the final results. The material for the study was the results of research by domestic authors. Positron emission tomography is a relatively young research method that allows you to see the presence and development of benign or malignant formations, predict the dynamics of their development, identify the functioning of all body systems as a whole. Based on the conducted research, it can be noted that positron emission tomography has certain advantages in the study of heart diseases over other imaging methods, since we can identify individual areas of the lesion, clearly see the blood filling of tissues and evaluate metabolism, and based on this

Every year, the number of women with various diseases of the mammary glands is growing at a tremendous rate. In this regard, it is of particular importance to study the effectiveness of X-ray mammography and other instrumental research methods in the diagnosis of breast pathologies.

The purpose of this study is to determine the role of X-ray mammography in the instrumental detection of breast diseases and the possibility of using other diagnostic methods to clarify its data.

The study presents data from various scientific articles reflecting the role of X-ray mammography in the diagnosis of breast diseases.

Currently, X-ray mammography is the main method of studying mammological diseases. It allows you to determine the nature and location of the pathological focus in time and with high accuracy. However, sometimes the results obtained during X-ray mammography need to be confirmed. In these cases, other instrumental methods of breast examination are used.

X-ray mammography is currently the leading method of research in the field of breast diseases. The clinical significance of X-ray mammography lies in the possibility of early diagnosis of diseases of the mammary glands, which is especially important when detecting oncopathology.

Researches of the effect of radionuclides on the human body remain relevant up to date. Their effect of penetrating the body is characterized by involvement of numerous systems of human body. The causal relationship of effects depleted uranium exposure has not been specifically defined, but people who live in zones of armed conflict, as well as armed forces personnel, had health problems of "unknown origin", and with remote symptomatic etiology. The risk of possible exposure is also may appear when manufacture of nose spikes for armor piercers and atomic energetics products. In view of these perspectives, depleted uranium, which used in various types of weapons, has been considered as the cause of complaints. Acute uranium intoxication is appeared in polytropic effect that is apparently depended on the resistence of the body. Getting into the internal milieu, depleted uranium exhibits radiation effect of exposure followed by alpha particles radiation. Long-term consequences after oral incorporation of depleted uranium with drinking water are matters of particular interest.

The study purpose is defined by assessing of morphofunctional state of the trachea and thyroid gland, united by topographic proximity and different by morphological heterogeneity, upon one month after a single oral incorporation of an aqueous solution of depleted uranium oxides.

General histological and histochemical staining methods on thin paraffin slices have been performed for studying on morphological and functional state of the trachea and thyroid gland

The results of the morphological and statistical analysis of the trachea wall upon staining with hematoxylin and eosin revealed changes in the structural components that determined deformation of its functionality a month after oral incorporation of an aqueous solution of depleted uranium oxides. Morphological diagnosis was characterized by a change thickness of the epithelial layer, its multi-rowed structure, the cellular composition of the epithelium, and the loss of special organelles. Modifying effect of depleted uranium is also extended to the glandular epithelium with exposure of secretory segments hypertrophy and excretory ducts. There was revealed the diffuse lymphocyte infiltration of the tracheal membranes and formation of lymph nodules. Histochemical analysis of hormone formation in the thyroid gland has demonstrated a change in the ratio of follicles according to the degree of iodization of colloid amino acids with accurate predomination of non-iodized amino acids of irregular shape with accurate smaller diameter against target parameters, with flat or low cubic epithelium, indicating a decrease of gland functionality.

The bioeffect of depleted uranium, independently from organ implementation and tissue organization, was prolonged indicating a functional inability.

A defect in the ventricular septum is a disease in which the septal integrity between the right and left ventricles of the heart is impaired. The ventricular septum is predominantly composed of muscle tissue, and the upper part is much smaller - from fibrous tissue, it is called a membranous septum. As a result of this defect, blood from one ventricle to another occurs, which leads to a disturbance of the heart. One of the reasons for the formation of this pathology is acute myocardial infarction, which leads to a decrease in myocardial tone and reduction of its contractionary activity. Myocardial infarction is defined as myocardial necrosis in a clinical situation corresponding to myocardial ischemia. Myocardial infarction can be divided into several types, for example, ischemia due to primary coronary damage (for example, plaque rupture, erosion or fracture; coronary dissection). Myocardial infarction predominantly affects the left ventricle, and it is possible to extend the process to the right ventricle and atrium. IM of the right ventricle usually develops due to occlusion of the right coronary artery or dominant envelope artery. The main manifestations are an increase in the filling pressure of PWDs, often combined with heavy tricuspid regurgitation and reduced cardiac discharge.

Relevance.
Cervical cancer (cervical cancer) occupies one of the leading positions among oncological diseases in women. The increase in the incidence of breast cancer is reflected both in global indicators and in the Russian Federation. Increasing the detection of breast cancer in women of reproductive age requires the search for new approaches to understanding the morphogenesis of the disease. The study of the interaction of the tumor and the cellular microenvironment is one of the modern approaches to the study of cancer morphogenesis. Mast cells (TC) are one of the frequent representatives of the microenvironment with the potential for local regulation at the tissue and cellular levels. However, the role of TC in tumor morphogenesis has not been fully studied and is sometimes contradictory. The purpose of our work is to study the role of TC in the morphogenesis of breast cancer.
Materials and methods.
Histological examination of biopsy material obtained from 21 women aged 25 to 74 years was carried out. Immunohistochemically, chymase and tryptase in TC were detected using the appropriate antibodies. The analysis was performed using a Carl Zeiss Primo Star microscope, magnification x40, within 5 fields of view. The calculation of TC, cell granules and mast cell cytoplasts was carried out both in the tumor and on the periphery of the tumor process. The degree of degranulation of TC has been established. Static data processing has been performed. Data differences were considered statistically significant at the level of statistical significance <0.05.
Results.
The total number of mast cells is 424, of which the degree of degranulation 0 was 31.4% (133), the degree of degranulation 1 was 14.9% (63), the degree of degranulation 2 was 34.4% (146), the degree of degranulation 3 was 19.3% (82). The number of mast cell cytoplasts was 109, free mast cell granules 120. On average, there are 4 mast cells, 1 free mast cell granule and 1 mast cell cytoplast per visual field. The average age of the patients was 47 years, the oldest patient 74 years, the youngest 25 years. Among them, the proportion of women of reproductive age is 42.9% (9), non-reproductive age 57.1% (12).
Conclusion.
Mast cells were found in all the studied cases. The distribution of mast cells was uneven both in the tissue of the tumor itself and in the invasive region. A different number of mast cells and mast cell components were found in different fields of vision, and a different degree of TC degranulation was established. However, no clear correlations of the studied indicators with other data have yet been obtained. Apparently, it is necessary to study TC in combination with other representatives of immunity. To establish the possible role of TC in oncogenesis is the next stage of our study.

Structured annotation
Modern society, unfortunately, is subject to a significant number of diseases, both infectious and non-infectious etiology. In this scientific study, I would like to analyze and highlight the issue of the defeat of young people with such pathology as ischemic stroke. Strangely enough, but it is this disease that causes great excitement among doctors not only specialized institutions and hospitals aimed at treating the consequences of neurological pathology, but also ordinary part-time therapists who encounter such patients quite often in their practice.
Ischemic stroke is a violation of cerebral circulation with damage to brain tissue, a violation of its functions due to difficulty or cessation of blood flow to a particular department.
The purpose of my research is to identify the specific causes of ischemic stroke, its early diagnosis and effective methods of prevention.
So, we have made a statistical analysis of the results of studies of young patients who received therapeutic care on the basis of BUZ VOKB No. 1, clinical examples from domestic and foreign literature were also considered. In hospital conditions , patients were thoroughly and comprehensively examined as follows :
They were assigned as laboratory methods of examination:
UAC (erythrocytes, leukocytes, platelets, hemoglobin, CP)
Biochemical blood analysis : lipid profile (HDL, VLDL,LDL,cholesterol), glucose (glucose tolerance test for people with suspected diabetes) , ,CRP, creatinine, liver enzymes (ASAT, ALAT)
Coagulogram
OAM: color, density, medium, presence of bacteria and cylinders , specific gravity, shaped elements of blood (leukocytes, erythrocytes)
And instrumental methods : MRI of the brain, ECG, echocardiography
During the analysis of the obtained data of laboratory and instrumental diagnostics, as well as medical histories, we have established the following possible causes of ischemic stroke.
Arterial dissections, the presence of rheumatic or infectious diseases in the anamnesis that provoked cerebral arteritis, in people taking narcotic drugs-thromboembolism from vegetations on the heart valves; also, women taking oral anticoagulants, which provoke all kinds of coagulopathy, for example, antiphospholipid syndrome, chronic stress and, as a consequence, spasm of the cerebral vessels, can be placed in a separate group. brain; drinking alcohol in large quantities and tobacco abuse.
Based on everything we have studied, we concluded that it is worth more in-depth and accurate diagnosis of the development of ischemic stroke in the early stages of its development, possibly with the use of more highly sensitive laboratory and instrumental examination methods, pay great attention to educational work with the young population, and do not forget about the role of prevention of relapses in those who have already faced this young age.

This paper presents an analysis of the literature regarding Parkinson's disease with COVID-19. Evidence is available regarding post-viral parkinsonism at the clinical and molecular levels. The world is currently under stress from the spread of the new coronavirus infection SARS-CoV-2. Of particular concern is the increased vulnerability of patients living with chronic diseases, including neurological conditions such as Parkinson's disease and other neurodegenerative diseases. Parkinson's disease (PD) is a slowly progressive, chronic disease associated with damage to dopaminergic neurons in the substantia nigra, leading to neurotransmitter imbalances. There is currently no clear evidence that the presence of Parkinson's disease increases the risk of susceptibility to COVID-19 or that COVID-19 increases the risk of Parkinson's disease, although, as noted in the literature, there are reports of worsening Parkinson's disease symptoms in infected patients, particularly those of older and older age.

Relevance. In almost all published studies, it was noted that with COVID-19, in addition to impaired function of the respiratory system, a third of patients (30%-35%) show signs of damage to the nervous system. There are descriptions of various neurological diseases that complicate the course of coronavirus infection or are its special clinical manifestation. One of the neurological complications of COVID-19 is meningoencephalitis (ME).

Purpose. To present a clinical case of a neurological complication after a coronavirus infection.  

Materials and methods. To analyze internal and world literature on neurological complications of COVID-19. The clinical case was analyzed based on the materials of the medical history. An examination was made and the results of the examination of a patient being treated at the Budgetary healthcare institution of the  Voronezh region "Voronezh City Clinical Emergency Hospital" №1 were analyzed.  

