bluuebunny/crossref_metadata_2025 huggingface dataset:
Possibility of age-related changes correction in the face and neck skin using laser technology
Authors: Shanina N A , Patrushev A V , Samtsov A V , Plakhov V N
Published: July 2021

The possibility of using combined erbium and neodymium lasers to correct the age-related changes in the face and neck skin by the «Fotona» apparatus using the «Fotona 4D» technique was investigated. To evaluate the results of the study in dynamics an index of age-related changes in skin was developed and applied. The results of photographic fixation and ultrasound of the facial and neck skin before and after laser procedures were also compared. It was determined, that the combination of two wavelengths of 2940 nm (erbium laser) and 1064 nm (neodymium laser) and the «Fotona 4D» technique with 4 patented technologies allows to carry out the procedure at the level of superficial, middle and deep structures of the face and neck tissues. Nowadays it is the only technology for non-invasive volumetric reconstruction and facial skin voluminisation, which is the result of a combination of synergistic methods of laser exposure. It was shown that one month after the second procedure of laser treatment, the face skin turgor increased, its dryness, pore severity, quantity and depth of wrinkles decreased, side effects and complications were absent. Ultrasound examination of the facial skin and index of age- related changes assessing in the face skin confirmed the positive dynamics of correction. Thus, the thickness of the skin in the area of nasolabial folds and superciliary arches increased by 0,5 mm (from 1,9 to 2,4 mm), derma by 0,6 mm (0,8 to 1 mm). The index of age-related changes assessing in the facial skin decreased by 10-13 points (before the procedure it was within the range of 20-24 points (average degree of age changes), after the procedure it was 11 points (mild degree of age changes). Thus, the use of combined erbium and neodymium lasers using the «Fotona 4D» technique showed a high efficiency of laser correction of age-related changes in the facial skin. Implemention of modern technologies in practice of dermatological clinics will improve skills of medical personnel on the use of laser technology.
Influence of primary disease incidence on the psycho-physiological adaptation of pilots in the Far North
Authors: Apchel V Ya , Zagorodnikov G G , Zagorodnikov G N , Gorichny V A
Published: July 2021

The analysis of three years of primary disease incidence of flight and ground personnel in the Far North is presented as well as the analysis of the main meteorological factors, their complex characteristics and amount of respiratory diseases in flight crews on the day of observation and the subsequent 4 days. Assessment of influence of meteorological factors was carried out simultaneously in two directions: determined differential impact on the body of flight crews of each meteorological factor and simultaneous identification of their complex actions. It was found that pilots (navigators), showed a statistically significant (p0,001) increase in the average incidence of diseases compared with average index of primary morbidity from other members of the flight crews. It was revealed that flight crews serving in the area of the Far North for less than one year, shows a statistically significant (p0,01) increase in the average index of primary morbidity, compared with flight crews serving in the area of the Far North more than one year. Thus, a statistically significant increase in the average primary incidence of the pilots (navigators), compared with the average indicators of the primary morbidity from other members of the flight crews and ground troops means that physiological adaptation of pilots (navigators) to the Extreme North occurs with a larger psychoemotional stress than in soldiers of other specialties. The obtained results on the incidence of primary aircrew in the Far North allow to better understand mechanisms of influence of health state on the successful adaptation to extreme climatic conditions.
Features of regulation of the immune system and sexual development in girls suffering from acne
Authors: Pilnik E N , Pyatibrat A O , Apchel A V , Shabanov P D
Published: July 2021

Comparative analysis of immune status and pubertal development in healthy girls and those suffering from acne disease. It is revealed that the immune status of girls suffering from acne disease, characterized by a decrease in cytotoxic lymphocytes, increase T-lymphocytes helper cells and immunoregulatory index. In the peripheral blood of these girls there was an increase in interleukin-4 and serum tumor necrosis factor, level of circulating immune complexes, mainly due to the low was significantly lower than in g concentration of serum interferon healthy girls. In girls suffering from acne in puberty the concentration of luteinizing and follicle-stimulating hormone in peripheral blood was significantly lower than girls in the control group. While menarche in girls 14-13 years old, with acne, there were significantly less than in the control group. The formation of breast and pubic hair at puberty, they lagged behind in comparison with girls in the control group. The indicators of basal metabolism indicate that girls with acne disease higher rates of creatinine and glucose, and also lower essential fatty acids and enzyme activities of alanine and aspartic transferases than girls in the control group. Thus, ladies suffering from acne, was characterized by delayed and at the same time disharmonious puberty. They are characterized by a later menarche, delayed the establishment of the rhythm of the menstrual cycle, some changes of rhythm humoral regulation and biochemical homeostasis.
Features of a functional state and special working capacity, highly skilled athletes, taking into account type of the vegetative regulation of a cordial rhythm
Authors: Brooke T M , Litvin F B , Terekhov P A , Tolstoy O A
Published: July 2021

