This article examines the risk factors for the formation and course of atopic dermatitis in children living in countryside.Material and methods: patients with atopic dermatitis aged 6 months to 12 years were under outpatient supervision in the state medical INSTITUTION of the Republic of Bashkortostan Karaidelskaya CRH.. The diagnosis was made in accordance with the Federal clinical guidelines for providing medical care to children with atopic dermatitis (Moscow, 2016). The severity of atopic dermatitis was determined by the SCORAD index (scoring of atopic dermatitis). All children had a General clinical examination, including collecting complaints and anamnesis of the disease during a personal conversation with the child and his parents, copying data from outpatient records, and laboratory and instrumental research: General blood analysis, General urine analysis, biochemical blood analysis, ultrasound examination of the abdominal organs, fibrogastroduodenoscopy (FGDs), feces on eggs worm, coprology.Results and conclusions: a patient with severe atopic dermatitis living in rural areas was characterized by the following: every 3rd child was born by cesarean section, mothers were 3 times more likely to have vaginal candidiasis, 4 times more likely to receive artificial feeding, 6 and 2 times more likely to have atopic dermatitis combined with bronchial asthma and allergic rhinitis, and also significantly more likely to have chronic nasopharyngeal pathology, gastritis and dyskenesia biliary tract. The risk of severe atopic dermatitis increased with early artificial feeding by 4 times; 31 times with vaginal candidiasis in mothers during pregnancy, 7 times with chronic gastritis, 5 times with the development of vegetative vascular dysfunction and 4.5 times in the presence of chronic tonsillitis.

Relevance: The Issue of treatment of urethral strictures is one of the most complex and relevant sections of operative urology. The lack of a single standardized approach and the variety of methods offered for the treatment of strictures and obliterations of the urethra remains a multifaceted problem for modern urology. Treatment options for urethral strictures can be divided into minimally invasive (endoscopic), which in most cases are palliative, and various options for urethroplasty.Objective: to analyze the effectiveness of treatment of urethral strictures.Material and methods: The article discusses methods of surgical treatment of urethral strictures and obliterations, taking into account the etiology, localization, extent, and severity of spongiofibrosis. A method is proposed for evaluating the optimal resection zone for anastomotic urethroplasty, buccal graft and flap fixation zones using a laser capillary blood flow analyzer, which will improve the results of surgical treatment of this category of patients.Conclusion and conclusions: Modern methods of surgical treatment of urethral strictures and obliterations, both anastomotic and magnifying urethral plasty are effective and reliable methods. Stable positive results were achieved in 80-90% of cases.

Relevance. Urological complications after kidney transplantation are the main causes of long-term hospitalization, loss of trans-plants and death of recipients, both in the early and long-term periods. The improvement of new methods of diagnosis and treatment makes it possible to predict and avoid the occurrence of urological complications during donor kidney transplantation, i.e. to qualitatively rehabilitate recipients with stage V CKD, which determines the relevance of scientific research in this field of medicine.Objective: to study the features of the clinical course and diagnosis of urological complications in patients with a transplanted kidney.Material and methods. The article discusses various methods of surgical treatment, both in the early and long-term postopera-tive periods, in patients after kidney transplantation. Indications for the use of modern minimally invasive endourological procedures and open reconstruction of ureterocystoneostomy in the treatment of extended strictures in a patient with a transplanted kidney were determined.Conclusions. Indications for ureterocystoneostomy reconstruction are narrowing of the lumen in a significant area, complete obliteration of the ureter, or failure of minimally invasive endourological procedures to eliminate obstacles to the outflow of urine.