Results. The following studies were performed: neurological examination of the patient, lumbar puncture, PCR test, computed tomography of the brain, computed tomography of the chest, electroencephalography. Meningoencephalitis is manifested by psychomotor agitation, headache, meningeal symptom complex, unsteadiness when walking, depression of consciousness.

Conclusion. This work confirms the neurotropic effects of COVID-19. The virus, penetrating the blood-brain barrier, can cause meningoencephalitis, as a complication of a coronavirus infection. It also contributes to the exacerbation of chronic diseases (polysinusitis, otitis media) and complicates the course of concomitant somatic diseases.

Aim: analysis of the results of various psychological tests, assessment of the nature and impact of psychological rehabilitation on the quality of life of cancer patients.

Methods: the following tests and questionnaires were used to analyze the mental state of patients: the Beck questionnaire, the TOBOL questionnaire, the scale for express psychological diagnosis of semi-structured depressive disorders (the D-N scale and the MDP-D scale, neuroses), the Eysenck mental state self-assessment test.

Results: patients with harmonious, ergopathic and anosognostic types of attitude to the disease accounted for 70%.
Patients with anxious, hypochondriacal, neurasthenic, melancholic and apathetic type of attitude to the disease accounted for 10%.
Patients with sensitive, egocentric, dysphoric and paranoid types of attitude to the disease accounted for 20%.Conclusion: psychological therapies are aimed at improving the survival of cancer patients and gaining skills to solve the problems they face, increase support and teach the person the skills to change negative thinking.

Relevance. Multiple sclerosis (MS) is a chronic autoimmune disease that affects the myelin sheath of nerve fibers in the brain and spinal cord. [one]. Often the disease affects young people who are actively engaged in labor and social activities, leading to disability or a deterioration in the quality of life. In addition, the number of people suffering from this disease is steadily growing [3,4,5]. As early as 1868, Jean-Martin Charcot noticed that the incidence of MS has an uneven geographical distribution (more common in areas with a cold and humid climate). Previously, there were no works describing the epidemiological situation with MS in the districts of the Voronezh region. The study of patterns in the epidemiology of this disease can play an important role in understanding various aspects of MS.

Target. To assess the dynamics and main trends in the epidemiology of MS in the Voronezh region over a five-year period.

Materials and methods. A retrospective analysis of epidemiological data on the incidence of MS in the Voronezh region for 2015-2019 was carried out. The study plan included a sample of patients with newly established verified diagnosis of MS. The obtained data were statistically processed. Based on the results of the analysis, a conclusion is formulated.

The objects of the study were patients living in the Voronezh region, with a first-time diagnosis of multiple sclerosis. The information was obtained by analyzing the reports submitted to the epidemiological service of the Voronezh region.

Main results of the study

The indicator of the share of MS in the structure of demyelinating diseases (DZ) in the Voronezh region from 2015 to 2019 increased by 7.8%, and the incidence rate decreased by 0.9 per 100 thousand population. According to the results of the study, it turned out that the districts of the Voronezh region with the highest rates of occurrence of DZ are Pavlovsky and Olkhovatsky, where this figure was 1.2 per 100 thousand of the population. In addition, the Olkhovatsky district has the highest intensity indicator in RS (8.9 per 100,000 population). The area with the lowest detectability of MS is Borisoglebsky. It is also worth noting that in many districts, 100% of the detected DZs are MS. These include: Buturlinovsky, Verkhnemamonsky, Gribanovsky, Kalacheevsky, Novousmansky, Olkhovatsky, Pavlovsky, Rossoshansky, Semiluksky. In the city of Voronezh, the frequency of detection of DZ over the studied 5 years increased by 0.08%, and the proportion of MS among these diseases decreased by 2.9%.

Conclusion. According to the results of the analysis of the epidemiology of MS in the Voronezh region, geographical heterogeneity and an increase in the proportion of DZ were noted.

The analysis was carried out for 5 years preceding the pandemic of a new coronavirus infection (2020-2021).

Relevance: the study of the special characteristics of the sexual profile of students is of great importance. It raises a whole list of questions in connection with the awareness of students on this topic, their values in matters of sexual behavior, their opinions about entering adulthood.
Objective: to obtain information about the degree of expression of empathic abilities; to identify the features of sexual behavior in the form of a peculiar profile among 5th-year students of VSMU; to compare the results obtained among foreign and Russian fifth-year students.
Methods: in our scientific article, we relied on the methodology of V.V. Boyko "Diagnostics of the level of empathy". Then the students were asked the question: "What, in your opinion, is the ideal age for the onset of sexual activity?"
The next stage was the methodology for assessing the sexual profile, which includes fourteen fundamental scales that reflect the ranking of forms of sexual behavior.
Results: in response to the question about the age of entry into sexual life, the girls replied that they consider the interval from 18 to 19 years to be ideal, the male part of the respondents preferred a younger age (16-17 years) for the beginning of sexual life. Most of the interviewed students, after passing the empathy test, received the following result: the identification channel firmly took the leading position. We also created a sexual profile for 5th-year students of VSMU on the basis of a questionnaire. At the end of the study, we compared the results obtained among foreign and Russian fifth-year students: according to the results of the test "Methodology for assessing the sexual profile", selectivity and expressiveness prevail in the former, jealousy and expressiveness prevail in the latter.
Conclusion: obtaining information about the degree of expression of students' empathic abilities is extremely important. Both groups of students equally believe that love is the highest feeling. Scrupulousness and sacrifice are also expressed in equal values.

At the time of 2020, the birth rate of children with a body weight of less than 1000 g was less than 1%. The survival rate of children with extremely low body weight ranges from 12.5% - 66.7%. This mortality is associated with the immaturity of the body systems, including the nervous system.The immaturity of the central nervous system is expressed in the early extinction of physiological reflexes, imperfection of thermoregulation, muscle hypotension. These facts show that children with extremely low body weight lag behind in neuropsychological development from their chronologically healthy peers. Also, children with ENMT often suffer from various neurological disorders: cerebral palsy, epilepsy, etc.There are many methods of assessing the NPR in children using various lines of development as an assessment. However, there is no unified, standardized scale that could be used universally, both in relation to the age of children and their nationality. Only in Russia, during the neurological examination of an infant, 2-3 scales are used at a time.The purpose of this work is to consider the most used and relevant methods of assessing NPR.To consider the selected issues, the following methods and scales of assessment of the NPR were selected: the Denver test, Assessment of the level of psychomotor development of a child by L. T. Zhurba and E. M. Mastyukova, Griffiths psychomotor Development Test, Bayley Infant Development Scale, Newborn Behavior Scale, the GNOME test, the Test of the development of children of the first year of life O. V. Bazhenova, Indicators of early childhood NPR according to N. M. Aksarina, G. V. Pantyukhina, K. L. Pechorina.To reveal the problems, the following methods were used: collection and analysis of literary sources, maintaining statistics on the use of NPR survey scales, highlighting the advantages and disadvantages of child survey methods.Results. Each of these methods has its own advantages and disadvantages. Some methods have not previously been used for the study of children with ENMT, other methods are actively used in modern practice. The main disadvantage of the methods considered is their redundancy of items and tests, which leads to an increase in the duration of the examination and discomfort for the child during the examination, but each of them, except for the Denver test, is more specific than a screening method.Conclusions. The scales considered by us are actively used in the practice of a neurologist and pediatrician. It is necessary to note the absence of both highly sensitive and highly specific methods of NPR research. In this paper, we have systematized a list of methods for studying neurological status, which will make it easier for a clinician to choose the necessary method of examining a patient, and for a researcher to develop a universal scale.

Relevance: is a result of high prevalence of vegetative dystonia syndrome, diagnostic difficulty and possibility of developing chronic diseases of various systems of the body. Quality of life of adolescents with vegetative dystonia syndrome is closely linked to adaptation in society, daily activity, capacity to learn. It may affect their social realization in the future.
Purpose: to assess quality of life of adolescents with vegetative dystonia syndrome.
Materials and methods: 61 patients aged 12 to 17 years were examined. 27 conditionally healthy individuals aged 15 to 16 years were interviewed. A.M.Wayne questionnaire, Spielberg–Hanin anxiety scale, The Pediatric Quality of Life Inventory, Visual Analogue Scale of pain, Kerdo index, results of Dagnini-Aschner and orthoclinostatic tests were used.
Results: all patients in the main group were divided into two subgroups: adolescents with severe vegetative disorders 62,3% and adolescents with moderate vegetative disorders 37,7%. Physical, emotional and role indicators of quality of life were significantly lower in the first subgroup in comparison with the second subgroup. No differences in social indicators between subgroups were received.
Physical and role indicators were significantly lower in the main group in comparison with the main group. The best results in both control and main groups were obtained in the social scale, the worst- in emotional scale.
Conclusion: quality of life of adolescents with vegetative dystonia syndrome is significantly lower in physical and role scales. Physical functioning depends on the severity of vegetative disorders. Psychosocial functioning is not connected to the anxiety level.

Relevance: The universal prevalence of obesity in children and adolescents is a huge problem for world health. Studying the mechanisms of thyroid gland influence on this pathology, can make a significant contribution to the understanding of obesity pathogenesis.
Objective: To study thyroid changes in children with different degrees of obesity
Materials and Methods: Retrospective analysis of case histories of patients undergoing inpatient treatment in the endocrinology department of the Voronezh Children's Clinical Hospital with a primary diagnosis of exogenous-constitutional obesity and morbid obesity.

Results: Twenty-seven case histories of children were analyzed. Of these, 15 (55.6%) were boys and 12 (44.4%) girls. There were 6 children (22.2%) with 1st degree obesity, 8 (29.7%) children with 2nd degree obesity, 6 (22.2%) children with 3rd degree obesity, and 7 (25.9%) children with morbid obesity. Of the total group of children, 7 patients had a history of diffuse nontoxic goiter. In the group of children with 1st degree obesity, the median age was 12.5 years, TTG 4.52±0.51 uIU/ml, with 2nd degree obesity the median age was 14.5 years, TTG 4.63±0.64 uIU/ml, with 3rd degree obesity the median age was 9.5 years, TTG 4.75±0.40 uIU/ml. In the group of children with morbid obesity, the median age was 7 years, TTG 5.35±0.59 uIU/ml.
Conclusion: In the study sample of children, there was an increase in TTG concentration, proportional to the severity of obesity.

