Purpose of the study. Comprehensive assessment of the effect of active tobacco smoking on the gastroduodenal zone in individuals with early onset of tobacco smoking.Material and methods. A questionnaire was carried out using the Gastrointestinal Symptoms Rating Scale (GSRS) and the Eating Behavior Questionnaire (DEBQ), followed by fibrogastroduodenoscopy (FGDS) using an Olympus CV-170 (Optera) apparatus with histological determination of H. pylori and pH-metry. For pairwise comparison of two independent samples, the Mann-Whitney U-test was used, for qualitative ones - the Chi-square test with Yates' correction for 2×2 contingency tables with the calculation of the odds ratio (Odds Ratio).Results. 60 young people were examined; the average age was 21.3 + 4.2 years. The average pack / year index for smokers was3.2±2.8. The examined people were divided into 2 groups: the first - 28 smokers, the second - 32 people (control). Questioning according to the GSRS scale and according to the DEBQ questionnaire did not show statistically significant differences in the groups. According to the data of pH-metry and quantitative determination of H. pylori, lower pH values were found in the group of smokers (p = 0.002), persons with a high degree of H. pylori contamination (+++) were also significantly more frequent (p = 0.031,95%, OR = 5.37; CI 1.30-22.17).Conclusions. Further research is required with a large coverage of the surveyed with the subsequent development of new methods of prevention, diagnosis and treatment of both nicotine addiction itself in actively smoking young people, and the consequences of tobacco smoking in the early stages.

Purpose: to study the peculiarities of the intestinal microbiota composition in adolescents with constipation type of irritable bowel syndrome.Material and methods. Clinical observations and examinations of 167 children aged 10 to 17 years (79 boys, 88 girls, mean age12,7±1,6) with a verified diagnosis of irritable bowel syndrome (IBS) were carried out on the basis of the Republican Children'sClinical Hospital (consultative diagnostic clinic), Ufa.In accordance with Rome IV criteria, using the Bristol Stool Type Scale, patients were randomized into groups, taking into account the clinical form of IBS. The study of the composition of the intestinal microbiota was carried out by DNA sequencing of the hypervariable regions of the 16S rRNA gene. Bacterial DNA was isolated from 44 fecal samples (which included 15 samples fromthe comparison group, 17 from the IBS-D group and 12 from the IBS-C group). From special research methods of instrumental diagnostics to determine methane in exhaled air, all children underwent a breath test using Gastro Check test systems.Results and discussion. The obtained methane breath test data for different types of IBS demonstrated significant differences (p<0,001) when compared in both groups with IBS and the control group. In all three groups, the limit of permissible CH4 concentrations (0-200 ppm) was not exceeded, but in the IBS-C group there was a significant (p<0,001) increase in the level of methane in the exhaled air 67 (52-79) ppm, compared with the control group 9 (2-17) ppm and IBS-D group 29 (18-37) ppm. At the phylum level, the analysis of 454-pyrosequencing showed that the human fecal microbiota with IBS-C contains more Proteobacteria than the control group. There is also an increased content of Archaea, in particular Euryarchaeota, Thermoproteales, Ferroglobus.Conclusions. The predominant microorganisms in adolescents with constipation type IBS were methanogenic archaeobacteria responsible for the excessive production of methane detected during breath tests.

Purpose: to analyze the hypotensive effect of surgical treatment of primary open-angle glaucoma by assessing the quality of life.Material and methods. The study included two groups of patients with primary open-angle glaucoma. Group I (22 people) underwent antiglaucomatous sinusotrabeculectomy with Glautex drainage implantation, group II - sinusotrabeculectomy with collagen hemostatic sponge drainage implantation (18 people). Assessing the level of intraocular pressure and quality of life using general, specific and psychological questionnaires before and after surgical treatment.Results and discussion. The performed surgical interventions effectively reduced the intraocular pressure, however, the clinical course of the disease improved.Conclusions. Since the clinical improvement in the course of the disease did not significantly affect the subjective self-esteem of patients, it is required to develop measures to improve their quality of life in the process of dispensary observation and treatment.