The purpose of the study - to analyze the influence of community-acquired pneumonia (CAP) against the background of metabolic syndrome (MS) on seeking emergency and urgent medical care for comorbid pneumonia diseases.Material and methods. The study included 120 patients hospitalized and discharged with community-acquired bacterialpneumonia. All patients were screened for MS. Patients in the CAP and CAP + MS groups were comparable in age (50±13 and56±13 years old) and gender (men / women - 50/50% and 43/57%, respectively). The observation was carried out for 1 year remotely using the regional medical information analytical system «ProMed». The time from the moment of discharge from the hospital tothe first call by the patient of an ambulance (EMS), the first emergency hospitalization was estimated.Results. In patients with MS after undergoing CAP, there is a shorter time than in patients without MS, before the first emergency call. The median was 202 days, without MS - 252 days (p = 0.03). The differences between the groups in time to the first call to EMS were statistically significant. Patients with MS have less time before the first emergency hospitalization after CAP. The median was 17 days, without MS - 252 days (p = 0.0006). Differences in time to first emergency hospitalization between groups were confirmed to be significant. The presence of MS affects the growth of emergency calls after pneumonia. An increase in the number of emergency hospitalizations after CAP is observed regardless of the presence of MS without a significant difference between the groups. After pneumonia in patients with MS, there is a significantly greater number of emergency calls due to respiratory diseases in general (compared with patients without MS), a significantly greater number of emergency hospitalizations due to diseases of the circulatory system as a whole.Conclusion. After CAP, patients with MS have an increased likelihood of seeking emergency medical services and emergency hospitalization in general. Postponed pneumonia leads to accelerated development of acute and exacerbations of chronic diseases in patients with MS.

Purpose. To assess the peculiarities of the clinical picture and eating behavior in overweight persons with biliary pathology.Material and methods. The clinical features of the pathology of the biliary system and types of eating behavior were studied in132 patients aged 18-35 years old with cholecystitis.Results. Pain, dyspeptic, asthenovegetative syndromes are shown in the three study groups. Restrictive eating behavior was observed in 52.8%, in 73.4% with overweight, in 87.5% with obesity. The emotional type of eating behavior in obesity was identified in 78.1%, p = 0.000001. With overweight the emotiogenic type of eating behavior was observed in 76.6%, p = 0.000001, with normal weight - in 44.4%, p = 0.0038. The external type of eating behavior was determined in overweight, p = 0.000002, in85.9%, with obesity, p = 0.012 in 78.1%, with normal weight - in 58.3%, p = 0.07.Conclusions. A comprehensive study of the clinical picture and changes in eating behavior in patients with pathology of the biliary system has demonstrated that the study of the course of the disease in combination with eating disorders will take into account the data obtained when administered by the attending physician.

Purpose. To assess the impact of dynamic observation of overweight patients with chronic non-calculous cholecystitis using a personality-oriented educational program for six months.Material and methods. The effectiveness of dynamic monitoring was studied in 64 patients with increased body weight aged18-35 years old with cholecystitis, risk factors of the biliary system were analyzed: hereditary, psycho-emotional, low physical activity, nutritional, a personality-oriented training program was conducted.Results. The types of eating behavior were determined in the subjects: external, restrictive, and emotional, and theircombinations, types of attitude to the disease, scales of the first, second, third blocks, psycho-emotional state, indicators of reactive and personal anxiety. The psychocorrecting effect of the training program was shown and positive behavioral skills were formed in patients, eating habits and physical activity have changed, and stress resistance indicators were increased.Findings. This comprehensive monitoring of overweight patients with cholecystitis showed that the identification of eating disorders, disorders of the psycho-emotional sphere would allow to take them into account during dynamic observation and optimize preventive measures. The emergence of rational eating behavior among patients, an increase in the first block of the type of attitude to the disease, developed behavioral skills, and normalization of anxiety levels indicate the effectiveness of dynamic observation using a personality-oriented educational program.

The aim: to evaluate the clinical course and results of treatment of patients with ulcerative colitis.Material and methods: 144 patients with ulcerative colitis. The diagnosis of the disease was made on the basis of the clinic, ultrasound data, endoscopy, histology, and surgical interventions. In more than half of the cases (64%), the duration of the disease did not exceed 5 years. The recurrent course of the ulcerative colitis was detected in 41.6% of cases.Results and conclusions: mild degree of the disease was observed in 28.4%, the medium severity - in 44.8%, severe degree - in26.8% of cases. The surgical treatment was performed in 57 patients (39.5%). The scope of the operation was limited to hemicolectomy, subtotal colectomy and colproctomy. In 61.4% of cases, the operation ended with the imposition of an ileostomy. The mortality was 23%, mainly in severe degree of the disease. During histological examination of the resected reparations, in addition to ulcerative-destructive and inflammatory changes in the mucous membrane of the colon, dysplastic changes in the epithelium of the glands were often found. This precancerous process is a precursor of colorectal cancer and is characterized by impaired proliferation and differentiation of the glandular epithelium.

