The aim of the work was to reduce the risk of unstable hemodynamic reactions in patients with arterial hypertension and heart rhythm disorders against amiodarone-inducible thyroid dysfunction after neurosurgical operations due to pharmacological optimization of premedication. The study was conducted on 51 patients with arterial hypertension and amiodarone-associated thyrotoxicosis type I, which were divided into two groups. 1 group (n = 30) - at the stage of preoperative preparation, patients received prolonged premedication (for three days before the operation) with long-acting benzodiazepines (diazepam) and magnesium preparations. 2 group (n = 21) - benzodiazepines of short action (midazolam) were used for premedication before the operation. As a result of the study, it was established that in patients with arterial hypertension with cardiac arrhythmias and type I amiodarone-associated thyrotoxicosis, the use of long-acting benzodiazepine with diazepam in prolonged mode in combination with magnesium sulfate compared with short-acting benzodiazepine midazolam provides a more effective reduction intravitual, short-term and medium-term variability of blood pressure, increasing the variability of the duration of the cardiac cycle, which a more stable and predictable hemodynamics reaction.

The purpose of research was the analysis of morpho-functional parameters of the subepicardial veins of the human heart in intermediate fetal period (13-24 weeks of pregnancy) . The research has carried out in 64 normal heart speciments of the human fetuses of gestation weeks 13-24 . The methods of macroscopic and microscopic preparation , morphometry , digital photography , variation statistics were used . In the issue the parameters and levels of formation of tributaries of the coronary sinus were studied . Obtained results maybe used in fetal cardiac surgery , with the purpose of more effective usefulness of subepicardial veins of the fetal heart in such manipulations as an occlusive retrograde venography or hyperemic venous return angiography , radiofrequency catheter ablation of additional conductive ways of heart , cardiac resynchronization therapy (CRT), correction of congenital heart diseases .

The article presents an analysis of surgical remodeling of the left ventricle of the heart in patients with postinfarction aneurysms. The original and traditional methods of plastics are compared. This shows the possibility of preoperative calculation of the final diastolic volume and the formation of a conical, close to natural, form of the left ventricle. The advantages of the original method of plasticity of postinfarction aneurysms are demonstrated.

Patients with postinfarction left ventricular aneurysm (PLVA) and mitral regurgitation rank among the most serious patient groups whose surgical treatment is associated with high risk. Development of cardiosurgery and significant improvement of surgical outcomes so far have not yet resulted in unambiguous indications and a one-for-all approach to the surgery of PLVA combined with mitral regurgitation. A broad spectrum of surgical modalities is allowed. Based on its own performance practice and capacity, each clinic opts for its own extent of aggressive approach to patient treatment. Development of new and more improved surgical treatment strategies will enable one to come much closer to the finding of optimal ways to correct PLVA with ischemic mitral insufficiency.

In the work presented by us, the assessment of dental status is given and the peculiarities of the influence of risk factors on the development of inflammatory periodontal diseases in persons aged 20 to 35 years living in the city of Ufa are analyzed. STEPS-approach is used in the diagnosis of periodontal inflammatory diseases, evaluation of their severity and prevalence. The analysis of hygienic and periodontal indexes depending on the revealed risk factors is made.

Diseases of the oral mucosa remain an important problem of dentistry, as their diagnosis and treatment are significant difficulties. The results of their treatment depend on the possibility of eliminating the etiological factor and the impact on the mechanisms of the disease. Physiotherapy procedures were used in the complex treatment of the oral mucosa. The result of the complex treatment was normalization of the composition of the oral microflora, expressed korregiruyuschee effect on local immunity, as well as an increase in the terms of remission of the disease, compared with patients receiving only conventional treatment.

The results of the study of patients with chronic gingivitis with an assessment of clinical and microbiological features are presented. Dental indices of patients with this pathology and dental status were determined. Statistical processing of the results was carried out. A comprehensive program of treatment using photodynamic therapy, electrophoresis in the near and long terms. It is established that as a result of application of this complex positive changes had expressed character.