The purpose of this study is to evaluate the possibility of using geometry to assess changes in microcirculation in the hernioplasty area after surgical treatment of inguinal hernias in the BSMU Clinic, and using this method (based on a comparison of data obtained when registering changes in the absolute values of active tissue resistances in the area of surgical access) to show the existing difference in the state of the postoperative wound during laparoscopic treatment of inguinal hernia and hernioplasty by Lichtenstein, namely the state of microcirculation in the area of hernioplasty on the 1st, 5th and 14th days after these operations.Material and methods: A medical rheograph RG 4-0.1 was used for the study. Changes in the absolute values of active re-sistances of patients in the hernioplasty zone were recorded. Percutaneous rheography was performed in 32 patients who underwent laparoscopic hernioplasty and 38 hernia carriers operated by an open method: before surgery, on the 1st, on the 5th and on the 14th day after it. The amplitude (h) in mm was recorded during rheography.Results: The possibility of using rheometry to assess the state of microcirculation in tissues after inguinal hernia surgery was shown, and rheometry data for laparoscopic hernioplasty and Lichtenstein herniation were compared.Conclusions: The results show that rheography as a safe and affordable research method can be successfully used to assess thestate of microcirculation in tissues in the area of postoperative wounds. The study showed that the violation of microcirculation in tissues in the area of surgery is minimal with the TAPP method, and the return of rheometry indicators to the initial figures is much faster than with open plastic surgery, which leads to a better effect of hernia defect repair and to earlier rehabilitation of patients after herniation.

Purpose. The paper analyzes the experience of providing organizational and advisory assistance and filling the staffing gap in the regions of the Russian Federation and neighboring countries by the forces of mobile field multidisciplinary teams, which were formed of specialists from the BSMU of the Ministry of Health of Russia, Ufa.Material and methods. A descriptive research method was applied. The formation of the regulatory legal framework for mobile field multidisciplinary teams of the Republic of Bashkortostan was retrospectively studied by the efforts of the Federal State Budgetary Educational Institution of Higher Education of the Belarusian State Medical University of the Ministry of Health of Russia.Results and discussion. In the period 2020-2021 on the basis of the BSMU Clinic, an infectious diseases hospital for patients with suspected coronavirus infection and a confirmed diagnosis (hereinafter referred to as the covid hospital) was repeatedly deployed. Employees of the Federal State Budgetary Educational Institution of Higher Education BSMU of the Ministry of Health of Russia traveled to the covid hospital of the Republic of Bashkortostan, to the regions of the Russian Federation and neighboring countries. In each region, an analysis of the epidemiological situation was carried out, the existing advantages and disadvantages of providing medical care were monitored. In the CIS countries, on the basis of the existing recommendations of the Russian Ministry of Health, the procedures for organizing the work of infectious diseases hospitals in accordance with the number of beds were formed, and changes were proposed to clinical protocols for the treatment of a new coronavirus infection. In the constituent entities of the Russian Federation, measures have been developed and implemented to reduce the risks of contracting a new coronavirus infection in medical organizations, among employees in non-infectious departments, and proposals to prevent professional burnout among employees working in covid hospitals. In all regions, it was recommended to strengthen the propaganda of anti-epidemic measures in the media, and the observance of individual protection measures by the population.Conclusion. Mobile teams are an example of flexible cooperation of medical and scientific personnel to provide organizational and advisory assistance and fill the personnel shortage in regions with a difficult epidemiological situation for the spread of a new coronavirus infection.

Purpose: to assess the radiological features of pneumonia caused by the SARS-CoV-2 virus, in particular the frequency of visualization of the most pathohomonic computed tomography (CT) patterns, for the period from 01.10.2020 to 01.12.2020, based on CT data taking into account patients gender, age and duration of the disease. Material and methods. Analysis of high-resolution computed tomograms of 310 patients with positive polymerase chain reaction (PCR) results confirming the presence of the new coronavirus SARS-CoV-2, who underwent a study at the outpatient computed tomography center of the Clinic of the Bashkir State Medical University, was carried out. Computed tomography was performed using a GE Discovery NM / CT 670 16-slice CT scanner. Chest scan parameters: tube voltage 120 kV, tube current 200 mA, step 1.25 mm. The studies were carried out with the patient lying on his back with his arms thrown back behind his head. As a result, on the images obtained, the nature and prevalence of lung lesions were assessed depending on the patients age, gender, age and duration of the disease.Results and discussion. The dominant CT patterns in SARS-CoV-2 pneumonia are ground-glass changes and pulmonary con-solidation. Frosted glass zones were present in 97-100% of patients, regardless of the duration of the disease. Pulmonary consolidation in the early stages is less common and appears as the disease progresses in 9-33% of cases, becoming more extensive and diffuse in later stages. The bilateral nature of the lesion is observed in 57-100% of cases. In 43-86% of the studied patients, pathological changes had a multilobar character, while subpleural localization was observed in 27-45%. Pleural effusion, a thickened pleural layer, is uncommon and has been reported in 3-11% of COVID-19 patients. The prevalence of CT patterns such as the inverse halo effect and cobblestone thickening of the interlobular interstitium in patients with COVID-19 ranges from 0 to 14%.Conclusions. A qualitative assessment of the results of the performed computed tomography is of great importance for the early prevention of the development of viral pneumonia caused by SARS-CoV-2, it allows us to assess the severity of the disease, in combination with other clinical diagnostic methods, it allows us to timely identify negative dynamics, the development of complications in the form of thromboembolism. Computed tomography allows you to assess the effect of the therapy and is a method of follow-up after treatment.