Relevance. Feeding a baby with breast milk (GM) is a natural type of feeding of children from birth [1]. Despite the benefits of breastfeeding, in Russia, according to 2020 data, only 39.2% of children received natural feeding before the year. This is especially true in the context of the COVID-19 pandemic [4].
purpose. To evaluate the effect of GW on the natural resistance (ER) of children under one year old.
MATERIALS AND METHODS. The study was conducted on the basis of the BUZ IN "VGKP No. 1" children's polyclinic No. 2. The object was 50 outpatient cards (f.112 /y) - the history of the development of children who reached the age of 1 year at the time of the study. Statistical, descriptive research methods and analysis were used.
Results. All children were divided into 2 groups depending on the duration of GW: group 1 – the first 6 months of life and group 2 - up to 12 months of life. Assessing one of the indicators of physical development - body weight (MT), it was revealed that in group 1, 75% had an average MT, 15% had a deficiency of MT and 10% were above average. In the 2nd group (93%) of children had an average MT, only 7% were above the average MT, and not a single child was deficient in MT. To assess the effect of GW on ER, the incidence of ARI in the first year of life was studied. It was revealed that 29 children (58%) did not have ARI in the first year of life, of which 37.9% were on GW up to 6 months, 62.1% of children - up to 12 months. 21 children (42%) were ill with ARI 1 or more times, 42.9% of them were on GW up to 6 months, 57.1% of children up to 12 months. So, there were 1.6 times more children of the 2nd group who did not get ARI, compared with children of the 1st group.
Differences in the duration of GW depending on the method of delivery: 60% of children were born naturally in group 1 versus 77% of group 2. In groups of children, depending on the order of childbirth: 65% of children were born from the first birth in the 1st group versus 60% in the 2nd group. In groups, depending on the supplementary feeding of newborns in the maternity hospital and the duration of GW: 55% of children received supplementary feeding in the maternity hospital in group 1 against only 3% of children in group 2.
Conclusion. GW has a positive effect on the formation of a child's EP and on physical development, which is the prevention of diseases. When choosing the nature of feeding, the advantage should be given to GW and factors that increase its duration.

Relevance. Diabetic kidney disease (diabetic nephropathy) is a specific progressive kidney disease in diabetes mellitus, leading to the development of terminal renal failure [1]. According to the Federal Register of Diabetes Mellitus (DM), 23% of patients with type 1 diabetes have chronic kidney disease (CKD), 13% of them need renal replacement therapy [2].The main criterion of CKD, determining its stages, is a decrease in the glomerular filtration rate (GFR). Currently, various formulas are used to calculate the GFR.
The purpose of the study: to conduct a comparative assessment of various formulas for determining GFR in children with type 1 diabetes.
Materials and methods: A retrospective analysis of the case histories of the 51st patient of the "VODKB No. 1", hospitalized with a diagnosis of E10 - type 1 diabetes mellitus, was carried out. The GFR was calculated using the following formulas: Schwartz 1976, Schwartz-Lyon, Schwartz "bedside", Qvr (age-dependent), Qrost (growth-dependent), Lund-Malmo revised, European Consortium (EKFC).
Results: when comparing the GFR calculated according to the above formulas, some differences were revealed. In children with type 1 diabetes, GFR, according to the Schwartz formula of 1976, was significantly higher (126.76 ± 16.37 ml/min/1.73 m2), compared with GFR calculated by other formulas (83.39 ± 10.59 ml/min/1.73 m2) according to the Schwartz-Lyon formula, (89.95 ± 11.82 ml/min/1.73 m2) according to the Schwartz formula "bedside", (89.81 ± 14.95 ml/min / 1.73 m2) according to the formula Qvr (age-dependent), (92.71 ± 13.53 ml/min/1.73 m2) according to the formula Qrost (height-dependent), (92.48 ± 10.1 ml/min/ 1.73 m2) according to the formula Lund-Malmo revised (87.03 ± 14.58 ml/min/ 1.73 m2) according to the formula of the European Consortium (EKFC).
Conclusion: According to the conducted research, differences in GFR indicators calculated by various formulas have been established. This applies more to the Schwartz formula of 1976. This formula overestimates the results of the GFR. The maximum correlation was established between serum creatinine and GFR, calculated according to the formula "Schwartz "bedside"" (-0.707) The revealed results among the studied patients indicate the continuation of the search for the most optimal evaluation of GFR in type 1 diabetes in children.

Bronchial asthma (BA) is a heterogeneous disease characterized by chronic airway inflammation and respiratory symptoms. To date, 348 million patients worldwide suffer from asthma. In Russia, the prevalence of bronchial asthma among children and adolescents is about 10%.

The aim of the study was to analyze the course of the disease and the experience of using targeted therapy in a 15-year-old patient with BA.
Materials and methods: a retrospective analysis of anamnestic data, the course of the disease, laboratory and instrumental diagnostics, methods of treatment in patients with bronchial asthma who were treated in 2021 in a specialized department of the State Budgetary Institution of Health "Children's Regional Clinical Hospital" of the Ministry of Health of the Krasnodar Territory was carried out (GBUZ "DKKB" MH KK) and received targeted therapy.

Conditions: the study was conducted on the basis of the State Budgetary Healthcare Institution "DKKB" of the Ministry of Health of the KK, data were collected on patients in the Krasnodar Territory receiving targeted therapy for BA. The selection criteria were: the experience of asthma and the duration of targeted therapy.
Inclusion criteria: a 15-year-old patient with severe BA for more than 10 years who has been receiving targeted therapy for 8 years.
Exclusion criteria: The study did not include patients with less than 10 years. of asthma experience and less than 8 years of targeted therapy.

Results: it was revealed that in 2021, 38 patients of the Krasnodar Territory receive targeted therapy. Some patients were not included in the study due to non-compliance with the selection criteria. Thus, the study included a patient suffering from asthma for more than 10 years with a duration of targeted therapy of 8 years. 

Relevance: at the moment, obesity is considered one of the most common chronic diseases in the world. The growth rate of people suffering from this disease allows us to consider the problem as a global epidemic of the XXI century. Therefore, the chosen topic is relevant today.

The aim of the study is to reflect the current picture and trends in the epidemiology of obesity both locally and globally.

Materials and methods: analysis of domestic and foreign publications, statistical data on the Voronezh region, Russia and the world.

Results: there is a rapid increase in obesity and overweight all over the world. The disease, which was previously considered characteristic of countries with high socio-economic development, is becoming increasingly widespread in low- and middle-income countries. Africa, South and East Asia, as well as the countries of the Pacific basin occupy leading positions in the prevalence of obesity. Russia is in the middle of the ranking of countries in terms of morbidity: 19.6% of the population. In Voronezh and the Voronezh region, there are trends of an increase in the prevalence of obesity, among children under 14 years of age – by 1.3 times, and the adult population - by 1.5 times.

Conclusion: the negative dynamics of obesity contributes to the development of preventive measures aimed at preventing the further spread of the disease among the population. The basis consists of state support measures, the activities of medical institutions and their employees, as well as self-control, which consists in observing the principles of a healthy lifestyle. This pathology increases the risk of developing a number of diseases, worsens the quantity and quality of life.

Relevance: non-hospital pneumonia is an urgent problem for the pediatrician, and in recent years there has been an increase in the incidence of the disease. In actual practice, especially in outpatient settings, the main challenges for the paediatrician are early diagnosis and rational therapy. This is due to the high prevalence and similarity of some clinical manifestations with other respiratory diseases of infectious nature. Despite advances in medicine, the rate of complications and deaths in children is rising. The main reason is late diagnosis or inadequate therapy without regard to the specific clinical manifestations of the disease.
Purpose: to identify possible diagnostic and treatment errors in the study of case histories.
Materials and methods: the study was carried out on the basis of State Budgetary Educational Institution of Higher Professional Education N.N. Burdenko Voronezh Children's Clinical Hospital from 2015 to 2021. Statistical software STATISTICA Base was used.
Results: during the study, the most common mistakes were incorrect prescription of antibiotic therapy, combination of ABP with antifungal and antihistamine drugs, continuation of treatment until the radiological picture disappeared rather than until clinical symptoms regressed.
Conclusion: the error rate in the diagnosis and treatment of pneumonia is approximately 20%, and only one third of patients are correctly diagnosed in the first days of illness.

Congenital hyperinsulinism (CHI) is an inherited disease characterized by inappropriate hypersecretion of insulin by pancreatic beta cells and leading to hypoglycemia. The incidence of CHI, according to the literature, is on average 1:30,000 - 1:50,000 live births.
Purpose: to evaluate the features of the course of congenital hyperinsulinism in children in the Krasnodar Territory.
Methods: a clinical observational cohort study of children who were examined in the endocrinology department of the children's regional clinical hospital in Krasnodar from 2017 to 2020 was carried out. Inclusion criteria - patients with congenital hyperinsulinism. From the case histories, anamnestic, laboratory, instrumental data, results of genetic and functional research methods were obtained.
Results: the study group included 9 patients, of which: boys - 2 (22.2%), girls - 7 (77.8%). By age, the patients were distributed from the neonatal period to 6 years. The average age was 2 years.
When evaluating complaints in 100% of cases, the following were revealed: refusal to eat, weakness, difficulty in stool, periodic abdominal pain, shortness of breath, drowsiness, anxiety between feedings. Seizures were observed in 75% of cases.
From the anamnesis of life, we found that the majority of patients 6 patients (67%) were born from a difficult pregnancy. Cytomegalovirus infection was diagnosed in 3 patients (33.5%). Intrauterine growth retardation was noted in 3 patients (33.5%).
The diagnosis of CHI in children was established at different times: in the neonatal period - 2 people (22.2%), in infancy - 4 people (44.4%), in pre-school age - 2 people (22.2%) and in preschool age - 1 person (11.1%).
In the course of the study, based on the results of daily monitoring, 100% of cases revealed hypoglycemia below 2.7 mmol / l, an increase in insulin over 30 μU / ml, C-peptide, and a low level of ketone bodies.
According to the morphological form of CHI, after PET-CT with 18F-DOPA, the observed group was classified as follows: focal form - 2 patients (22.2%), diffuse form - 7 patients (77.8%). According to the results of a genetic study, the following mutations were identified: KCNJ11 - 4 patients (44.4%), GLUD1 - 1 patient (11.1%), ABCC8 - 1 patient (11.1%) and in 33.3% of cases molecular no genetic pathology was found.
According to the results of the fasting test against the background of insulinostatic therapy, 100% of patients had euglycemia, normalization of insulin levels, and an increase in the level of ketone bodies to normal values.
Conclusion: 9 people with CHI were identified in the Krasnodar Territory. Conservative treatment was carried out in 6 patients (66.7%); operative - 3 patients (33.3%).
Key words: children, congenital hyperinsulinism, hypoglycemia.