The article is devoted to the study of optical density of patients with paradentium diseases. The aim of the study was the evaluation of indicators of optical density of bone tissue of jaws using dental computerized tomography in patients with chronic generalized parodontitis. Materials and methods: in the research following methods were used: dental computerized tomography, densitometry, index estimation of paradentium tissues. The characteristics of clinical, functional features of patients were given. The method of treatment was developed. The effectiveness of this method was evaluated. The positive dynamics of clinical symptoms is more pronounced in patients that received the offered method of treatment, than in patients that received basic therapy. This revealed in the reduction of time of the treatment on 10 days in average. The disappearance of edema, hyperemia of the gingiva, pain and bleeding during the probing and during eating, the restoration of densely elastic consistency of the gingiva, correct configuration of marginal papillae and full gingival edge are clinically revealed. Complex use of basic therapy, laserphoresis with Kanalgat gel in patients with chronic generalized parodontitis of mild severity caused to significant increase in the clinical effectiveness of treatment.

Medication-associated osteonecrosis of the jaw - severe complication that can happen in patients received therapy with bisphosphonates and in persons that are taking narcotic surrogates (desomorphine, pervitin). The relevance of the research is conditioned by wide use of bisphosphonates in patients with proven bone metastases, during myeloma, Paget disease. The remaining number of people that used narcotic surrogates, the use of red phosphor during self-crafted production of desomorphine and pervitin by patients with drug addiction is considerable. In hese two categories atypical forms of osteomyelitis are developing. The article is based on retrospective study of clinical record and data of radiological examinations of patients that are staying on the treatment in the department of maxillofacial surgery of MAI «Central city clinical hospital №23» in 2003 - 2017.

The influence of mechanoactivated (nanodispersed) form of calcium gluconate (inside and locally) on the bone mineral density (BMD) and osteointegration processes in 89 patients aged 35-44 with chronic generalized periodontitis with reduced BMD within T-score from -1.1 to -2.5 SD was evaluated. The clinical condition, indicators of mineral metabolism (Ca, Mg, P) in blood plasma, markers of bone remodeling were studied. The inclusion of traditional training and accepted Protocol of dental implant receiving mechanically activated (nanosized) amorphous form of calcium gluconate in patients with chronic generalized periodontitis with reduced mineral density of bone tissue contributes to the correction of calcium-phosphorus metabolism and bone metabolism with the improvement of osseointegration of dental implants.

For the purpose of studying of risk of development of diseases of an oral cavity in the employees of mining and processing works occupied with production and processing of copper-zinc ores comprehensive dental examination of 235 workers and group of control of 90 people is conducted. Results of researches have shown that the dental incidence of workers of UGOK is caused by influence of harmful factors of production. In size of relative risk, the etiologichesky share has made 41-100% that corresponds to professionally caused and occupational diseases.

The problem of choosing laparoscopic cholecystectomy in patients with unfavorable comorbidity background: respiratory failure, cardiovascular failure and obesity - is observed in the article. Due to the RF patent No. 2016105265 “The determination method of indications for laparoscopic operations in conditions of carboxyperitoneum and laparolifting’, a functional test was provided to patients passed in the experimental group at the preoperative examination. This test was a pseudoabdominal compression, where measurement changes in cardiovascular activity and respiration have been examined. The results of this research allow to increase the number of indications for laparoscopic cholecystectomy in patients with pathologies in cardiovascular and respiratory systems.

With the aim of studying the genetic aspects of the pathogenesis of adhesive disease polymorphism of genes of cytokines TNF-a, IL-1 p, IL-6 polymerase chain reaction DNA synthesis is determined and estimation of clinical-genetic associations in predicting risk of disease is made. Genetic markers of susceptibility to the development of adhesive disease peritoneum are genotype of GG polymorphic locus-308G > A TNF-a gene (OR = 1.914) allele (T) polymorphic locus-511C > T gene IL-1 p (OR = 1.700) and genotype of CC polymorphic locus-174 g > C gene IL-6 (OR = 2.554). Markers of resistance to adhesive disease development of the peritoneum are genotype of GA polymorphic locus-308G > A TNF-a gene (OR = 0.462), genotype and allele with polymorphic locus-511C > T (OR = 0.510 and Or = 0.589).