Aim. To study the incidence, mortality, neglect, active detection of colorectal cancer in a particular region of the Russian Federation - the Republic of Tatarstan - for the period of 2014-2018.Material and methods. To study the incidence, mortality, neglect and active detection of colorectal cancer, we used the statistics published in the following collective volumes: «Malignant neoplasms in Russia (incidence and mortality)» and «The state of cancercare for the population of Russia» for the period from 2014 to 2018 edited by A.D. Kaprin and co-authors and tables 2000 and 2100of forms No. 7 and No. 35 of the annual reports of the SAHI RCOD MH RT (State Autonomous Healthcare Institution RepublicanClinical Oncology Dispensary of the Ministry of Healthcare of the Republic of Tatarstan) for the period 2014-2018.Results. In the Republic of Tatarstan, for the period of 2014-2018, the incidence of colorectal cancer increased from 43.23 to56.1 per 100,000 population, and this malignant neoplasm took the first place in the structure of the oncological morbidity in the Republic of Tatarstan in 2018. The increase in colorectal cancer incidence occurred due to increasing incidence of rectum and anus cancer on the male population aged 60-64 years. The growth rate of the incidence of rectum and anus cancer is ahead of that of the colon cancer. Indicators of neglect and within-one-year mortality remain high with low detection rates of colorectal cancer at preventive examinations. This makes the organization of colorectal cancer screening in the Republic of Tatarstan still relevant.Conclusions. The epidemiological situation in respect to colorectal cancer in the Republic of Tatarstan requires not only screening for this pathology as part of preventive and periodic medical examinations for the adult population, but also the reduction of the age limit of screening, the introduction of a digital rectal investigation as a routine diagnostic method for preventive and periodic medical examinations, the replacement of diverse blood tests with a single test with proven accuracy, for example, Hexagon OBT, mandatory colonofiberscopy at the second stage of the periodic medical examinations.

Objective: to analyze the occurrence of thrombotic complications in patients with myeloproliferative neoplasms.Material and methods. The data of 224 outpatient case histories of patients with myeloproliferative neoplasms were analyzed inCity Clinical Hospital № 13 of Ufa for the period of 2007-2018.Results. Of 224 patients, thrombotic complications were observed in 26 (11.6%): myocardial infarction - 11 (4.8%), acute cerebrovascular accident - 13 (5.6%), venous thrombosis of the upper extremities - 1 (0.4%), vein thrombosis of the lower extremities - 1 (0.4%). Different disability groups were given to 53 patients (23.7%): I disability group - 0, II group - 20 (8.7%), III group - 33 patients (14.3%).Conclusions. Myeloproliferative neoplasms increase the risk of thrombosis and bleeding. Often the patient is referred to a hematologist by a cardiologist, neurologist, therapist in connection with an increased number of platelets or hemoglobin in the treatment of an already completed stroke, heart attack, vein thrombosis of the lower and upper extremities. Thrombosis and bleeding can be prevented if drugs are taken to prevent thrombotic complications.

The purpose of the work is to determine the dynamics of mortality rates of HIV-infected patients in the Republic of Bashkortostan for 2017-2019.Material and methods. We used materials from a database obtained in Republican Centre to Combat and Prevent AIDS and In-fectious Diseases in 2017-2019. 3508 registered deaths of HIV-infected people were studied. The mortality rate and mortality index from HIV infection were calculated.Results. Comparative analysis of mortality rates of HIV-infected in the Republic of Bashkortostan for 2017-2019 revealed adownward trend in mortality from 12.4 to 11.4 per 100 thousand people (by 7.9%). The mortality rate from HIV infection decreased from 3.03 to 2.02% (1.5 times). In the structure of mortality of HIV-infected people, the leading place is occupied by HIV infection, including AIDS, in the dynamics their share is decreasing - from 50.1% (22.2%) in 2017 to 39.4% (16.6 %) in 2019The proportion of tuberculosis in the mortality structure of HIV-infected patients decreased by 2 times, and respiratory diseases rate increased significantly from 2.1 to 7.9%. The proportion of mortality from pathology of the gastrointestinal tract, cardiovascular system remains stably high. The mortality rate from sepsis decreased by 22.9%. An increase in the specific gravity of oncopathology was found to be 1.5 times (3.7%), unspecified cases (8.1%) in the mortality structure of patients with HIV infection.Conclusion. Studying the dynamics of mortality rates for HIV-infected people allows us to evaluate the effectiveness and shortcomings of ongoing treatment and preventive measures and introduce new methods of diagnosis, treatment and prevention of HIV infection into clinical practice.