Relevance. The pandemic of a new coronavirus infection COVID-19 is currently one of the most pressing problems in all countries of the world. The disease affects not only adults, but also children, who make up 7% of the total number of infected in the Russian Federation.
Target. To study the features of the clinical picture of COVID-19 in children in the Lipetsk region and the city of Lipetsk, who were hospitalized at the State Healthcare Institution "LOKIB".
Materials and methods. A retrospective analysis of medical records of case histories of 210 children aged from 1 day of life to 17 years was carried out.
Results. Data on the course of COVID-19 in 210 children being treated at the LOKIB State Health Institution, Lipetsk, are presented. In most cases, the disease in children proceeded in a moderate form. Based on the collected data, the clinical picture showed an increase in temperature in 180 patients (85.7%), of which subfebrile fever occurred in 73 children (40%), febrile - in 68 children (38%), high - in 39 children (22 %). Cough bothered 118 people (56%), signs of intoxication (myalgia, nausea, general weakness, headache, loss/lack of appetite) in 185 children (88%). Some patients experienced dyspeptic phenomena such as vomiting (9%) and diarrhea (14%). Skin rashes were observed in 18% of children. There were 6 people in the intensive care unit, no deaths were noted. Treatment depends on the severity of the disease, with a moderate degree, protocols are used for the treatment of acute respiratory viral infections, bronchitis, bronchiolitis, and pneumonia.
Conclusion. Among children, mild and moderate variants of the course prevail. Severe forms occur in the presence of anomalies of the constitution, chronic diseases.

E.A. Volynkina

Supervisor: T.N. Petrova, I.O. Elizarova

Voronezh N.N. Burdenko State Medical University

Department of preventive medicine

Department of hospital therapy and endocrinology

Relevance. Diabetes mellitus is a disease which is called the"pandemic of the XXI century". The total number of people with diabetes in the world has more than doubled in the past 10 years, and by the end of 2019 was 463 million people. At the same time, type 2 diabetes occurs in 92% of the total number of patients. The results of the Russian epidemiological study NATION showed that the specified diagnosis is identified only in 54% of cases, and the real number of people suffering from type 2 diabetes in Russia is at least 10 million people (about 7% of the population). Type 2 diabetes is the cause of macrovascular complications, which lead to disability and an increased risk of death. At the same time, it is a socially significant disease that can be prevented. It is important to ensure the dissemination of information about type 2 diabetes and its prevention methods among the population in order to increase active longevity and reduce overall mortality.

The purpose of the research is to assess the level of knowledge of medical school students about type 2 diabetes and ways to prevent its development.

Materials and Methods. This investigation was carried out at N.N. Burdenko State Medical University as part of the "Endocrinological Dictation". A total of 201 participants (80% were students, among whom 42.3% were 1st year students and 20% were residents) took part in an anonymous questionnaire survey. The dictation included 17 test questions with one correct answer, which the respondents had to give. The questions were related to early detection and prevention of diabetes mellitus.

Results. The results of the research showed that 45% of the respondents pointed out the presence of a family member with diabetes and 64.2% knew what glycated hemoglobin was. However, the level of knowledge concerning the issues of prevention and detection of type 2 diabetes among the respondents was insufficient.

Conclusion. Thus, the results indicate the need to increase the awareness of students on the prevention of diabetes mellitus and its early detection.

Educational activity of students is connected with emotional experiences, achievement of the set goal and overcoming of difficult situations, especially during examinations. At the present moment there are no unified data about adequate methods of diagnostics and study of this type of stress and its consequences. However, control of psycho-emotional state of students and its timely prevention can allow to reduce the risk of psycho-emotional disorders.

Objective. To study and analyze correlation between sensorimotor parameters of attention deflection tasks and peculiarities of bioelectrical activity of frontal brain areas of students in different periods of study. Study of peculiarities of autonomous regulation in anxious subjects during intersession and exam periods.

Materials and methods. Two stages of the study were conducted: pre-examinations and examinations. We examined psychometric data using Spielberger-Hanin questionnaire (personal and situational anxiety), cognitive task with the dot-probe test, specific features of alpha rhythm power in EEG recordings of frontal leads, salivary cortisol level, and heart rate variability.

Results. The study showed average and high levels of situational and personal anxiety, typical for students in the first years of study, which was reflected in peculiarities of their emotional attention, bioelectrical activity of the brain, and changes in vegetative parameters. During the examination period, a high tone of sympathetic regulation was observed in all study participants, but the predicted increase in cortisol levels in saliva was observed only in the study participants who passed the exam "successfully," and the opposite pattern was observed for "unsuccessful" students.

Conclusion. Thus, the frontal asymmetry of the bioelectrical activity of the brain, vegetative and hormonal status can be used as markers of the manifestation of psycho-emotional stress.

Relevance: The relevance of this topic lies in the fact that the formation of the psychology of children in the prenatal and postnatal period is of great importance for the harmonious development of the child in the future.
Indeed, at present the attention of many psychologists around the world is drawn to the problems of early childhood.
This interest is far from accidental, since it turns out that the first years of life are the period of the most intensive and moral development, when the foundation of physical, mental and moral health is laid. The future of the child largely depends on the conditions under which it will proceed.
The influence of the mother's relationship with the unborn child is extremely important for its development.
Objectives: Our main goal was to study the impact of maternal psychological support during the period of infancy of a child, using the method of collecting empirical information according to the methods: PARI E. Schaeffer and R. Bella in the adaptation of T. V. Neshcheret, assessment of the neuropsychic development of young children ( modification by S.N. Kostromina). Methods of data processing were the methods of qualitative and quantitative, statistical analysis.
Results: Analysis of the research results showed that the provision of psychological comfort to the child by the mother, all kinds of support for the child, encouraging him create conditions for his accelerated harmonious development.
Conclusion: In general, according to the results of the study, it can be concluded that the children of those women who attended specialized courses and prepared for the birth of a child develop more harmoniously both physically and mentally, compared with the children of those women who the birth of a child was not specially prepared.

Normal vision is a great blessing for any person. The modern way of life and its rhythm have sharply increased the load on the eyes. In the world there is a significant increase in eye pathology, and above all myopia. Experts say about the "epidemic" of myopia in young people.

Under conditions of intense visual load, for the preventive purpose, it is necessary to actively carry out a complex of health-improving measures for the normal functioning of the visual analyzer. This is a mandatory adequate general physical activity, a balanced fortified diet, the presence of periods of active and passive rest for the eyes.

Vision hygiene includes the optimal mode of visual work, competent organization of the workplace, performing gymnastics for the eyes, dosing the time of work with electronic devices.

Questioning students showed awareness of the majority of respondents in the prevention of myopia. The focus on a healthy lifestyle, awareness of the existence of factors that negatively affect the eyes, will help young people maintain eye health and normal vision for many years.

The school of motherhood is one of the forms of preventive work of medical personnel among the population of our country, which consists in teaching pregnant women, young fathers (future parents), the rules of child care. The purpose of this school is to reduce the risk of developing pathology during childbirth, during pregnancy, the postpartum period and the newborn period. The main areas of work of the school of motherhood: 1. Psychological preparation for motherhood, prenatal preparation 2. Training in general recommendations during childbirth and pregnancy 3. Explain to future parents the current aspects of newborn care. 4. Popularization of natural feeding 5.To increase the interest in the care and awareness of future fathers. The role of a nurse in the organization and work of the maternity school: 1. Informing future parents in an accessible form. 2. To update the awareness of the expectant mother on pregnancy and childbirth. 3. Show and work out a set of exercises for pregnant women

Neonatal sepsis is a generalized purulent-septic infection characterized by the presence of a primary focus and circulation of infection in the blood. It is newborns who fall into the risk group for the occurrence of purulent septic diseases (GSI), since their immunity is not strong enough to fight pathogenic microflora. Therefore, the purpose of the work is to study the knowledge of the population about sepsis and GSI of newborns, for planning further preventive measures. The study was conducted by questionnaire, in 2021. 50 people participated in the survey. The study of public awareness of neonatal sepsis showed that not all respondents are aware of this disease, its treatment and preventive measures. Ignorance about GSI can lead to negative consequences.

Despite the work of medical workers, their preventive measures, lectures and conversations, there is a need to use the mass media and the Internet more widely to update information.

The aim of the study is to conduct diagnostic studies that allow us to scientifically substantiate the development of an integrated approach to diagnosis, taking into account the component of vertical growth in patients with distal occlusion.

Correlations of vertical and horizontal ratios of the jaw bones have been revealed, which will allow the orthodontist to predict the likelihood of aggravation or self-regulation of the problem. Thus, the conducted diagnostic studies allowed us to scientifically substantiate the development of an integrated approach to diagnosis, taking into account the component of vertical growth in patients with distal occlusion.

On the basis of 16 teeth (8 multirooted and 8 single-rooted) we performed a clinical study to evaluate the temporal effectiveness of ossification and to compare the healing rate in single-rooted and multirooted teeth. During the treatment we used instrumental treatment of the root canals by means of manual files - K-reamer, Hedstroem, Protaper, root canals obturation was made by means of gutta-percha cone and Endometasone Siler. After the treatment we evaluated the ossification of the apexes of the teeth we had previously treated 6 months later on the basis of targeted X-rays. As a result of the study, we found that the rate of bone regeneration in the apex area of single-rooted teeth is 40% higher compared to multi-rooted teeth. The results tell us that the anatomy of canals in single-rooted teeth lends itself to more thorough instrumentation and irrigation compared to multi-rooted teeth. We should also note that we did not use the technique of temporary obturation with calcium-containing preparations as a result of treatment, which allowed us to avoid not only the number of patient visits, but also to reduce the time interval for healing of periapical lesions.