The results of research of high-speed, speed-strength abilities and special anaerobic endurance in highly skilled male and female athletes are presented. It is established, that the indices of physical working capacity depend on the type of vegetative regulation of the heart rhythm. Athletes (male and women), who have the same level of skill with moderate dominance of central mechanisms vegetative regulation of a cordial rhythm, significantly higher speed-strength indicators. In particular, for men, with moderate dominance of central mechanisms vegetative regulation of a cordial rhythm (1 type), during the work in the anaerobic mode, gather higher speed, which on 4,1% is statistically higher in comparison with athletes with moderate domination of the autonomous mechanism of regulation of a cordial rhythm (3 type). At the same time, the time of achievement of frequency of rotation of pedals of a veloergometer, equal 70% of the maximum size, they on 3% (р0,05) less. The women, with the 1 type of a regulation of a cordial rhythm, indicators of absolute, average and relative power (р0,05) on 1,6; 2,6 and 8,9 higher. With an increase in the duration of anaerobic work, the indices of special endurance are statistically reliably higher in athletes with moderate dominance of the autonomous regulatory mechanism. For example, for men, the indicator of total work power on 4,2% higher, and indicators of maximum, average and relative power by 2,4;2,9 and 1,9%, respectively (p0,05). The women, with type III multiple scores, the rates were significantly higher by 3,2; 4,2;4,1; 3,6%, respectively (p0,05).
Effect of isolated smoking cessation on incidence rates among military personnel with previous work experience in coal mines
Authors: Churkin D V , Mamedov V Sh , Lastkov D O
Published: July 2021

Smoking and experience of previous work in coal mines have a negative impact on the incidence of acute respiratory viral infection and pneumonia in the servicemen. Isolated cessation for six months leads to a reduction in the numbers of acute respiratory viral infection cases, complicated forms of acute respiratory viral infection, episodes of community- acquired pneumonia, however, the duration of acute respiratory viral infection and pneumonia do not change. The structure of complicated forms of acute respiratory viral infection with a predominance of sinusitis over bronchitis changes. L.Kh. Garkavi’s adaptation index before the study in the group of smokers reflects the marginal tension of adaptation mechanisms. After 6 months there were significant differences with the group continuing to smoke, significant differences remain with a group of non-smoking servicemen. Pharmaceutical expanses after 6 months were different with the smoking group and there were no reliable differences with the non-smoking group. The authors consider an isolated cessation to smoking tobacco in a group of military with previous experience of underground work in coal mines to be an insufficiently effective measure of primary prevention of acute respiratory viral infection and pneumonia, and consider it reasonable to use medicines and biologically active additives with proadaptive action.
Matrix metalloproteinase-9 blood level as a predictor of post-stroke cognitive impairment
Authors: Kalinsky D P , Lobzin V Yu , Ulyanov I G
Published: July 2021

Ischemic stroke is one of the leading causes of disability of the population. Among the consequences of stroke besides motor, speech disorders, the most important cause of cognitive impairments, it’s frequency is variable between 25-40%. Post-stroke cognitive disorders are pathogenetically heterogeneous conditions. The nature, modality and severity are determined by the clinical subtype of it’s development. So, cognitive impairment most often can be a consequence of a strategic infarcts, multi-infarct damage, decompensation of chronic cerebrovascular pathology against the background of an acute condition or neurodegenerative process that existed earlier and diagnosed before the appearance of any signs of stroke. In addition, the subtype of ischemic stroke also matters. In stroke, a family of zinc-binding proteolytic enzymes, in particular matrix metalloproteinase-9, plays a significant role in the development of damage of the brain tissue, which is of great importance in the reconstruction of the extracellular matrix. A high serum concentration of metalloproteinase-9 increases the severity of ischemic damage, the severity of the stroke and worsens the functional outcome of the disease. In addition, metalloproteinase-9 is also considered as a biomarker for Alzheimer’s disease, since it acts as a proteolytic enzyme, which, along with neprilizine, cleaves the amyloid protein. The results of a survey of 135 patients in the acute and early recovery period of ischemic stroke are presented. The level of metalloproteinase-9 and cognitive impairment have been studied on 1-2 and 21-22 days of the disease. It was found that a higher level of metalloproteinase-9 in blood plasma reflects a high probability of post-stroke cognitive impairment at the end of an acute period of ischemic stroke. The increase in metalloproteinase-9 did not depend on the localization of the focus of the stroke and its volume. Thus, metalloproteinase-9 investigation in the acute period of the ischemic stroke can predict the development of post-stroke cognitive decline.
Morphological substantiation of clinical efficacy of platelet rich plasma in males with androgenic alopecia
Authors: Pakhomova E E , Smirnova I O , Telichko I N
Published: July 2021