Objective. To determine the side effects of the antiretroviral therapy, depending on the treatment scheme of patients with HIVinfection.Material and methods.173 patients were under observation, registered at the AIDS Centers in the cities of Tashkent and Ufa and at the Republican Clinical Perinatal Center in the city of Ufa. Of these, 82 (47.4%) were male patients and 91 (52.6%) were female. The number of patients from 8 to 14 years old was 69 (39.9%) (39 boys and 30 girls); from 15 to 17 years old - 84 (48.5%) (43 boys and 41 girls), respectively; and from 18 to 30 years old - 20 pregnant women (11.6%). Side-effect studies have been conducted with six different antiretroviral therapy regimens in HIV-infected patients.Results. Gastroenterological, neurological, allergic, hematological side effects were revealed with six different ARVT regimens. The study found that the greatest number of gastrointestinal side effects was found with the use of ABC + 3TC + LPV / r (87%). Psycho-neurological side effects were most pronounced with AZT + 3TC + EFV (52.8%), allergic side effects - when using ABC +3TC + NVP (27.3%). Side effects in the form of anemia were most pronounced with AZT + 3TC + NVP (25%). Conclusion. The study showed that it is necessary to approach each patient in a personalized manner at the time of prescribing antiretroviral therapy, taking into account the clinical condition, comorbidities, comorbid conditions of the patient and possible side effects of the applied ARVT regimen.

In order to study the role of the genes of the enzymes of free radical and toxic compounds metabolism in the development of the adaptive background, the susceptibility to extraneous agents and the resistance to infectious diseases, we carried out a comparative analysis of the allelic distribution in the NQO1 gene of rs1131341polymorphic marker in populations from different ecological regions. We studied 2713 people belonging to ethnic groups of Russians (n=490), Bashkirs (n=492), Tatars (n=1529) and Abkhazians (n=202). Allelic variants of the NQO1 gene were identified by PCR-RFLP. Population heterogeneity was analyzed using the Arlequn program (V. 3.0). Among the four ethnic groups, the highest level of heterogeneity was found between groups of people living in different environmental conditions - Abkhazians and residents of the Republic of Bashkortostan (P<0.05). Abkhazians also differ significantly from individuals from other world populations (P<0.05). The ethnic groups of Tatars, Bashkirs, and residents of East Asia showed a similar character of genotypes frequencies distribution (P=1).

Aim. To establish the effectiveness of enalapril in patients with chronic heart failure with mid range ejection fraction from the standpoint of influencing the clinical picture, the parameters of central hemodynamics and the level of the natriuretic peptide.Materials and methods. The study included 47 patients with chronic heart failure with mid range ejection fraction. All patients underwent a comprehensive clinical examination, as well as a standard echocardiographic study.Results. During the observation period, against the background of the therapy, a significant improvement in clinical and functional state was revealed, and in most patients the use of enalapril improves the parameters of central hemodynamics, increases the ejection fraction, and decreases of natriuretic peptide.Conclusion. The use of enalapril in most patients with chronic heart failure of ischemic etiology with mid range ejection fraction helps to improve the clinical condition and central hemodynamic parameters during the year of observation.

The purpose of this study was to determine the influence of GC-DNA on the expression of hypoxia and oxidative stress marker genes in breast cancer MCF7 cells knocked out for the TLR9 and AIM2 encoding intracellular DNA sensor molecules. Material and methods. The study was conducted on intact MCF7 cells, four clones of MCF7 cells knocked out by the TLR9 gene (TLR9-/-), and two clones of MCF7 cells knocked out by the AIM2 gene (AIM2-/-). The protein expression was determined by flow cytofluorometry. The gene expression in cells was studied by real-time PCR.Results. The results of the study showed that knockout MCF7 cultures, in contrast to intact ones, respond to GC-DNA fragments stimulation by reducing the oxidative stress and hypoxia marker genes transcriptional activity both resulted in increased survival of cancer cells.Conclusions. The key role of TLR9 and AIM2 DNA sensors as triggers of adaptive survival-promoting responses of malignantcells to the CGDNA fragments originated from the tumor landscape has been proved.