The purpose of the study: to identify the clinical manifestation of diabetes mellitus in the human oral cavity, to determine the algorithm of preventive measures after diagnosing the disease in order to minimize its harmful effects on the human body, in particular on the oral cavity and periodontium.
Materials and methods. Diabetes mellitus is, first of all, an endocrine disease that is directly related to impaired glucose uptake and develops with a lack of the hormone insulin. As a result, it is possible to develop a disease such as hyperglycemia, a condition in which the level of glucose steadily rises. This disease is chronic. Such types of metabolism as protein, carbohydrate, fat, water-salt and mineral are violated. This disease is typical for humans, as well as cats and dogs. Diabetes mellitus is divided into two types: 1. Insulin-dependent (type 1). Young people are often affected by this type. The cause of this type is the death of pancreatic cells (about 90%). This type of diabetes mellitus develops as a result of a decrease in immunity or a viral infection. In this case, the body's ability to produce insulin disappears. The treatment for this type of disease is insulin therapy according to the basal-bolus scheme.2. Insulin-independent (type 2). With this type of diabetes, insulin can be formed in the body on its own, but the cells lose their sensitivity to it and do not perceive it. The second type is hereditary and occurs mainly among people over 40 years of age. With this disease, treatment with biguanides is prescribed. Symptoms of diabetes mellitus. - a constant unquenchable feeling of hunger and with it a sharp weight loss; - Frequent urination, the amount of urine can increase up to 9 l / day; - enlargement of the parotid glands; - itching of the skin and mucous membranes, their inflammatory lesions; - muscle weakness and headache; - X-ray examination in patients shows diffuse osteoporosis and atrophy of the alveolar bone of varying severity. Symptoms of diabetes mellitus in the human oral cavity. inflammatory infectious diseases of the gums and massive dental deposits are noted; - dryness in the oral cavity, a feeling of thirst and burning, xerostomia; - dryness, inflammation, cracks in the red border of the lips, as well as the development of seizures in the corners of the mouth; - a decrease in salivary secretions. One of the initial symptoms diabetes mellitus, there is an increase in the parotid salivary glands. This leads to dry mouth, i.e. xerostomia. Xerostomia contributes to the development of diseases such as gingivitis, candidiasis, stomatitis, caries. Gingivitis is an inflammatory process in the oral cavity (localized), resulting from the "start" of immune and inflammatory reactions in the host body by bacterial endotoxins, antigens and other virulent factors. Over the course of life, the condition of periodontal tissues worsens, there is an active development of signs of chronic generalized periodontitis of the middle or severe. These signs are accompanied primarily by destructive processes in the bone tissue, as well as severe tooth mobility, loss of periodontal attachment and an increase in periodontal pockets. The risk of periodontitis increases with a lack of control of diabetes. It is worth noting that timely treatment of periodontitis can affect glycemic control and can help prevent the occurrence and development of diseases such as cardiovascular disease and nephropathy. Treatment of periodontitis in diabetes mellitus is a mandatory procedure and cannot be considered as optional. Examination of patients with diabetes mellitus allows you to pay attention to the fact that in such patients the risk of developing non-carious lesions of the hard tissue of the teeth is much higher. One of the most common comorbidities in diabetes mellitus is oral mucosal candidiasis. Its manifestation is characterized by thinning and dryness of the bright red mucosa. Against the background of systemic immunosuppression, there is a high risk of developing diseases of the oral cavity membrane of a chronic course, in the event of which the repair period during surgical interventions is lengthened, and the process of engraftment of implants worsens. Such diseases are lichen planus, recurrent aphthous stomatitis, recurrent viral, fungal and bacterial stomatitis. Treatment, removal and prosthetics of teeth in patients with diabetes mellitus. Dental treatment in such patients can occur only in the compensated stage of the disease, however, in the case of a serious infectious disease treatment can also occur in the uncompensated stage of diabetes mellitus after taking a dose of insulin, and after treatment, the patient is prescribed antibiotics and analgesics. Anesthesia is also used only at the stage of compensation for this disease; in any other case, the use of local anesthesia is acceptable. Prosthetics in patients with diabetes mellitus is carried out exclusively by a dentist who has certain knowledge and skills in working with this disease and is able to competently draw up a treatment plan that is acceptable for people with this diagnosis. Dental prostheses for patients with diabetes must meet all the requirements for the correct distribution of the load, and also be made from certain materials that can be used in this disease. It is unacceptable to use cobalt-chromium, nickel-chromium alloys. In this case, only a gold-platinum alloy is preferred, and removable dentures should only be with a titanium base.
The option of implantation is also considered in the presence of diabetes, but only by a competent specialist who is familiar with all the nuances of working with such patients.Extraction of teeth can also be carried out in people with diabetes, however, only in the morning after taking insulin (the dose should be increased). Otherwise, there is a risk of developing acute inflammation. Rinse your mouth with an antiseptic before surgery.
Modern research.One new study, published in Preventing Chronic Disease, shows that people with diabetes are twice as likely to lose teeth as people who don't have the disease, and that this probability is also related to a person's race. . According to statistics, patients of the Negroid race have a higher risk of tooth loss than the representatives of the Caucasian. To conduct this study, a total of collected data on more than 37 thousand patients. Thanks to additional analyzes, it was found that in 1999-2000. patients with diabetes were 34% less likely to have at least 21 teeth compared to relatively healthy people.

Preventive oral care for diabetes mellitus.

The rules of preventive oral care include:

- Twice a year it is obligatory to visit a dentist for a complete examination and professional oral hygiene;
- Brushing and rinsing teeth after each meal. If there is no bleeding gums, then the use of a brush of medium hardness is acceptable;
- Daily used toothpaste should not contain highly abrasive substances, antibacterial substances, as well as strong peroxides;
- Since patients with diabetes are often people with hypersensitivity, the most preferred are pastes based on silicon dioxide, which remove dental deposits without damaging the enamel;
- Mouthwashes should never contain alcohol.

Results.
As a result of the study, the basic definition of diabetes mellitus and its types were studied. Also, possible symptoms were considered, both of a general nature and purely dental manifestations, the possibilities of treatment and extraction of teeth in this disease, as well as preventive oral care for diabetes mellitus.Discussion.
Thus, diabetes mellitus has a great impact on the state of the body and the health of the oral cavity, which will directly affect the dental interventions of specialists.
Conclusion.
In the course of the work, a sufficient amount of specialized, educational literature, scientific literature was analyzed, on the basis of which a relationship was revealed between the state of the oral cavity and teeth and diabetes mellitus.

STRUCTURED SUMMARY

Abstract. Modern dentistry occupies one of the leading positions in terms of the number of undesirable immune reactions. The variety of dental materials, the lack of knowledge of the causes of intolerance to dental materials, the lack of universal, fast and affordable means of diagnosing allergic status directly in the patient's chair, insufficient prevention, limited time for collecting anamnesis, lack of materials for laboratory diagnostics indicates the urgency of the problem of allergic conditions at a dental appointment. . Target. Actualization of the problem of allergies in dentistry, the formation of an idea of ​​the basic materials that can cause an immune response, the study of the main clinical manifestations of allergies and ways to prevent it in the practice of a dentist. Materials and methods. To assess the frequency of occurrence of cases of adverse reactions at a dentist's appointment, 980 respondents aged 18 to 35 were interviewed using the method of anonymous Internet questioning. Results. The frequency of adverse reactions to dental appointments was 1.53% of the respondents. In the group of respondents from 18 to 25 years old, allergy to local anesthetics was in the first place, immediate reactions were the main part of them. Conclusion. The main materials causing adverse reactions in dentistry are presented. The main types of immune responses and their clinic, as well as types of diagnostics and prevention of allergic conditions are considered.

The use of various structural types of intraoral retainers in the orthodontics clinic has been increasing over the past years. The personalized approach and the complexity of the clinical management of individual groups of patients revealed the need to separate the devices for retaining the achieved results after active orthodontic therapy into removable and non-removable ones. The increasing number of recurrences of dental anomalies and deformities after treatment with a bracket system strongly indicates a pronounced problem of achieving stable results of orthodontic treatment in adolescents and adult patients. Therefore, the relevance of this work is due to the complexity of the choice and clinical application of the entire spectrum of these designs, due to the lack of a single differentiated and personalized retention period protocol. Goal. The aim of our research was to develop modern innovative approaches to the use of various types of retainers in the practice of an orthodontist to minimize the recurrence of dental anomalies and deformities.Research objectives:To study the effectiveness of standard retention methods in adolescents and adults.Evaluate the possibility of a combination of removable and non-removable retainers.To estimate the duration of the retention period when using different types of structures. Materials and methods: In the course of the study, a comprehensive diagnosis and statistical analysis of the results of the retention period was carried out using various types of retainers after orthodontic correction using modern non-removable multibonding equipment in 120 patients with a history of violations of the position of individual teeth, dentition and malocclusion aged from 14 to 35 years. The study period was 18-24 months.In the process of complex orthodontic diagnostics , the following methods were used:- Clinical method of examination in accordance with the recommendations of WHO (1985) and T.F. Vinogradova (1988).- Biometric analysis of diagnostic models of jaws.- X-ray analysis of targeted intraoral radiographs and orthopantomograms of the jaws;- Photometric method;- Statistical analysis of the results of the study was carried out using the STATISTICA 6.0 application software package from StatSoft Inc. When studying the data, the evaluation of the studied features in groups was carried out, the comparison of groups was carried out, the relationship of features was studied using parametric and nonparametric methods, depending on the type of distribution.Results: in the course of the conducted scientific and practical research, we obtained results indicating the complexity of the approach to the implementation of the retention period in orthodontic patients. The main problem at this stage of orthodontics development is the lack of a structured approach to the stage of retaining the achieved results.Conclusions: In our study, we proved a scientifically and clinically sound approach to retention as differentiated and personalized. Only by considering each clinical case as an individual can we achieve sustainable results of orthodontic treatment.

Relevance. SARS-CoV-2 is one of the most dangerous RNA viruses. It causes COVID-19. The emergence at the end of 2019 of diseases caused by the new coronavirus has already gone down in history as an international emergency. In addition to damage to the respiratory and cardiovascular systems, COVID-19 also affects the tissues of the oral cavity, causing a long-term decrease in local immunity, and is the cause of the exacerbation of various chronic diseases of the oral cavity and the emergence of new pathologies.

Among the causes of problems are the weakening of the local immunity of the oral cavity, the deterioration in the supply of tissues with oxygen and nutrients against the background of a low intensity of blood flow and the reproduction of harmful microflora. All of these factors occur in patients who have had COVID-19, even in a mild form.

Methods. We decided to study the course of generalized periodontitis in people who had this dangerous infection. To conduct the study, it was decided to compare the manifestations of coronovirus infection in the oral cavity, as well as to study the influence of post-COVID syndrome on the development of diseases in the oral cavity, the duration of the course and the dynamics of recovery. To do this, we identified a group of patients who had a history of a coronovirus infection and compared the course of moderate generalized periodontitis with a group of patients with other general somatic diseases, but who did not have COVID-19.