Morphological substantiation of the clinical efficacy of platelets rich plasma was carried out in the treatment of 22 men with androgenetic alopecia from the 1st to the 4th stage according to the Norwood-Hamilton scale were included. All patients received intradermal injections of platelets rich plasma 0,15 ml per injection. The course of treatment consisted of 4 procedures with an interval of 4 weeks. Clinical efficacy was assessed by the dynamics of morphometric indices of hair growth. Histological examination was carried out on horizontal sections, stained with hematoxylin and eosin, the morphology of the hair was counted at four levels. Evaluation of morphometric growth parameters conducted before treatment and 4 months after the onset of it. It was established that the therapy of platelet-rich plasma has a pronounced clinical efficacy, consisting in a significant (p=0,00025) increase in hair density by 11% and average hair diameter by 10% (p=0,00766), a 14% decrease in the share of hair follicles (p=0,00959). Histologically, the increase in hair density was significant at the level of the bulb of the hair follicles by 148% (p=0,0034) and at the level of the sweat glands by 65% (p=0,0326), and also by the tendency to increase their number at the level of the sebaceous glands. This was combined with a significant decrease in the proportion of telogen hair at 47% (p=0,0153). Thus, the positive clinical effect of plasma-rich plasma therapy in men suffering from androgenetic alopecia is based on reliable morphofunctional changes in the hair follicles.
Comparative evaluation of percutaneous endoscopic and microsurgical lumbar discectomy
Authors: Kravtsov M N , Mirzametov S D , Malakhovskiy V N , Gaidar B V , Svistov D V
Published: July 2021

The results of percutaneous endoscopic and microsurgical discectomy have been compared. It was established that the operative intervention time, bed-day medians and disability period were significantly shorter (p0,001) in the percutaneous endoscopy group. The average effective dose of radiation exposure for a patient during transforaminal endoscopy was 4,4 mSv, for interlaminar endoscopic techniques and microsurgery - 0,8 mSv. The proportions of complications and repeated operations in both groups were comparable. The risk of recurrence was 10% for the endoscopic group, 4,8% for the microsurgical group. Significant differences in terms of local and radicular pain, quality of life and the physical component of health have not been established. The mental component of health was the best in the endoscopic group. Good and excellent results on the MacNab treatment satisfaction scale in the endoscopy group were observed in 78,2% of cases, after microdiscectomy - in84,9%. Lower invasiveness of percutaneous endoscopy affected the reduction in the period of hospitalization and disability. The effectiveness of percutaneous endoscopic discectomy methods was comparable to standard microsurgical techniques. A statistically insignificant increase in the risk of hernia recurrence after percutaneous endoscopic discectomy was noted. Infectious complications were not typical for percutaneous endoscopic discectomy. Differences in the frequency of complications and reoperations between percutaneous endoscopic and microsurgical lumbar discectomy are also not confirmed.
Analysis of decreased bioelectric activity of a brain with pharmacoresistant epilepsy
Authors: Arkhipova N B , Ulitin A Yu , Alexandrov M V
Published: July 2021

High-frequency bioelectrical activity in pharmacoresistant epilepsy is analyzed. It has been established that pathologic high-frequency oscillations are a potential marker of the epileptogenic zone. We propose a classification of pathological high-frequency oscillations: 1) continuous high-frequency oscillations; 2) modulated pathological high-frequency oscillations, associated with slow waves; 3) modulated pathological high-frequency oscillations, associated with spikes. An example illustrating the application of the analysis of high-frequency bioelectrical activity for the localization of the epileptogenic zone in the widespread irritative zone is given. Variants of interrelation of the regions generating pathological high-frequency activity and epileptic activity in the range up to 70 Hz are demonstrated. Recording of epileptic activity in the frequency range up to 70 Hz is not an exclusive criterion of the epileptogenesis. Recording of modulated pathological high- frequency oscillations associated with spikes allows the differentiation of two spike types. We can assume that the mechanism for generating spikes containing high-frequency component differs from the one for plain spikes. The generators of the pathological high-frequency oscillations are characterized by a smaller size, which should allow more precise localization of the focus of pathological activity. In some cases, the analysis of the high-frequency component of the electrocorticogram makes it possible to differentiate the secondary irritative zone. It has been demonstrated that in patients with extratemporal, especially frontal, epileptogenic zone localization pathological high-frequency oscillations provide additional information about the location of the generator of abnormal activity.
Early diagnosis of violation of mineral metabolism, as a way of primary and secondary prevention of fractures Arctic army groupings
Authors: Tyrenko V V , Aganov D S , Toporkov M M , Tsygan E N , Bologov S G
Published: July 2021