Total hip replacement is an effective method of treating diseases and injuries of the hip joint. After hip replacement surgery develop complications. The most common complication of endoprosthesis is dislocation. The risk factors of dislocation in the postoperative period associated with the characteristics of the patient and the features of surgical technique. Performing endoprosthesis taking into account risk factors can reduce the frequency of dislocation in the postoperative period. Tactics of diagnosis and treatment of dislocation after total hip replacement determined. Nevertheless, dislocations in the postoperative period after total hip replacement are an urgent problem that requires further solutions.

The paper presents the results of using the Argus sling system in order to combat incontinence after prostatectomy for prostate cancer. The study included patients with persistent incontinence 2-3 years or more after prostatectomy. In these patients, immediately after the operation, the quality of life and urological status were assessed using the King's questionnaire, and their psychological state was assessed using the Spielberger-Khanin level of anxiety. Control was performed on a representative sample without installing a sling system. It was shown that in the vast majority of prostatectomized patients, correction of urinary incontinence through the installation of the Argus sling system gave a pronounced rehabilitation effect. So, after the installation of the Argus system, 32.3% of patients assessed their health as normal, 45.2% - as good, 16.1% - as satisfactory and only 6.5% of patients did not notice improvement and still assessed their condition health as bad. As for the psychological status, after surgery, the proportion of patients with a low level of situational anxiety was 87.1% with a sharp decrease in the proportion of patients with moderate and high levels of this type of anxiety.

Malignant neoplasms of the pelvic organs in men are an actual problem of modern medicine. In connection with a steady increase in the incidence of the need for surgical treatment on the pelvic organs increases. Despite the constant improvement of surgical technologies, a number of complications that significantly reduce the quality of life, the main one of which is erectile dysfunction, accompanies these surgical interventions. This article provides an overview of the world literature on the development of erectile dysfunction in patients undergoing surgical treatment of prostate cancer, bladder cancer, rectal cancer. The advantages of using nerve-sparing technology are reflected. Conclusions are drawn about the need for an integrated approach to the problem of erectile dysfunction, an interdisciplinary approach to the diagnosis and treatment of erectile dysfunction in patients after radical surgery on pelvic organs, based on close interaction of physicians of different specialties.

Over the past decades, there has been an increase in the incidence of multiple pregnancies, which is associated with an increase in the age of parturient women, the widespread use of assisted reproductive technologies, the prolonged intake of hormonal oral contraceptives, and stimulants of ovulation. The cardiovascular system in pregnant women with multiple births undergoes major changes, which leads to a significant transformation of hemodynamic parameters. All changes in the work of the CCC of a pregnant woman are due to the formation of an additional utero-placental circle of blood circulation. Changes in the work of the cardiovascular system are associated with both hemodynamic and mechanical factors. Restructuring of the circulatory system during pregnancy consists in an increase in BCC against a background of increased capacity of the vascular bed and cardiac output, when cardiac output increases significantly. These changes provide a higher level of performance for various maternal systems, corresponding to the increasing energy and metabolic needs of the fetus.

This article presents data on the development and justification of measures to eliminate (weaken) negative medical and social risk factors that have a significant effect on the rate of delivery by cesarean section. For this purpose, the degree of influence of medical and social risk factors was determined using the prognostic model developed by us to predict the proportion of these factors' influence on delivery by cesarean section. In order to study the effectiveness of preventive maintenance of delivery by cesarean section according to the measures developed by us, an organizational experiment was conducted. This organizational experiment was conducted in 2015-2016. in women's consultations, medical organizations in Kazan. The measures we developed for the prevention of delivery through cesarean section have made it possible to obtain a noticeable preventive effect in reducing the frequency of this operation and increase the effectiveness of the obstetrician-gynecologists work. Thus, according to our study, elimination of 49.6% of negative medical and social risk factors among pregnant women allowed, in comparison with the control group, to reduce the rate of delivery of operations by cesarean section by 56.8%, and among women planning pregnancy the frequency of delivery by cesarean operation The cross section decreased by 60.5%.