Results. During the observation, it was found that the first group of patients who had COVID-19 a month ago had a more aggressive and prolonged course of chronic generalized periodontitis of moderate severity than the second group of patients who had never had a coronavirus infection. groups - 15 days, the onset of the remission stage - 10 days after the exacerbation. The duration of the exacerbation of the disease in the second group is 10 days, the onset of the remission stage is 5-7 days after the exacerbation.

Conclusions. A longer and more aggressive course of exacerbation of periodontitis in the first group of patients is due to a previous coronavirus infection. COVID-19 and ongoing therapy against it have a negative impact on the tissues of the oral mucosa. The oral cavity is attacked by SARS-CoV-2, so its condition should be given maximum attention.

The increase in life expectancy of the population of Russia implies an increase in the number of gerontological patients at a dental appointment. For successful treatment of this category of patients, it is necessary to know the psychological, physiological and, most importantly, dental features associated with age.

Relevance: At the dental appointment there is a special category of patients - gerontostomatological. The reality is that the state of the oral cavity in recent years, according to statistics, has been deteriorating significantly due to a significant change in the environmental situation and the quality of life in general. Aging patients a priori need all specialized types of dental care: therapeutic, surgical, orthopedic. An important problem is the treatment of diseases of the oral mucosa.

Purpose: This study is to analyze the features of dental care for the elderly.

Materials and methods: the analysis of primary medical documentation of age patients who applied for help to the dental clinic of the Voronezh State Medical University named after V.I. N.N. Burdenko for one reporting year (in the period from 12/21/20 to 12/20/21 with diseases of the oral mucosa)

Results: An analysis of the appealability of gerontostomatological patients with diseases of the oral mucosa is presented;

This problem was previously dealt with by E.V. Sidova, F.N. Paleev, O.N. Startseva M. (educational manual "Fundamentals of Geriatrics for Primary Care Physicians", 2019), O.I. Doroshina, Yu.V. Lebedev, L.V. Tokarskaya. Yekaterinburg (textbook "Gerontopsychology" 2020).

The dental portrait of elderly patients is described in detail in the work of the same name by Cheremnykh A.I., Russkikh I.S.

When writing this article, scientific and methodological literature was used, as well as the actual data of polyclinic case histories.

Conclusion: Analyzing the presented data, it should be noted that the appeal of age patients for dental care is significant. This applies to all narrow specialties of the dental profile. Oral mucosal diseases are no exception. The basic requirements for a primary care physician are still the same: correctly diagnose, adequately treat: if necessary, involve relevant narrow specialists.

Age patients with diseases of the oral mucosa make up the vast majority of those who seek medical help. It should be noted that patients belonging to the group "Elderly" aged 55-74 years prevail among other groups. Patients from the "long-livers" group are rare.

When analyzing the appealability of gerontostomatological patients according to the nosological forms of mucosal diseases, it should be noted that oral candidiasis is the leader among other diseases of this group, and in two age groups: “Elderly” and “Old”. According to the frequency of referral, patients with glossalgia phenomena take the second place, and with manifestations of lichen planus of the oral cavity, the third.

Precancerous conditions of the oral mucosa occur in various diseases (lichen planus, leukoplakia); from the doctor require special attention.

Relevance. The COVID-19 pandemic has huge implications for WHO and the world at large. From December 31, 2019 to the present, the number of infected exceeds 410 million people, the number of deaths is more than 5.8 million people.

Target. In our work, we analyzed the results of the activities of the Voronezh Regional Clinical Center for Disaster Medicine in organizing medical care for patients with a new coronavirus infection COVID-19.

Materials and methods. The study was based on: the method of expert assessments, statistical data analysis

Results Using the method of expert assessments, statistical analysis, the important role of the KUZ VO "VOKTSMK" in the provision of medical care in the fight against COVID-19 was determined.

Conclusion. KUZ VO "VOKTSMK" contributed to the creation on the basis of LMO of a system of staged medical care, the provision of timely specialized, including high-tech, medical care using various equipment

Relevance. Competition improves and modernizes business processes. In order to ensure that demand for the product is maintained, certain instruments are applied.  One such tool is delegation, through which functions are carried out     marketing and outsourcing. Marketing promotes the health organization in the health care market that  increases the recognition and loyalty of patients to this clinic.

Objective. To assess the advantages and disadvantages of outsourcing in the health-care system, to analyse the degree of introduction and stages of development in Russia and abroad.

Methods. Comparative analysis of the methodological approach to the study of outsourcing in the health-care system: the case of the Russian Federation and  abroad used.

Results. Outsourcing helps delegate responsibilities, that other organizations can do to help with medical business. The article discusses the main trends and benefits of outsourcing for health care, coverage of domestic and foreign health care.

Conclusion. Key issues identified and examined  impeding the active introduction of the methodology in highly specialized areas of medicine in the Russian Federation. Further prospects for outsourcing for Effective management of health organizations and improvement of quality of care public health services.

Relevance. Currently, as argued in the research literature, there is a rejection of the old, traditional (patriarchal) model of the family, where the head is a man. In this model, there is a particular hierarchical sequence of "father - mother - children". Today's young families are undergoing a transition from the old model to a newer, "transitional" model, which has completely different values. In this model, the equality of all family members prevails, and the importance of the personal opinions of each of them, even of the children, is emphasized. On the other hand, it cannot be said that human relationships themselves have undergone some changes - they have not. People are still subject to feelings, they still love their parents, their partner, their children. The modern family model has only brought a more pronounced emotional component and mutual support for each other.

Objective. To study attitudes towards family, family life of different age groups of pediatric faculty.

Methods: statistical analysis, descriptive, also using Google Forms platform 1800 students of pediatric faculty, as well as 150 young specialist doctors were surveyed. An oral survey was used to obtain the opinions of 50 faculty and staff members.

Results. Opinions of different age and professional groups (students, professionals, and educators) were obtained and analyzed during the study. However, the similarity of views of most respondents regardless of age and other social factors is noted.

Conclusion. Nothing stands still in the modern world, and the institution of the family is also changing. Many people are increasingly abandoning the traditional family structure towards more equality in terms of sharing family responsibilities and raising children. Even so, many things remain important and unchanged, such as the importance and significance of formal marriage.

Aim: the purpose of this study is to systematize information about the biographies of the department's employees who participated in the Great Patriotic War, their military path and scientific achievements.

Materials and methods: the main method of this study is the analysis and comparison of literary sources. In this work, the basis is archival documents, historical notes, as well as data given in the project "Memory of the People". Results: the missing information about the military path of the employees of the Department of Otorhinolaryngology was systematized and supplemented. Conclusion: the historical search is a thorny path to comprehend the past. Not all great names are presented in this article.

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A comparative assessment of the epidemiological situation in the regions implies a comparison of statistical indicators characterizing the level of morbidity. Since February 2020, Covid-19 morbidity statistics have been constantly covered in the media. In particular, daily reports are published on the number of new cases of infection, deaths and recovery in the Russian Federation as a whole and in the regional context.Purpose: The purpose of the article was to develop a model for a generalized assessment of the severity of the epidemiological situation in the region.Methods: The study was conducted on the basis of data on the incidence of Covid-19 in the regions of the Central Chernozem region, presented on the website "Coronavirus statistics by regions of Russia" [1] in 2021-2022. Relative morbidity rates are normalized, and a generalized indicator is calculated based on them.Results: It is demonstrated that the proposed model allows us to determine the rating of regions according to the severity of the epidemiological situation, taking into account data reflecting the specifics of the disease. Its application is used to evaluate the rating of the regions of the Black Earth region on the incidence of Covid-19.Conclusions: The proposed model can be used in scientific research to determine the rating of regions according to the severity of the epidemiological situation and to assess the effectiveness of measures taken to prevent the development of the disease.

Relevance: The COVID-19 pandemic has created a special interest in medical knowledge among people who are not professionally involved in health care. This is due to the relevance of first aid for life-threatening conditions to loved ones and the lack of information on this topic. Although first aid is a part of the life skills syllabus at schools, vocational schools and universities, training is often formal, and the skills learned are often forgotten over time. Most sudden deaths occur mostly outside medical facilities, so in real life situations, only someone who is on hand and knows how to administer PPE will be able to help the victim before the paramedics arrive.

Objective: To create a mobile app for training and first aid as adaptable as possible.
Materials and methods: Development of the app started in October 2021 and is still ongoing. It is created using the Capacitor platform version 3.

Results: The application is created on the basis of the Order of the Ministry of Health and Social Development of Russia dated 04.05.2012 N 477n and suggests the content of algorithms of actions under 8 emergency conditions: lack of consciousness, respiratory and circulatory arrest, external bleeding, foreign bodies of upper airways, injuries in different areas of the body, burns and effects of high temperatures, thermal radiation, freezing and other effects of low temperatures, poisoning. The design of the app implies sound and animations.

Conclusion: the app is intended for all those willing and obliged to provide first aid. It will be useful for non-medical people and medical students as well as non-urgent medical workers.

Key words: first aid, mobile application, emergencies.

Relevance: Considering the trend of recent years to increase the volume of public investment in the healthcare sector, as well as the current epidemiological situation in connection with the pandemic of a new coronavirus infection, it is necessary to ask questions about the most rational use of available resources, attracting new personnel to the above-mentioned area and improving the quality of services provided. At the same time, there are a number of problems in public health that complicate the process of its development and reduce the satisfaction of the population with the work of budgetary organizations. It is their solution that should become the primary task of the organizers of modern Russian healthcare. This article is aimed at creating a comparative description of the budgetary and private health care systems, as well as highlighting the organizational and other aspects that can be adopted by state and municipal institutions from private ones in order to improve their functioning and improve the quality of medical care provided.

Objective: To compare the positive and negative sides of public and private health care systems. Suggest ways to improve the functioning of state and municipal organizations, as well as improve the quality of medical care provided by modernized approaches used in private organizations.

Materials and methods: The paper studied, analyzed and summarized information posted on the Internet in the form of scientific articles and concepts for the development of the health care system through mental analysis, full induction and comparison. It took 30 days to conduct the research and write the article (from January 11 to February 10, 2022).

Results: The study revealed that both studied Russian healthcare systems have an emphasis on the following characteristics: efficiency of management and use of resources, attitude towards modernization and innovation, customer focus and individualization of approaches to diagnosis and treatment, as well as the speed and availability of services. At the same time, on average, in budgetary organizations, the above characteristics have a negative connotation (low quality of patient care, great inertia towards the perception of innovations, etc.), and in private ones they are positive (increased service quality of the services provided, rapid implementation of modern information systems), although and there are a number of exceptions. The solution of the identified problems should consist of both organizational measures (for example, regular assessments of the effectiveness of organizations, both external and internal), and socio-economic ones, in the form of measures provided by the state to stimulate the development of public-private partnerships.