One of the mandatory controlled parameters of pharmaceutical substances is «water». Water content can change with improper storage and lead to the occurrence of such undesirable processes as hydrolysis, oxidation of the drug and the appearance of toxic impurities.The purpose of this study is development and validation of coulometric method for determination of the water content in thesubstance of rosuvastatin by the Fisher method. Material and methods: The object of the study was the pharmaceutical substance rosuvastatin (Amoli Organics Pvt. Ltd., India). The measurements were carried out on the coulometer «Expert-007» («Econix-Expert», Russia) using modified Fisher's reagents: KFI-Anode and KFI-Cathode («Aquametria», Russia). The leakage test of the coulometric cell was carried out by measuring the drift, which did not exceed 0.05 mg H2O/min. The accuracy of the water determination was checked using a standard solution HYDRANAL - Check Solution 1.00 with a content of 1.00 mg H2O/g.Results: The method was validated in terms of the following indicators: specificity, linearity (r = 0.9991) and application range,accuracy and precision (relative standard deviation ( S r) does not exceed 0.02).Conclusion: The validation assessment showed the validity of the coulometric determination of the water content in the sub-stance of rosuvastatin according to the Fisher method.

Tifungicide group - ketoconazole was used for the production of an ointment based on the gel «Tizol», called «Ketoconazole». To implement it in medical practice, the aim of the study was established - to develop methods for qualitative and quantitative spectrophotometric analysis of ketoconazole in the soft drug form «Ketoconazole».Material and methods. For the study, the pharmaceutical substance ketoconazole (India), 95% ethyl alcohol, ointment containing 0.1 g of ketoconazole and 9.9 g of Tizol gel, acids and strong bases prepared according to the State Pharmacopoeia of the Russian Federation XIV edition were used. The absorption spectra were studied in the near UV region, using domestic spectrophotometer SF-2000. Statistical processing of the experiment results was performed in accordance with the requirements described in the State Pharmacopoeia of the Russian Federation XIV edition, using a personal computer and MS Office application package.Results. Identification of ketoconazole in the substance and ointment is proposed to be carried out by the optical characteristics of the absorption spectrum of the acid solution of the drug. According to the method of quantitative determination of ketoconazole, spectrophotometric analysis is performed at a wavelength of 241 nm, calculating the drug content according to the equation of the calibration graph. The sensitivity of the method has a value of 0.755 μcg/ml, the relative error is ± 1.42 %.Conclusion. The developed methods of qualitative and quantitative spectrophotometric analysis of ketoconazole in the soft drug form «Ketoconazole» allow to identify the drug and establish its content within acceptable regulatory deviations without prior separation from the titanium-containing base of the ointment.

The genus Juniperus L. is the largest in the Cupressaceae family, the species of which are widely used in folk medicine of different countries.The goal is to determine the quantitative and qualitative content of phenolic compounds in Juniperus communis growing in Yakutia.Material and methods: The needles of J. communis, collected in the Verkhoyansk district of the Republic of Sakha (Yakutia) in2019, were the object of the study. The total content of phenolic compounds was determined by the Folin-Ciocaltheu method. The qualitative and quantitative composition of phenolic compounds was studied using HPLC-UV.Results: As a result of metabolic analysis, the presence of 17 different compounds in the needles of J. communis was identified,including phenylpropanoids and their glycosides, flavonoids both in the form of glycoside and in the form of aglycon, catechin, procyanidins and terpenes. The dominant compounds in J. communis are ellagic acid (14,97 ± 0,31 mg / g), catechin (5,71 ± 0,11 mg / g) and rutin (3,54 ± 0,07 mg / g).Conclusions: Alcohol extraction of needles of J. communis contains up to 37,7% ± 0,5 phenolic compounds. The results prove the promise of the use of needles J.communis as a medicinal plant material.