The dependency of incidence of different diseases in children born by Cesarean section and by natural birth canals on peculiarities of food is shown in the article. In the result of conducted statistical analysis the risk factors of different diseases, which happened more frequently in children born by Cesarean section, were established.

The last years were marked by a growing interest in the problems of people of the elderly age. The reason for this was the phenomenon of the aging of the world’s population. In implementing the concept of «healthy or the benefits of aging», considered by UN experts as one of the main directions of the «Program of Scientific Research work of the problems of Aging in the 21st Century», great importance is attached to changing a person’s life (refuse of bad habits, the time of beginning of sexual activity, dietary habits and others), which can prove to be very effective not only in increasing life expectancy, but also in improving its quality. For medical care. This article provides information about the health condition of elderly women in the foothill areas of Dagestan, using the example of the Akushinsky district for identifying priorities for older women and developing proposals for executive bodies, which was the purpose of this study.

In order to develop a system of measures to improve the quality and availability of outpatient care for rural population in 20162017. a study was conducted on the basis of polyclinics 3 CRH Republic of Dagestan. A survey of 817 patients served by district doctors was conducted. The advantages of the work of General practitioners in rural areas compared with local therapists. The answers of patients on the reasons for which they consider activity of General practitioners effective are rather indicative: there is no need to address to different doctors (47,5%); the number of referrals to specialists decreased (24.4%); the number of laboratory tests decreased (20.2%). With the introduction of General practice medical care has become more accessible (48%), more qualified (36.2%) and more volume (32.4%). On the basis of the materials of the research recommendations and proposals on optimization of outpatient care for rural population were developed.

A systematization of the symptoms of connective tissue dysplasia with a subsequent scoring is suggested in this study. The evaluation is based on the systemic involvement of connective tissue in the pathological process. This serves as a criterion for the severity of dysplasia and helps differentiate the syndrome and non-syndrome forms of connective tissue dysplasia. Constants (2 points) and periodic (1 point) signs of connective tissue dysplasia in children and adolescents, in patients of older age groups were identified. The assessment of dysplasia by both external and internal signs on the part of the reproductive system is supplemented. In this article, the following system of registration of signs of DST in children is suggested: in early age groups (infancy, early age, ie, up to 6 years, when the child does not yet have all the dysplasia syndromes by age), it was suggested to use a scoring only dysplastic symptoms. Since the age of seven, it has been suggested to evaluate dysplasia with the help of syndromes. This evaluation system can be used in any age group, beginning with the early age and ending with the senior age period. The claimed method of diagnosis of DST in children and adults makes it possible to identify the course of this state of connective tissue at earlier stages of the disease, to prescribe corrective therapy. This will slow the progression of manifestations of connective tissue dysplasia later on.

This paper presents an analysis of the study of aggression in adolescents with connective tissue dysplasia and adolescents without dysplastic processes, which did not reveal significant differences in the structure of aggression in both groups. The relevance of this work lies in the fact that the widespread distribution of connective tissue dysplasia in the adolescent population, its progressing course, the duration of the disease, the tendency towards early disability pose the question of studying behavioral characteristics, in particular aggression and its influence on the course of the disease, before psychological science and practice. In adolescents of both groups, defensive aggression predominates, which determines hostile actions that arise in response to real or perceived threats. Teenagers are trying to protect themselves from people who have power over them or suppress them, limit things in some way, prohibit something, usually they are parents, older in age or teachers. Surrounded by peers, adolescents are afraid of being unrecognized, becoming an object of ridicule, afraid that they will be discussed. Protective aggression can actively manifest itself at the behavioral level and be transformed into active aggression. Adolescents with connective tissue dysplasia, in comparison with peers without dysplastic manifestations, have less pronounced qualities such as: envy, distrustfulness, suspicion towards other people, resentment, suspicion, guilt, index of hostility. In adolescents with dysplastic disorders, active aggression predominates in comparison with healthy adolescents. An analysis of the degree of aggression showed that the adolescents of the main group are dominated by a high level of aggression, and adolescents without dysplastic processes had a weak level of aggression.