The main challenges leading to the decrease of bone mineral metabolism in the conditions of the North are covered. The presented results of a study of 29 soldiers serving in the extreme conditions of the North, to study the mineral density of bone tissue in the distal forearm. Revealed a significant decrease in bone mineral density, as well as a deficiency of essential elements in this cohort. So, when densitometric training of servicemen serving in the North, the average Z-test was 0±1,8 SD, the change in bone mass corresponded to the Z-test less than -2 SD, was determined at 31,03%. Vitamin D3 deficiency was detected in 96,5% of cases. Analysis of the bio-element state of the hair revealed a deviation of the reference interval in 100% of military personnel, a decrease in essential elements: cobalt, selenium, magnesium, vanadium and an increase in the level of barium, bromine, arsenic, as well as caesium. The interrelation of the elemental status and bone mineral density is revealed. 100% of the examined hair samples showed a significant decrease in the level of cobalt, selenium and iodine. (p0,05) a decrease in boron, magnesium, calcium, vanadium (p0,05) and a significant increase in chromium, manganese, and copper. A quantitative study of toxic elements revealed a significant (p0,05) increase in mercury, rubidium, strontium, and caesium. A correlation was established between the Z-test and the level of vitamin D3, body mass index and dynamometer. The data obtained determine the required level of trace elements in order to prevent disturbances of mineral metabolism and bone loss.
Problems of rendering primary prosthetic and orthopedic help in the megapolis
Authors: Suslyaev V G , Vladimirova O N , Sokurov A V , Ermolenko T V , Zhdanov Yu I , Gorchaninov O N
Published: July 2021

On the basis of studying of statistical data, medical documents, results of the carried-out questioning in 2012-2015 the specific weight of the patients who have transferred amputation of the lower extremity owing to complications of diabetes and the obliterating diseases of vessels of the lower extremities, their distribution for the reason and level of amputating defects is estimated. Circulation periods of citizens on primary prosthetics of the lower extremities are studied and analysed. The problems of primary prosthetics connected with presence at patients of the accompanying pathology of the blood circulatory system, breath and the musculoskeletal device are designated. The prevalence of elderly people with amputating defects of the lower extremities is revealed. Features of prosthetics for elderly people, which have decreasing of weight-bearing on safe lower extremity, physical weakness, decreasing of the cognitive functions leading to difficulty of use of technical means of rehabilitation, decrease in learning ability to skills of use of artificial limbs is characteristic are specified. Problems of early rendering the prosthetic and orthopedic help and primary prosthetics of patients after amputation of the lower extremities in the megalopolis are considered. The new technology of early primary prosthetics of the lower extremities developed by specialists of Federal Scientific Center Rehabilitation of the Disabled named after G.A. Albrecht is presented by express method. Results of introduction of modern techniques of prosthetics by express method and their value for rendering primary parotezno-ortopedicheskoyy the help in the megalopolis are discussed. This type of the help can be rendered before formation of the individual program of rehabilitation and an abilitation of disabled people in the conditions of the medical organizations when rendering out-patient and stationary medical care. Rendering early primary prosthetic and orthopedic help is feasible when healing a wound of a stump after amputation, lack of contraindications to prosthetics, high motivation of the patient. Advantages of this technology of early primary prosthetics by express method is restoration of ability of the patient to movement and self-service, decrease in dependence on assistance and leaving, prevention of emergence of some defects and diseases of a stump at uluchsheny the general condition of an organism.
Surgical tactics treatment of the peptic ulcer of the stomach, complicated by bleeding
Authors: Sinenchenko G I , Verbitskii V G , Demko A E , Parfenov A O , Sekeev A N , Zaitsev M G , Kosachev A V
Published: July 2021

Currently, endoscopic hemostasis is the «gold» standard in the treatment of patients suffering from ulcerative gastroduodenal bleeding. General mortality in ulcerative gastroduodenal bleeding according to the Department of ambulance organization of the research Institute of emergency care. I.I. Dzhanelidze in St. Petersburg in 2016 was 5%, and postoperative8,5%. Transcatheter arterial embolization, due to the development of endovascular hemostasis techniques, is an alternative to palliative surgery in the failure of conservative treatment of ulcerative gastroduodenal bleeding using endoscopic hemostasis techniques, especially in the group of patients with high risk of surgery and adverse outcome. It was found that the reduction in mortality in patients with gastric ulcer bleeding can be achieved by reducing the number of palliative interventions, wider use of angiographic embolization for the prevention and treatment of recurrent bleeding and expanding indications for urgent radical operations outside the recurrence of hemorrhage. The use of transcatheter arterial embolization in elderly patients with severe somatic pathology and recurrent gastric ulcer bleeding can prevent the recurrence of bleeding and perform hemostasis. The success of the transcatheter arterial embolization procedure depends on many factors. Primarily from the anatomical features of the patient. In one case, the patient had a 60% stenosis of the proximal segment of the gastrointestinal splenic trunk, which did not allow the procedure to be performed. Important is the choice of agents for embolization depending on the location and diameter of the source of bleeding. Success also depends on the technical equipment of the hospital and the experience of the surgeon. The absence of significant differences in mortality between the main and control groups, in our opinion, is due to the severity of the General somatic condition of patients included in the study. The obtained results determine the need for further studies to optimize the indications and methods of transcatheter arterial embolization in emergency surgery of gastroduodenal bleeding.
Criteria for the morphological diagnosis of sepsis
Authors: Chirsky V S , Yuzvinkevich A K , Andreeva E A
Published: July 2021