Objective. Develop a scientific approach to the development of recommendations on the choice of medicines for children in the framework of responsible selftreatment.Material and methods. The study used a system approach consisting of 2 steps:- Content-analysis of international and Russian publications, recommendations, instructions on the medical use of anticongestive agents;- Comparative analysis of 5 international generic names - naphazoline, phenylephrine, tramazoline, xylomethazoline and ox-ymethazoline, including combinations with addition of preservatives and/or other pharmacologically active components.Results. Selection criteria are created for drugs of non-prescription dispensing from positions of prevention pharmacotherapeutic risks in children's practice. The score assessment of active substances from the pharmacotherapeutic group of anticongestive agents was carried out according to formed selection criteria. Excipients included in anticongestive drugs and their effect on the child's body are considered.Conclusions. Based on the studies carried out, a methodical approach to the selection of drugs of non-prescription dispensing for children (on the example of anti-congestive agents) is proposed, which allows pharmaceutical specialists to carry out professional recommendations of the safest drugs of non-prescription dispensing taking into account the age and physiological characteristics of a particular child.

We present a clinical case of successful surgical treatment of a patient with isolated abdominal aortic aneurysms, common iliac and common femoral arteries and associated bladder cancer. Surgical treatment was performed in the following areas: resection of the abdominal aorta, aorto-bifemoral prosthetics with reimplantation of the lower mesenteric artery, in connection with a pronounced adhesion process, to reduce surgical trauma and blood loss, aneurysmatic bag of the aorta and iliac arteries was not dissected. The postoperative period proceeded without any special features. The patient was discharged for the eighth day into the medical rehabilitation department. The presented case of non-standard intervention allowed to avoid a terrible complication of the aneurysmrupture of the abdominal aortic aneurysm (AAA) and iliac arteries in case of severe accompanying pathology.

The article presents a clinical case of Proteus syndrome in a 16-year-old girl who was admitted to the cardiology children's department of the Republican cardiology center (Ufa) in December 2019 with complaints of pain in the heart area. From anamnesis: since birth there was a deformity of the hand fingers, for which she was operated on at 2 years old. At the age of 6, she was examined at the Federal center where she was diagnosed with Proteus syndrome. The operation was repeated - corrective osteotomy, excision of excess soft tissue and plasty on the left hand.

The Global Prevalence of Infections in Urology Study showed that 10-12% of patients in urological departments develop nosocomial infection. Material and methods. Patient U., 47 years old, underwent two-stage minimally invasive percutaneous nephrolithotripsy (MIP) on both sides. The urine bacteriological analysis using sector seeding method on a nutrient medium (nutrient agar, 5% blood agar, sugar broth) revealed Klebsiella pneumoniae 107 CFU / ml, with sensitivity to gentamicin, amikacin, meropinem, norfloxacin, bacteriophages: piobacteriophage complex, klebsiellosis polyvalent. Before the first stage, pre-stenting and antibiotic therapy with norfloxacin 400 x 2 per day for 10 days were performed. After that the MIP was made. The second stage of MIP on the right side was to be performed in 1.5 months. A day before operation antibiotic prophylaxis with amikacin 500 mg x 2 per day was made.Results and discussion. The time of the first operation was 65 minutes. The blood loss was 150 ml. The patient was discharged on the fifth day for outpatient treatment with continued antibiotic therapy gentamicin 80 mg x 2 times a day for 5 days. The operation time of the second stage was 100 minutes. The blood loss was 300 ml. An inflammatory reaction of subcutaneous fat in the area of the postoperative wound developed due to antibiotic resistance. This was stopped by local use of antiseptics ( 0.5% alcohol solution of chlorhexidine). The patient was discharged on day 14 for outpatient follow-up. The ureteral stent was removed in ambulatory after 2 week treatment. A distinctive feature of this case was the tendency to antibiotic resistance in the patient against the background of two-stage treatment of bilateral urolithiasis.Conclusion. The use of MIP allows to get rid of kidney stones of any renal part and it is the standard surgery treatment for urolithiasis. The increasing trends for antibiotic resistance requires more deep preparation of patients before operation and using antibiotics that are sensitive to the urine culture.

The goal is to study the main characteristics of the stromal-vascular fraction and to analyze the possibilities of its use in radiation medicine and coloproctology.Material and methods. The study involved 40 females with post-radiation injuries of the rectum. The studied method of treatment was adipose-derived regenerative cells (ADRC).Results. Analysis of the main histological changes allows to track changes in the histological pattern, ranging from necroticchanges and fibro-ulcerative defect inherent in post-radiation rectal damage to the formation of mature tissue.Conclusion. ADRCs are widely used in modern medicine. As part of the stromal vascular fraction (SVF), they are effectively used to restore post-radiation injuries of soft tissues, including the rectum.