Prevention and control of HIV infection in the Russian Federation are recognized as a nation-wide one and are one of the priorities for Russia's healthcare. The main principle of implementation of the State Strategy for the Prevention of the Spread of HIV Infection in the Russian Federation until 2010 and beyond is interdepartmental interaction and increase of the availability and quality of medical care and social support for patients with this pathology. The study of the regulatory and legal framework that determines the organization and provision of medical care to HIV-infected persons has been conducted. A number of legislative contradictions, which require the improvement of legislation regarding HIV-infected persons, were established.

The results of the evaluation of the antioxidant effect of therapeutic and prophylactic programs based on the use of drinking mineral water, the original phytocomplex, natural koumiss in combination with hydrogen sulphide baths and physical training in 273 people at risk of developing atherosclerosis in a sanatorium are presented. It is established that the developed programs contribute to the inhibition of the processes of lipid peroxidation with a decrease in the level of diene conjugates, malonic dialdehyde, ketodienes and conjugated trienes, lead to an increase in the activity of antioxidant catalase enzymes, superoxide dismutase, an increase in the overall antioxidant activity of blood plasma, with an increase in adaptive and reserve capabilities of cardiovascular system, cardiovascular system in persons at risk of developing atherosclerosis.

Issues of prevention of the incidence of diseases with temporary disability always remain relevant, because this part of medicine is aimed to preserve and to maintain the health of labor collectives. The prevention of the incidence of diseases with temporary disability for agricultural workers is especially relevant, as this category of workers provide the population with food. It should be noted that poultry-farming workers are exposed to a wide range of harmful production factors and need comprehensive protection. According to majority of researchers, the development of prevention programmes should be based on indicators of incidence of diseases with temporary disability, as well as the quality of medical examinations and treatment. Authors note the considerable effectiveness of the usage of personal protective equipment in the prevention of diseases.

Methodical approaches to screening target segments for import substitution by the aggregated assortment portfolio of pharmaceutical plants of the Urals Federal District have been developed. The rating of potential segments for import substitution from the position of investment attractiveness is presented. The ranking of individual ATX_L2 segments of the pharmaceutical market was carried out, from the positions of the market potential for the pharmaceutical enterprises of the URFO.

The objects of the research were erythrocytes and lymphocytes of humans and rats and human buccal epitheliocites. The hemolysis of erythrocytes and microelectrophoresic cell mobility in solutions of saline with the orotate magnesium tautomers was studied. The mobility of erythrocytes in the solution with the dihydroxy-form showed negative dynamics (the number of active erythrocytes decreased in 2 times), the activity of cells increased in hydroxy-forms solutions: the amplitude of vibrations of the erythrocyte membrane increased more than in 2 times. Moreover, in solutions with hydroxy- and dihydroxy-forms the active forms of lymphocytes appeared. In oxo-form solution this effect was not observed. Buccal epithelium cells react in a similar way. The amplitude cytolemma and the nuclear membrane vibrations is higher in solution with hydroxy-form magnesium orotate. Activation of nucleated buccal cells in solutions of hydroxy-form are more pronounced than activation of red blood cells. The stability of the erythrocyte membrane of animals with experimental magnesium deficiency to the action of a hypotonic solution is restored on the 10th day after taking tautomers and is more pronounced when taking the hydroxyl-form of magnesium orotate.Magnesium orotate tautomers have different mechanisms of absorption and have different properties in relation to participation in biochemical processes.

Under fusemide-induced hypomagnesemia in animals, the hydroxy form of magnesium orotate shows a higher rate of compensation for magnesium deficiency in the blood compared to the oxo form. Furosemide load is accompanied not only by hypomagnesia, but also by the development diselementosis of the body. Changes in elemental status are different depending on the organ. The amount of magnesium in the furosemide load decreases in serum, does not change in the heart, rises in the spleen and thymus. The injection of the hydroxy form of magnesium orotate levels the ratio of micro- and macronutrients in blood plasma and organ tissues. Magnesium deficiency is accompanied by signs of immuno-inflammatory reaction, leuko- and lymphocytosis, eosinophilia, a decrease in the number of erythrocytes and a decrease in the level of hemoglobin. An earlier and complete restoration of cytological parameters is noted in the group of animals with the introduction of hydroxy form of magnesium orotate.