Purpose: analysis of the relationship between the physical parameters of the body and the level of intraocular pressure in a new coronavirus infection and assessment of the psychoemotional state of patients.Material and methods. 155 patients with a diagnosis of «new coronavirus infection» were included in the study, who received treatment in infectious diseases hospital on the basis of City Clinical Hospital № 10 in Ufa city. Correlation analysis of the results ofphysical examination (saturation, respiratory rate, volume of lung damage, heart rate, systolic and diastolic blood pressure, bodytemperature) with the level of intraocular pressure was carried out. Patients underwent a questionnaire based on the «Hospital Anxiety and Depression Scale» questionnaire.Results and discussion. A statistically significant correlation was found between changes in the parameters of physical data andthe risk of developing ophthalmic hypertension and / or glaucoma; subclinically expressed anxiety and depression were established in patients.Conclusions. It is necessary to control intraocular pressure in patients with COVID-19 for the timely detection and prescriptionof local antihypertensive treatment in order to correct ophthalmic hypertension. Identification of subclinically expressed symptoms of anxiety and depression in patients requires additional examination of patients, if indicated, correction of the disturbance of their psychoemotional state.

The purpose of the research: to determine the role of polymorphism of a number of genes of the hemostasis system in the course and outcomes of COVID-19.Material and methods. The study included 102 people with extremely severe (Group 1, n = 27), severe (Group 2, n = 53), mild and asymptomatic (Group 3, n = 22) COVID-19. There were 17 patients with a fatal outcome, thrombotic events were noted in 12 people. Allelic variants of genes associated with hemostasis dysfunction (FGB, FII, FV, FVII, F13A1, PAI-I, Gp1a, and Gp3a) were determined using PCR blood samples. Only mutations of high thrombogenic risk FV Leiden and prothrombin (G20210A) were considered thrombophilia. For statistical analysis the Statistic ver. 12 software (Stat Soft, USA) was used. We performed comparative analysis of independent categorical (binary) variables using contingency tables and Pearson's χ2 test with Yates' correction and Fisher's exact test. We calculated risk ratios RRs [CI].Results. Thrombophilia was a predictor of death (RR=3,13 [1,33 - 7,32]), thrombocytopenia RR=13,5 [3,56 - 51,23], and coagulopathy RR=8,4 [2,2 - 21,3] in patients with COVID-19. All patients with fatal COVID-19 (100%) showed the absence of protective polymorphism for FVII 10976 G → A and the carriage of the T risk allele in the alpha-2 integrin gene (Gp1a). COVID-19infection was a significant triggering factor for the phenotypic manifestation of the prothrombogenic genotype with a high relativerisk of thrombotic complications (RR = 22.5 [7.1 - 71.7], sensitivity - 75%, specificity - 97%). Information on the presence of thrombophilia should be used to prescribe therapeutic doses of anticoagulants during hospitalization and to resolve the issue of longterm thromboprophylaxis in the period after COVID-19.

Purpose.To study the features of clinical manifestations of the treatment of a new coronavirus infection (COVID-19) in patients of mild and moderate severity at the stage of hospitalization, paying special attention to changes in the gastrointestinal tract (gastrointestinal tract).Material and methods. The gastroenterological manifestations of the new coronavirus infection (COVID-19) were previouslyretrospectively studied in 1180 patients, a questionnaire and a study design were compiled, which included 80 patients, whose average age was 45 years, hospitalized with a confirmed diagnosis of COVID-19, 19 of them had mild and 61 - moderate severity of the disease. The scope of the examination included questionnaires, traditional clinical, clinical and laboratory, biochemical, instrumental and radiation studies, as well as unique methods for studying microbiota and intestinal permeability.Results. The features of the course of COVID-19 at the stage of admission to the hospital were studied, the most significant clinical manifestations of the disease, including from the gastrointestinal tract, were identified. Thus, the presence of dyspeptic syndrome was detected in 83.8% of patients, diarrhea - in 37.5%, heartburn - in 27.5%, abdominal pain syndrome - 45% of patients. The development of gastroenterological manifestations of COVID-19 was combined with a more severe course of the disease and required the development of individual approaches to their correction.

This article discusses the effect of the new coronavirus infection SARS-CoV-2 on the course of pregnancy, delivery and the condition of newborns. It is known that immunological relationships in the maternal-placental-fetal system are complex and not fully understood. Infectious diseases in pregnant women due to immune tolerance are often more severe than in non-pregnant women, and the presence of comorbid somatic diseases only aggravates the clinical picture. In most cases of SARS-CoV-2, clinical manifestations during pregnancy are similar to the general population picture, but during gestation, the risk of severe pneumonia, thrombosis, multiple organ failure increases, increased need for intensive care and the need for endotracheal intubation. Therefore, pregnant women infected with SARS-CoV-2 are at high risk of developing a severe course of the disease.Infection with the new coronavirus infection COVID-19 leads to various complications of gestation, which is characterized by an increased incidence of preterm labor, abnormal delivery, operative delivery, complicated course of the postpartum period, the risk of infecting the newborn.