The article raises the question of the effectiveness of the use of brain natriuretic peptide for diagnosing and predicting the severity of the course of heart failure in patients with new coronavirus infection.Purpose of work: to analyze modern scientific data on the brain natriuretic peptide as a predictor of heart failure, and to studythe possibility of using this biomarker for its diagnosis in patients with COVID-19.Material and methods. Content analysis of the retro- and prospective researches results presented in an open electronic database of scientific literature PubMed.The results of the study. Presented data demonstrate that the majority of cases of heart failure progression in such patients are associated precisely with the effect of COVID-19, presented international recommendations also show the value of cerebral natriu-retic peptide for the heart failure indication.At the same time, it is shown from the presented research results that a high plasma concentration of the cerebral natriuretic peptide is specific not only for heart failure, also an increase in this biomarker level is observed in other severe conditions, such as acute respiratory distress syndrome, shock and sepsis, it is also recommended for their diagnostics. The article presents data from international observational studies that demonstrate that in the case of severe coronavirus, the above conditions often occur in patients, in detached or combination form, including with heart failure.Conclusion. It was noted that in patients with coronavirus, a high concentration of cerebral natriuretic peptide positively corre-lates with a high probability of an unfavorable outcome, however, an increase in its plasma concentration cannot be used to diagnose the degree and rate of progression of heart failure due to COVID infection.

The Aim of the study: to analyze modern literature on the topic of systemic autoimmune reproductive loss (RAFS); to study the cases of pregnancies described in the literature in women with systemic lupus erythematosus, antiphospholipid syndrome, circulation of antibodies to phospholipids; to note the features of gestational period; to formulate modern principles for the diagnosis, treatment and pregravid preparation of women with signs of systemic autoimmune reproductive loss syndrome.Materials and methods: the analysis of modern scientific literature on the problem of systemic autoimmune reproductive loss is carried out.Results: the presence of autoantibodies in a woman is associated with a high risk to the health of both the woman and the fetus. Autoimmune diseases lead to such complications during pregnancy and childbirth as miscarriage, preterm delivery, premature detachment of normally situated placenta, preeclampsia, eclampsia, fetoplacental insufficiency, intrauterine growth retardation[11,14,15]. Early diagnosis of the disease, pregravid preparation and well-chosen therapy are the main measures to prevent complications of pregnancy, childbirth, the occurrence of fetal malformations.

Preeclampsia - is a pathological condition that clinically manifests itself after the 20th week of gestation, characterized by arterial hypertension, proteinuria, often edema and disturbances from vital organs and systems. The frequency of this condition is 13-18%of all deliveries [1,2,4]. The World Health Organization (WHO) in their report on the causes of maternal mortality gave second place to hypertensive disorders in pregnancy [5]. The possible reasons for the development of preeclampsia are placental, neurogenic, immune, hormonal and genetic factors. The basis of the pathogenetic mechanism of preeclampsia is considered endothelial dysfunction [1,3,4]. In spite of the available research, study of possible causes and risk factors for this condition continues. According to numerous data from systematic reviews, which were carried out in different countries of the world, it has been proven that some environmental factors and climate change affect the development and course of hypertensive disorders in pregnant women, there is also a seasonal influence on the prevalence of preeclampsia depending on the time and season of conception. This article provides a literature review of the influence of environmental factors, climatic and geographical conditions, time of year on the course and development of preeclampsia.

The need to study and know the pelvic and perineal fasciae is determined by the necessity to make surgical interventions in this area. There is a lot of literature describing the perineal fasciae but it is ambiguous and conflicting. To optimize the teaching process, we have done the comparative analysis of the literature dedicated to anatomy and surgery of perineum.We used the textbooks and manuals describing the muscles and fasciae of the perineum, starting from classic manuals of normal and topographical anatomy written in the last century up to the modern and most popular Russian and foreign literature of normal and topographical anatomy.All the authors of the analyzed sources have different points of view on the names and location of the perineal fasciae and on the number of tissue planes. Thus, anatomists and surgeons do not have a universal approach to the study of perineal region. This effects the equality of understanding of this topic and potential underevaluation of the relations between the components of the perineum by future doctors.