80 cases of lethal outcomes with a clinical diagnosis of sepsis were analyzed. In 31 of them, the pathologoanatomical diagnosis was confirmed - histologically, the internal organs showed metastatic purulent foci. This criterion for the morphological diagnosis of sepsis corresponded to the modern definition of sepsis as a pyogenic bacterial infection with hematogenous generalization and the absence of a specific pathogen. When re-examining archival micropreparations, special attention was paid to finding inconspicuous small metastatic septic foci in the myocardium, kidneys, and brain (mini foci). Their detection required careful searches with a high magnification of the microscope due to fading with adequate antibiotic therapy with therapeutic pathomorphosis. To confirm suppurative inflammation in metastatic septic foci, neutrophilic granulocytes were identified by immunohistochemistry with an expression of CD15. Most often, mini-foci were found in the myocardium, less often in the brain. The presence of morphological signs of microcirculation disorders in all 80 observations was also recorded: leukostasis, «sludge-phenomenon», diapedesis haemorrhages, convolutions in the lumen of the vessels. In the group where sepsis was confirmed, leukostasis, sludge-phenomenon and diapedesis haemorrhages were more common. Comparison of the number of signs of microcirculation disorders in sepsis, confirmed histologically, with violations in the clinical diagnosis of «sepsis», not confirmed pathologically, was made. The obtained ratio made it possible to consider the pronounced and widespread microcirculatory disorders as objective microscopic criteria that require the study of additional sections for the detection of metastatic pustules for reliable diagnosis of sepsis. At the same time, it is possible to detect single mini-foci, indicating the presence of sepsis.
Foci of chronic infection and vascular rigidity in persons of military age
Authors: Evsevyeva M E , Eremin M V , Italyantseva E V , Rostovtseva M V , Sergeeva O V
Published: July 2021

The role of focal infection as a possible risk factor for development of atherosclerotic cardiovascular diseases is discussed quite intensively now. Estimated some parameters of vascular stiffness in young men of military age with the features of their infectious-inflammatory medical history by the type of foci of chronic infection. It is established that in young men with foci of chronic infection such indicators of vascular stiffness, as peripheral augmentation index, augmentation index, normalized to heart rate, and augmentation index of the aorta were significantly higher than in their peers with a positive history. The differences in the first two indicators have reached a reliable level. It should be emphasized the presence of more low blood pressure in the presence of foci of chronic infection , which eliminates the distortion parameters of vascular status, influenced by the tensile effect from the blood pressure in the time of the study. The obtained data clearly indicate the higher rigidity of the walls of the aorta and large arteries in young men under the influence of their foci of chronic infection. Some tendency to development of left ventricular dysfunction in young people with presence of chronic tonsillitis and other infectious and inflammatory diseases was also revealed. This dysfunction is expressed in reducing the maximum rate of growth of blood pressure and increasing the period of expulsion of the left ventricle. The presented results confirm the concept of lifelong formation of «infectious-inflammatory load» in terms of increasing vascular rigidity and subclinical changes in the functioning of the myocardium at young age, subject to the presence of a focal chronic infection. These data allow us to regard foci of chronic infection as another risk factor of atherosclerosis, which in turn requires consideration when carrying out the relevant preventive measures among young population in the process of health checkups.
Paresthesia of mucosae membranes of an oral cavity against the background of taking inhaled hormonal drugs
Authors: Kazarina L N , Chuvarkova I M
Published: July 2021

Bronchial asthma draws the attention of increasing number of doctors worldwide. The prevalence of this disease is from 4 to 10%. Nowadays basic medicines for treatment and control of bronchial asthma are inhalation hormonal drugs which are taken daily and for a long time, often the whole life of a patient. According to numerous literary data, this drug group owing to a way of their introduction causes a series of complications in an oral cavity. The most frequent of them are the oropharyngeal candidiasis, a dysphonia and paresthesia of a mucosa of a mouth. Above-mentioned complications are directly bound to the existence of a dysbiosis of a mouth that contributes to the development of an immune failure and sensitivity to organism microbial antigens. It was established, that patients with bronchial asthma of medium-weight severity with various experience of intake of inhalation hormonal drugs were examined highly often complaint to dryness, a burning sensation not only in an oral cavity, but also in the field of a larynx and a pharynx, on a food faddism, pain at meal, on availability of scurf of white color on various sites of a mucosa of an oral cavity. There were not only existence of characteristic symptoms of these diseases, but also depression of the immunologic status and change of a microbial landscape of an oral cavity at the patients with bronchial asthma taking the inhalation hormonal drugs. The above confirms the fact of obligatory detailed studying of implications in an oral cavity at the patients with bronchial asthma taking the inhalation hormonal drugs and the related complications, their nature, and further development of a rational way of the etiopathogenetic scheme of treatment and also their prevention.
Experimental simulation in the modern wound ballistics
Authors: Denisov A V , Anisin A V , Logatkin S M , Demchenko K N , Ozeretskovsky L B
Published: July 2021