Conclusion: Summarizing all of the above, it is necessary to take into account that the identified positive and negative aspects of the budgetary and private systems, as well as approaches to their organization, are a consequence of both the general state policy regarding health care and the attitude of each individual citizen to their health and the service sector responsible for him. Therefore, it is important not only to engage in modernization, but also to promote the idea that taking care of one's health is the responsibility of every person.

The social conditionality of the health quality of modern society actualizes the scientific and practical significance of the issues of preventive medicine focused on the prevention and minimization of adverse effects on the physical and social health of the population of multiple environmental risks. At the same time, practical healthcare is not free from difficulties that prevent the implementation of preventive tasks in full. These include the discrepancy between the volume of theoretical developments and the degree of their practical application. Another problem is that preventive medicine in Russia is still among the most underestimated types of medical care. As a result, the preservation of health as a norm and the daily culture of life is not perceived by a significant part of Russians as a priority value.

Stomach cancer is the most common type of tumor worldwide. Currently, various methods are used to treat this disease, including the use of targeted therapy. This is one of the priority directions of pharmacotherapy, which is based on blocking the growth of cancer cells necessary for carcinogenesis by interfering with the mechanism of action of specific target molecules. It is characterized by a directed effect on the cancer, its receptors, DNA and other structures, which leads to a slowdown in the further spread of metastases. This is the difference from other methods, for example, from chemotherapy, which affects the growth of all cells capable of rapid division. One of the drugs used in targeted therapy is Trastuzumab. It is a synthetic antitumor drug containing recombinant monoclonal antibodies that have activity against a membrane protein of the HER₂ tyrosine protein kinase type.  The article demonstrates the use of this drug among cancer patients of the Lipetsk regional Oncological dispensary, analyzes the side effects, their number, strength of manifestation, as well as the spread among patients. It is noted that Trastuzumab combines efficacy with fewer side effects, which makes it a priority in prescribing for patients with HER2-positive tumor status.

In the modern world, there is a wide range of drugs that contain a large number of antioxidants. In the human body, a physiological process of lipid peroxidation takes place, which is involved in the renewal and maintenance of the functions of biological membranes, cell division. The role of antioxidants in this process is expressed by inhibiting the oxidative process and neutralizing the action of free radicals; there is also evidence to prevent the destructive effect of free radicals on cells and slow down the aging process of cells [1]. The article presents an experience that evaluates the antioxidant activity of medicinal plant materials in order to use it as adjuvants for the treatment of diseases associated with cognitive impairment.

In this article methods of marketing research of different objects of pharmaceutical market and also their role in practical pharmacy are discussed. There are presented authors who had done marketing research of medication of different pharmacological groups on federal, regional and local pharmaceutical markets in the period from 2017 to 2021. Some of the theoretical aspects of marketing research in pharmacy are laid in the foundation of pharmaceutical help, which is an integral part of improvement of Russian healthcare system.

E.A.Volynkina, D.M.Kungurova

Supervisor: Cand.Sc.(Biology), doc.V. A. Semiletova

Voronezh N.N. Burdenko State Medical University

Dep. of Normal Physiology

Relevance. Modern man is influenced by the increasing number of stress factors, which have a great negative impact to the functional state of the body. One of the methods, which contributes to growing of efficiency and helps to make the health better, is Sand-art therapy. Due to this methodology there are activation of the right hemisphere of the brain and actually hemisperic synchronization. So owing to it there are opportunities to show creativity and to make yourself feel better. Using the special quality sand has a directly impact to the development of tactile sensitivity, fine motor skills and movements’ coordination. Additionally, it has a relaxing effect and contributes to normalization of some cardiovascular parameters. Besides, the influence of light and shadow promotes the development of associative thinking, which in total with the other mechanisms ensures a positive outcome. 

Objective of the study.  To analyze the effect of a Sand-art therapeutic session on the functional state of a person.
Materials and methods. The complex research of physiological and psychological parameteres was carried out among the 22 participants. The average age of the participants was 20+1,2 years. The criteria for inclusion in the group was the absence of cardiovascular diseases and color perception defects. Informed consent was obtained from each participant. Analysis of the studied parameters was performed before the Sand-art therapeutic session and after it. Drawing with sand of a special fraction was performed on a special table equipped with a backlight creating a background for the process. The respondents were asked a questionnaire, which consisted of questions, allowing them to assess their condition before and after Sand-art therapy. For the purpose of assessing psychological status, a Lusher test and simple visual-motor reaction were carried out before and after Sand-art therapy. Statistical processing was made with the help of Excel and IBM SSPS Statistics 26.
Results.According to the results of the research, changes in the parameters of the simple visual-motor reaction test and the Lusher test were revealed, as well as the characteristics of the first and last drawings depicted during the Sand-art therapy session.
Conclusions. Thus, the results testify to the significant influence of the Sand-art therapy session on the functional state of the person.

For the third year, the whole world lives in the conditions of the spread of a new infection COVID-19, [1] so each of us is in a state of stress to one degree or another. Aromatherapy is one of the popular recreational methods. In this regard, the purpose of our work is to study the effect of aromatherapy (orange and pine oils) on a person's simple visual-motor reaction.

The study involved 21 volunteers aged 18 to 21 years.

The subjects were at rest, inhaling aromatic oils of orange and pine. Each subject signed an informational consent, underwent a questionnaire and a study of a simple human visual-motor response (pPMT). Statistical data processing was performed using Excel and IBM SSPS Statistics 26.

The results of the study made it possible to state the high effectiveness of the effect of aromatherapy on the functional state of a person. It has been established that orange oil eliminates psychoemotional arousal, relieves fatigue, increases visual-motor response and fallacy, which, we believe, is associated with calming effects. Pine oil tones and saves from exhaustion. Also, the study revealed some sexual sensitivities and gender differences in responses to the aromatic effects of pine.

Relevance. The Voronezh Region is a region with a natural iodine deficiency. Every year, the indicators of primary and general morbidity of thyroid pathology remain at a high level. Therefore, the study of the quality of life in patients with thyroid pathology with different hormonal profiles is relevant.
The aim is to study the features of the hormonal profile and psychological status of patients with thyroid diseases in the region with mild iodine deficiency and assess their quality of life.
Materials and methods. A survey of patients and students of the medical University was conducted using the SF-36 questionnaire. To assess the quality of life, the data of patients with thyroid diseases having different hormonal profiles were compared with a group of healthy patients without thyroid pathology. We performed a comparative analysis of the quality of life of students and healthy patients. Methods of statistical processing, the Microsoft Excel program and Statistica 6 were used.
Results.
Based on the results obtained, it was found that in patients with nodes in the thyroid gland, the normal hormonal background provides a higher level of both physical and psychological components of health compared with patients with hypothyroidism. Patients with nodular formations in the thyroid gland with its normal function, who do not require surgical treatment, as well as healthy patients, have similar indicators of physical, vital, social activity and mental health. Patients with autoimmune thyroiditis with reduced thyroid function, compared with patients with normal function, note a restriction of physical activity, daily activities, the presence of pronounced pain, a low assessment of health status, decreased vital activity and the presence of psychological distress. The absence of thyroid pathology and its normal hormonal background determine high quality of life indicators.
Conclusion.
The conducted study on the quality of life showed its decrease in comparison with practically healthy individuals, both in patients with normal thyroid function and in patients with hypothyroidism. With a decrease in thyroid function, the quality of life suffers on six of the eight analyzed scales, while affecting the physical component of health to a greater extent than the psychological component of health. In healthy people, the quality of life is affected by age.
Keywords: hormonal profile, psychological status, thyroid diseases, quality of life.

Relevance: the main task of sports training of athletes is to achieve the highest results, therefore, it is important to search for such methods of improving physical qualities that allow him to get the maximum training effect.
Key words: athletics, alactic anaerobic process, interval method, training process, sports, sprinters.
Purpose: to substantiate the necessity and effectiveness of the interval method for its frequent use in the preparation of sprinters.
Materials and Methods: In the study, a test for speed-strength qualities was used - a 60-meter run. There were three successive races with rest breaks. Testing was performed by young athletes. The results were evaluated using a stopwatch.
Results: As a result of testing, it turned out that a rest interval of 30 seconds was less effective than a rest equal to a minute, that is. the results of each individual run (second and third sets) were worse when the rest interval was 30 seconds
Conclusion: the conducted observations confirmed the percentage of low effect of rest intervals within 30 seconds and the hypothesis of the interval training method in the preparation of sprinters. Interval exercises of maximum power, with 1-3-minute rest pauses, contribute to the development of alactic anaerobic abilities.

Objective: to compare the results of physical fitness of students engaged in anaerobic exercises using the Cooper test.
Methods: the study was conducted in the premises of the fitness center of Voronezh, in the gym ("Red"), in the premises of the Voronezh State Medical University named after N.N. Burdenko, as well as training at home. Four target groups of students participated in the study. The first and second visited specialized institutions, and the third and fourth studied at home in their free time using a fitness bracelet to measure the following indicators: pulse, time (stopwatch).
The authors conducted the Cooper test to assess physical fitness, for five months, in which the time of the test was recorded. For additional assessment of physical parameters, pulse measurements in all subjects were carried out monthly, during training and during exercise

Results: As a result of the studies conducted with the applicable Cooper test, the first group of students is the most prepared. According to the testing, the indicators of the first group have high values. The lowest values are noted in the fourth group. Good productivity is observed in the third group. In the second group, there are no significant changes, it has stable results in terms of the test. It was revealed that the pulse rate depends on physical fitness and on the type of physical activity.

Conclusion: in the course of the study, the strengths and weaknesses of the physical fitness of all groups of students were revealed. All subjects were satisfied with the results, which is why it can be argued that the Cooper test serves as a motivation to improve the physical fitness of students.

Relevance: during the world lockdown, the problem of physical development and health occupies one of the central places. Students are in rather closed conditions, as a result of which the mode of motor activity is severely limited. In addition, the problem of the development of physical qualities remains relevant, taking into account modern health-saving technologies for the qualitative solution of professional tasks.

Objective: to develop a methodology for improving the coordination abilities of university students based on the dance direction "hip-hop" and its further use in practical physical education classes as a means of developing physical qualities.

Methods: the study was conducted during distance learning of students (coronavirus pandemic) at home. The study involved a group of 3rd year students (10 girls and 5 boys) in the age category of 19-20 years. The authors conducted a Romberg test to assess coordination abilities on two tests for maintaining balance. The time of maintaining balance in the "heel-toe" pose and the "heron" position were recorded. Also, the subjects were assessed the technique of performing a combination of basic steps "hip-hop", according to six criteria. Trainings were conducted twice a week for four months, with regular recording of test scores, to assess the effectiveness of the impact of dance style on the development of coordination abilities in students.

Results: as a result of the conducted research, it was revealed that most of the participants engaged in dancing significantly improved their coordination abilities, sense of rhythm, ability to improvise and express the individuality of the performer.

Conclusion: after analyzing the data obtained, we concluded that it is necessary to include modern dance systems ("hip-hop") in the practical classes of students as a means for the development of physical qualities

Purpose: to find out whether philosophy is an integral part of the formation of the personality of a future doctor.

Methods: Theoretical.

Conclusions: Thanks to philosophy, the most important qualities are formed, without which it is impossible to imagine a real specialist.

The purpose of this work is to analyze the essence of love, its manifestations, and also to understand what is meant by this concept - passion, affection, or something more that can determine the meaning of all being.

Methods: analysis, comparison

As a result of the study, it was determined that love will be studied for many more centuries, but only one thing will remain unchanged - no matter what love is, between a man or a woman, between a mother and children, or is it love for one's neighbor - it will forever remain the meaning of life on earth.

Conclusions: Having considered love in various periods of the history of philosophy, having considered all aspects of its manifestation, we can conclude that this is one of the most beautiful things that can be in a person. After all, she encourages him to change his inner world, to reconsider his views on life, as well as on everything that surrounds him. Therefore, this feeling has a huge impact on the development of the individual, making it unique, inimitable. Love is the stronghold of the whole human soul, the whole human essence, because without it neither faith nor hope can exist in the hearts of people.

Relevance: The study is devoted to the problem of distortion of cognitive functions due to a large number of information flows, which has acquired special importance in the era of the global crisis.
Purpose: To study the relevance of the problem, to analyze the literature on the topic of distortion of cognitive functions. Determine the percentage of people affected by information flows.
Methods: Analytical, statistical, empirical methods, as well as methods of induction, deduction, abstraction, analysis and synthesis were used in the course of the study. A survey of 2,500 respondents was conducted, as a result of which the influence of information flows on the cognitive functions of students was revealed.
Results: During the study, it was possible to determine the degree of influence of information flows on the intellectual abilities of respondents.

Background: The limited knowledge of medical terminology among first-year medical students leads to the need to use different dictionaries for translating medical texts, which do not always correctly reflect the essence of the information presented in the scientific literature. The parallel text can be used by the student as an extra material from which one can take necessary terms and knowledge for translation, which will improve the comprehension of the original text.
The aim of this study was to evaluate the advantages of translating scientific medical articles using the method of "parallel texts" in comparing with translation using an electronic dictionary.
Materials and methods. Translation of scientific and medical texts using an electronic dictionary and the "parallel texts" method.
Results. A total of six Russian-language articles dealing the same issues as the original English text were used as parallel texts in the translation of the initial article.
Conclusions: The method of "parallel texts" is more time-consuming and labour-intensive, but it allows to achieve greater adequacy in the translation of medical terms, expands significantly the volume of cognitive information obtained during translation, and contributes to the development of students' skills during the work with scientific medical texts.

Relevance: In industrialized countries, according to some estimates, smoking contributes to mortality of about 80% of men and 60% of women, and in developing countries, 45% of men and 20% of women. In the Russian Federation, 23.1% of the adult population is addicted to nicotine.

Methods and materials. A retrospective analysis of the medical records of patients with pulmonary tuberculosis who received treatment in the day hospital of the anti-tuberculosis dispensary named after A.I. Smoking status was determined using a survey. According to laboratory data, the sensitivity of tuberculosis microbacteria to anti-tuberculosis drugs was determined. Also, according to X-ray or CT scans, residual changes in the lungs were found at the time the patient was discharged from the hospital.

Discussion of the results. From 2019 to 2021, 202 patients with respiratory tuberculosis were observed for treatment in the day hospital of the anti-tuberculosis dispensary. dependence, more severe forms of tuberculosis were recorded, and there was also resistance of Mycobacterium tuberculosis to drugs.

Regular inhalation of tobacco smoke and its chemical compounds leads to the formation of multiple and extensive drug resistance, which complicates the treatment process. The solution to the problem is quitting smoking, which is not only part of effective treatment, but also the prevention of many diseases, including tuberculosis.

ConclusionTobacco. smoking is widespread among patients with tuberculosis of the respiratory organs and accounts for 61.38% of all patients treated in the day hospital of the KUZ VO VOKPTD named after. N.S. Pokhvisneva in the period from 2019 to 2021 inclusive.

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Relevance. Currently, tuberculosis is one of the most important health problems. According to the latest WHO data for 2019, about 10 million cases of tuberculosis were detected on the planet. The steady decline in the number of cases in the Russian Federation (RF) indicates a positive trend on this issue, however, against the background of a decrease in the total number of patients, the proportion of the number of people with this pathology among the adult population of urban and rural areas has remained virtually unchanged for 11 years. In addition, it should be noted that despite the use of new chemotherapy regimens, in recent years there has been a decrease in the effectiveness of treatment of patients with this disease, this is facilitated by an increase in cases of drug resistance (LU), as well as frequent forms of pulmonary tuberculosis, which tend to rapidly develop a destructive process and massive bacterial excretion. The introduction of alternative therapies will increase the effectiveness of the treatment of the above-mentioned forms of tuberculosis, for this purpose, collapse therapy is used in combination with chemotherapy.

Goal. To evaluate the effectiveness of complex treatment of patients with destructive forms of pulmonary tuberculosis, both with and without drug resistance of the pathogen, using methods of collapse therapy.

Materials and methods. The current research, foreign and Russian literature for the period 2010-2021 on the presented topic were analyzed.

Results. Collapse therapy is a method of treating pulmonary tuberculosis aimed at reducing the volume of the affected lung and partial convergence of the walls of the cavity, by introducing air into the pleural or abdominal cavity.

The most important aspect of studying collapse therapy is to determine its prognostic significance in the treatment of destructive and LU forms of pulmonary tuberculosis. A number of studies have determined that this method increases the effectiveness of treatment against the background of rational chemotherapy.

Discussion. Taking into account all the above results, it should be said that collapse therapy is definitely an effective method of treating destructive and LU forms of pulmonary tuberculosis.

Conclusion. The importance of this type of treatment is increasing due to the steady growth of antibiotic resistance and the spread of destructive forms of pulmonary tuberculosis. IP and PP undoubtedly predict good results at an early stage of treatment, which is confirmed by the studies described above.

Objective: study of the prognostic value of the 6-minute walk test distance (6MWT), NT-proBNP level, left ventricular (LV) diastolic dysfunction in the progression of atrial fibrillation (AF) in CHF patients.

Materials and research methods: 96 patients with CHF of the second or third functional class (FC) according to NYHA, who were included in the regional register of CHF patients in September-November 2014, took part in the study. The definition of the functional class of CHF was carried out according to the results of a six-minute walk test. The average follow-up period was 35±2 months. Routine examinations were carried out by researchers every 3 months. Annual clinical and laboratory-instrumental examination: Nt-proBNP level, ECG, halter ECG monitoring (24H ECG), echocardiography. Two groups of patients were formed depending on the clinical course of AF: group 1 - patients without arrhythmia progression (n=65) during the observation period, group 2 - patients with arrhythmia progression (n=31).

Results: In patients with progression of AF, the results of 6MWT were 33 m lower compared to group 1 (p=0.0159). The average level of Nt-proBNP when enrolling patients in the study, obtained by ELISA in the group of patients without AF progression, was 1.7 times (p <0.001) lower than in patients with identified AF progression. At the time of inclusion of patients in the study, according to the results of echocardiography, there was no significant difference in the value of LVEF in both groups (43.03±1.23 and 44.18±0.65%, p=0.08). LV CSR (4.11±0.07 and 4.06±0.06 cm, p=0.46), LVESD (5.63±0.09 and 5.25±0.05 cm, p=0,77), LA size (4.51±0.12 and 4.46±0.14 cm, p=0.32), left ventricular (LV) posterior wall thickness (1.24±0.05 and 1.27±0.02 cm, p=0.71) and interventricular septum thickness (1.19±0.03 and 1.24±0.02 cm, p=0.09) also did not have significant differences in the compared groups.

Conclusions: Thus, in patients with CHF, the predictors of AF progression with the transition of arrhythmia to stable forms can be an increase in the level of Nt-proBNP, impaired relaxation of the myocardium (diastolic dysfunction), and a decrease in 6MWT distance.

Relevance The progression of chronic heart failure (CHF) is associated with repeated hospitalizations and a decrease in the quality and duration of life. In this regard, the search and development of effective treatment and prevention programs are relevant and necessary today.

The research objective To assess the effect of physical training on the clinical course, laboratory and instrumental parameters in patients with CHF with preserved (CHFpEF) reduced (CHFrEF) ejection fraction.

Methods The study included 160 patients with CHF (86 men and 74 women) with an average age of 72.2±8.8 years.  The separation into groups was made on the basis of the left ventricular ejection fraction (LV EF).  In each group, two subgroups were formed depending on the inclusion in the therapeutic program of physical training. At the time of inclusion and after 12 months, a determination of exercise tolerance, laboratory and instrumental examination were carried out. Statistical analysis was carried out using the Statistica 10 software package.

Results Re-examination after 12 months in subgroups undergoing physical rehabilitation revealed a statistically significant (p≤0.05) decrease in the level of N end fragment of natriuretic peptide (NT-proBNP), highly sensitive C-reactive protein (hs-CRP), interleukin-1 β (IL1 β), interleukin-6 (IL6), tumor necrosis factor - alpha (TNF - alpha). There was an increase in exercise tolerance  , evaluated using 6MWT.

Conclusion Physical rehabilitation in patients with CHF with both preserved and reduced LV FV is accompanied by a significant improvement in the clinical course, an improvement  in stress tests (6MWT), a decrease in the level of pro-inflammatory cytokines, hs-CRP, NT-proBNP.

Objective: to study the comparative characteristics of calcium-phosphorus metabolism and the activity of alkaline phosphatase in blood serum, depending on the state of bone mineral density (BMD) in children with chronic bronchitis (CKD).