The main medical and biological aspects of conducting experiments in wound ballistics are considered. It is established, that currently in the studies devoted to the study of wound ballistics of firearms ammunition, the method of experimental modeling using simulators of various origins is widely used. A detailed description of the main simulators used by the leading domestic researchers is given now with a reflection of their positive and negative properties. The question of choice of an optimal laboratory animal for the solution of certain problems of ballistic experiment is considered. The world practice of studying the problems of wound ballistics has shown that the organs and tissues of a pig are the closest, of all known animals, to organs and tissues of man in a whole series of morphofunctional properties. The similarity in the structure of organs with a human can in some respects be quite striking, which is used in experimental surgery, especially for studying cardiovascular diseases and in organ transplantation studies. To transfer experimental data from a model (simulator) to a human, it is necessary to observe the main condition of modeling, namely, the principle of similarity of the experimental model to the process that should be reproduced. The problem of use of human corpses and corpse material is reflected, and also attention is paid to a need of observance of ethical rules and norms at carrying out this kind of experiments. It is concluded that despite the extensive list of available materials of non-biological origin, it is not possible to completely abandon the use of laboratory animals and corpse material at this stage of development of science, and their use should be carried out with mandatory compliance with certain norms of ethical and legal nature.
Increasing in level of education of physicians in questions of psychosomatic medicine as one of the ways of psychosomatic medical aid optimizing
Authors: Skripov V S
Published: July 2021

The results of a survey of physicians of various specialties with the purpose of revealing a level of training of specialists in the field of psychosomatic medicine are presented. The importance of this study is determined by the wide spread of psychosomatic pathology among the population. Wide prevalence of psychosomatic pathology in the practice of doctors of various profiles was revealed. It was found that a significant proportion of patients (on average, 11,1±1%) had complaints at the time of examination, but no objective evidence was provided in favor of one or another pathology. At the same time, it was shown that insufficient awareness of physicians in psychosomatic issues, including an understanding of terminology of psychosomatics and nosologies capable of inducing psychosomatic disorders as well as the possibility of using different scales for a mental pathology detection. Almost a quarter of the doctors surveyed (23,1%) misinterpret the term «psychosomatic disorder», while the incorrect interpretation of this concept is significantly higher among general practitioners and therapists than among doctors of particular specialities. In addition, the need for doctors to expand their knowledge in the field of psychosomatic medicine has been established. Thus, 67,3% of doctors note a lack of knowledge in the field of psychiatry. At the same time, only 11,5% of respondents use questionnaires and surveys in their daily practice to identify various psychiatric disorders among their patients. Practically one third of the doctors surveyed (28,8%) cannot list any indications for sending patients to the psychosomatic department. The results of the study confirm the importance of developing and implementing a course of psychosomatic medicine for clinical residents of various specialties.
Characteristics of psychophysiological indicators of students with different interhemispheric asymmetry
Authors: Kisina A A , Filippova E B
Published: July 2021

Abstact. Psychophysiological parameters (short-term visual memory, speed of successive addition of numbers in visual perception, indicators in the Raven progressive matrices test and the Stroop test) were investigated among left-handed and right- handed men (aged 19-25 years). It was found that the verbal stimuli perception in competition with the corresponding sensory perception of right-handers are more pronounced. At the same time, sense perception of the image and its indicating verbal stimuli associated to a greater extent for left-handed persons. The advantage of the left-handers in the test of the Raven progressive matrices test and the advantage of the right-handers in the sequential addition of single-valued numbers were noticed. All indicators of short-term visual memory demonstrated the advantage of left-handers. The use of factor analysis showed that right-handers have greater productivity in performing the proposed tests. This is mainly due to the functions of the left hemisphere - verbal thinking and consistent processing of information. The second important factor is visual spatial thinking. Productivity of left-handers is largely determined by the function of the right hemisphere: sensory perception and spatial thinking. The third most important factor is the interaction between figurative and verbal thinking and the attentional set-shifting. Thus, right-handers in a greater extent than left-handed people, have more success in intellectual activity because of the development of the functions of the dominant hemisphere.
Possibilities of biological control of extracorporeal photochemotherapy
Authors: Manuilov A S , Kudryavtsev I V , Serebriakova M K , Trulev A S , Bardakov S N , Apchel A V , Belskih A N , Zakharov M V , Tishko V V , Sokolov A A , Vasylieva I A
Published: July 2021

The results of the determination of levels of apoptosis in vitro in lymphocytes during the procedures of extracorporeal photochemotherapy (extracorporeal photopheresis) using flow cytometry are described. It was found that carrying out extracorporeal photopheresis does not have a significant effect on the viability of cells immediately after the procedures. Thus, the relative content of living cells in the samples after isolation of the mononuclear fraction of peripheral blood did not differ from both samples prepared for photopheresis and samples after this procedure. It should be noted that carrying out extracorporeal photopheresis does not lead to rapid cell death. At the same time, the level of living lymphocytes at the beginning of the experiment averaged about 90%, while the protocol used to extract the mononuclear fraction of peripheral blood cells and further manipulations with them in vitro allowed increasing the percentage of living cells in the samples to90% or more. An increase in the level of cells in the early stages of apoptosis occurs already in the first day after the beginning of the experiment, which is confirmed by the data of other researchers indicating that there are significant differences in the viability of cells with an initial point in the interval of 20-24 h in vitro incubation. The launch of the processes of programmed cell death in the case of own experiments was not related to the preparation of samples for extracorporeal photopheresis (as evidenced by the absence of significant differences between freshly isolated lymphocytes and samples prepared for the procedure), but with the procedure of photopheresis itself.
Chronic hepatitis С and non-alcoholic fatty liver disease. Main aspects of pathogenesis
Authors: Zhdanov K V , Karyakin S S , Kozlov K V , Gusev D A , Sukachev V S , Saulevich A V , Yaremenko M V , Kizhlo S N , Shahmanov D M , Lobzin D Yu , Kurtukov M V , Dzheriev M A
Published: July 2021

The main pathogenetic aspects of non-alcoholic fatty liver disease as a comorbid factor of chronic hepatitis C are considered. Non-alcoholic fatty liver disease is currently the most common liver disease worldwide, both among adults and children. It is usually accompanied by obesity, insulin resistance and diabetes mellitus. Non-alcoholic fatty liver disease includes a spectrum of pathologies from simple fatty liver infiltration to non-alcoholic steatohepatitis, which is characterized by inflammation with potential progression to fibrosis and cirrhosis over time. On average, non-alcoholic fatty liver disease occurs in 55% of patients with chronic hepatitis C, which is significantly higher than the prevalence of each disease individually. This condition leads to a greater rate of progression of fibrosis, as well as a continuing high risk of developing cirrhosis and hepatocellular carcinoma even after achieving a sustained virological response. In this regard, complex therapy aimed at normalization of the nutritional status, optimization of body weight, correction of impaired intestinal microflora, reduction of severity of liver steatosis and achieving a sustained virological response is a priority task in the treatment of patients with chronic hepatitis C.
Future developments and advances in disinfectants and application modes for use in departments, military units and medical facilities in a climate of the Arctic and Extreme North
Authors: Ivanov A A , Seleznev A B , Komissarov N V , Ivchenko E V , Yudin A B , Musaev A A , Prigorelov O G
Published: July 2021

There were performed test and development review concerning disinfection procedures in a climate of the Arctic and Extreme North, an assessment of their sophistication, and determination of possible ways to enhancement of efficiency. It was found that long-term low temperatures, geographical distance and hard-to-reach territories, weak natural self-regeneration mechanism of biocenosis, development of human hypersensitivity to infectious agents, congestion of personnel at camping and operation places define the urgency of creation of modern chemical and technical disinfectants which are effective in the north. The basic requirements to these disinfectants were formulated. Thus, process chemical solutions should not become frozen over a period that biocide effect takes; disinfectants to use in human presence should meet the operational criteria for sealable inhabited objects. Engineering tools should be equipped with productive snowmelters, heat-insulated rooms, all-terrain running gear, liquid fuel -powered cauldrons, heaters, electric power station. Promising directions of new disinfectants advancing and development were determined. It’s necessary to study infectious and parasitic morbidity in the Arctic and Extreme North, the causes and conditions governing its structure and dynamics, specificity of epidemic process. The establishment of special climate chambers with variable capacities for materials and goods disinfection mode development, including the use of engineering tools; it is essential to choose or develop the study methods of arctic climatic factors influence on test microorganisms, operating procedure behavior of disinfection, worked objects’ properties. The studies of microbial contamination specifics seemed perspective, both in the environment and within inhabited objects, under long-term exposure of low temperatures; the search of biocidic technologies and factors for making disinfectants, modes and methods of application; substantiation of disinfection procedures tactics. Instructional and methodological base preparing will allow to perform perspective studies and disinfection procedures in a climate of the Arctic and Extreme North in accordance with contemporary requirements.
Most important epidemiological tuberculosis indicators in the beginning of the III Millennium
Authors: Brazhenko N A , Loshchakova A I , Brazhenko O N , Zheleznyak S G , Tsygan N V
Published: July 2021

Tuberculosis in the beginning of the third Millennium continues to be a major threat to humanity. Its burden in the world is significant and is characterized by great morbidity, mortality, and prevalence. The structure of newly diagnosed tuberculosis in the Russian Federation is 90,4% represented by respiratory tuberculosis and 9,6% by extrapulmonary tuberculosis. These indicators reflect the state of early detection of tuberculosis in the regions and the country as a whole. In tuberculosis of respiratory organs, the proportion of patients with pulmonary tuberculosis, which proceeds with destruction- patients with disintegration in the lungs and with fibrous-cavernous processes is analyzed. In 2015, the registered incidence in Russia declined to 57,7 per 100000 population. It was different in various regions of Russia, which is associated with demographic and socio-economic conditions. The incidence of tuberculosis is also indicated by the high incidence rate in young and middle age with a predominance among men. Patients releasing mycobacterium tuberculosis with sputum represent the greatest danger. At the beginning of the III millennium in Russia, the incidence of tuberculosis with the isolation of the pathogen by any method was 35 per 100,000 population (for bacterioscopy - 23-24, for inoculation - 41,8). A major problem of modern phthisiology, which hardens effective treatment, is the problem of resistance of mycobacterium tuberculosis to anti-tuberculosis drugs - multiple and broad drug resistance. High mortality in tuberculosis is observed in African, East- Mediterranean and South-East Asian regions - more than 40 per 100000 population. In Russia in 2015, the mortality rate for tuberculosis was less than 10 per 100000 population. Thus, there is a constant need in further improvement of principles of active control of this socially significant disease.
Sarcoidosis of respiratory system at the beginning of the III Millennium
Authors: Zheleznyak S G , Loshchakova A I , Brazhenko N A , Brazhenko O N , Tsygan N V
Published: July 2021

Sarcoidosis of respiratory system is a systemic granulomatosis disease accompanied by the development of epithelioid cell granulomas. During the treatment by glucocorticosteroid drugs or spontaneously, these granulomas disperse or get compacted. Connective tissue with annular distribution is formed around them. Sarcoidosis is etiologically, clinically and morphologically close to tuberculosis. The highest incidence of sarcoidosis has been observed among the urban population of the North of Europe (England, France, Sweden, Poland) - from 20 to 40 per 100000 population. In Russia summary data on the incidence of sarcoidosis does not exist. In the beginning of the Third Millennium according to the St. Petersburg sarcoidosis data it was 8-11 per 100000 people. The basis for justification of the tuberculous nature of sarcoidosis was the similarity of granulomas structure, its combination with tuberculosis and its transformation into tuberculosis with the release of Mycobacterium tuberculosis. The main argument among the opponents of this etiology of the sarcoidosis - is the lack of effect from taking antituberculous medicine. Inefficiency takes place because the point of application of these drugs is the microbial wall. In sarcoidosis, granular and L-forms of mycobacteria with thin cell wall and changes in its structure with which antituberculous drugs contact them are detected in patients. Growth of such microorganisms on special nutrient media causes the restoration of the structure of microbial wall with the restoration of the bacteriostatic effect of anti-tuberculosis drugs.
Meningococcal infection: clinical and epidemiological characteristics in modern conditions
Authors: Sharabkhanov V V , Zhdanov K V , Zakharenko S M , L’vov N I , Kozlov K V , Lyashenko Yu I , Ivanov K S , Bulankov Yu I , Yaremenko M V
Published: July 2021

The problems of the incidence of meningococcal disease and the epidemiological situation in the world, in the Russian Federation and in the Armed Forces are consecrated. In the past decade, there has been a global decline in the incidence of meningococcal disease, but there is still the possibility of new outbreaks and epidemics. From 1996 to 2016, a decrease in the incidence of meningococcal disease was also noted in Russia. In certain regions of the Russian Federation, an increase in incidence was recorded, which did not affect the general trend. Against this background, the idea was formed that in the coming years, thanks to a favorable epidemiological situation and the possibility of preventing meningococcal infection with the help of a vaccine, it is possible to achieve control of this infection. However, meningococcus showed all the classic properties of variability and fitness. Changes in the structure of circulating serogroups of meningococcus led to the formation of a non-immune layer of the population in the face of increasing pathogenicity of the dominant serogroups. The activity of the epidemic process is indirectly indicated by the high diversity of genetic and serological clonal complexes, serogroups and serotypes of the pathogen. The incidence of meningococcal disease over the past ten years in the Armed Forces of the Russian Federation can be assessed as low, but mortality has high values. The peak incidence was in 2010, but the maximum percentage of mortality was in 2017-18,2%. The increase in mortality from invasive forms of meningococcal infection, on the one hand, is associated with an increase in the total number of sources of this infection, on the other hand, with errors in early diagnosis and, as a consequence, in the incorrect provision of emergency care at the prehospital stage, which recur from year to year and are of a similar nature.