In the context of the financial and economic crisis, falling real incomes and the population's ability to pay, pharmacy organization (PO) have to adapt their activities under environmental factors under the strict control of a manager.Purpose: to develop a portrait of a PO that carries out retail trade (dispensing) of medicinal products for the manager using sociological research.Material and methods. The research was carried out by the method of a sociological survey using a questionnaire survey of 132 managers of the city of Ufa.Results and discussion. It was revealed that the heads of pharmacy organizations are young married women who graduated from educational institutions located in their hometown. Their choice of a profession is due to its prestige (21.2%). In the work of amanager, knowledge of management and psychology is more often used (28.8 and 34.8%, respectively). Working as a manager inmodern conditions in 75.7% of respondents causes stress of varying severity, up to emotional burnout.Conclusions. Thus, overestimated requirements for specialists in the pharmaceutical industry, lack of labor rationing and low wages lead to emotional outburst and retirement from the profession.

The article presents the results of the analysis of the federal and regional budget expenditures for drug provision of patients with malignant neoplasms of the prostate gland. There were identify: the structure of costs, the most frequently purchased names of medicines, and the dynamics of the need for preferential medicines in patients with this nosology.The aim of the article to study the structure and dynamics of costs for drug provision, from the regional and federal budgets, patients with malignant neoplasms of the prostate gland (on the example of the Orenburg region).Material and methods. A software package for centralized data processing (provision of necessary drugs, normative reference information, prescription forms for prescriptions for prescriptions of preferential drugs used in the treatment of prostate malignant neoplasms.Results. In the course of the study, it was revealed that in the period from 2017 to 2020, the largest number of drugs used in the treatment of malignant neoplasms of the prostate gland was purchased at the expense of the regional budget of the Orenburg region (4 392 785.86 rubles, 2020). The most frequently purchased drug was Buserelin 3.75 mg No. 1: 2017 (30%), 2018 (40%), 2019 (86%) at the expense of the federal budget. For the period from 2017 to 2020, new anticancer drugs have appeared - "Abiraterone250 mg No. 120" (2017), "Degarelix 80 mg No. 1" and "Enzalutamide 40 mg No. 112" (2020).Conclusions. To improve the quality of provision and availability of pharmaceutical care for urological oncological patients, it is necessary to reduce the financial burden on the regional budget and improve approaches to the formation of an optimal assortment.

One of the most important directions of pharmacoepidemiological studies is the analysis of the consumption of antimicrobial drugs. This is due to the formation of resistance of pathogenic microorganisms with the wide use of drugs of this group in the region, the country and the world as a whole.The aim of the work was to study the frequency, pattern of consumption of antibacterial drugs in the surgical departments of the multiprofile hospital of the Republic of Tajikistan, to identify the most frequently consumed and most expensive antibacterial drugs.Material and methods. The pharmacoepidemiological analysis was carried out using the recommended ATC / DDD methodology by the World Health Organization.Results. The pharmacoepidemiological analysis of the consumption of antimicrobial drugs in the surgical departments of the multiprofile hospital showed that in 8 years there has been a significant increase in the level of consumption and at the same time asignificant change in the structure of consumption of antimicrobial agents in surgical pathology. There is a clear trend towards thetransition to antimicrobials of the group of cephalosporins and, in particular, ceftriaxone. At the same time, the general level of consumption of antimicrobials from the group of penicillins and partially fluoroquinolones has been reduced. During the whole study period, the highest level of consumption of antimicrobial drugs was noted in the department of urology and the otolaryngology department, the minimum in the therapeutic departments.Conclusion. The analysis of the consumption of antimicrobial drugs in the departments of the multiprofile hospital showed that the evaluation of DDD-indicators of drug consumption allows to change and bring into line with the department profile the quantity and range of the drugs used, and also to optimize expenses under the article "Medicaments".

Purpose: to study of models of total ischemia and ischemia-reperfusion of the myocardium from the standpoint of modern concepts of the development and course of acute coronary syndrome.Material and methods. The described experiments were carried out under in vivo conditions on 70 mature male rats. Laboratory animals were divided into groups for modeling total myocardial ischemia (n=30) and for modeling myocardial ischemia-reperfusion (n=30). A separate group (n=10) was singled out as intact rats. Myocardial changes were determined by the following groups: histological studies, the state of the hemostasis system, biochemical parameters. The animals also underwent electrocardiography and echocardiography.Results and discussion. The histological picture of the group of animals of «total ischemia» showed that after a day in the necrosis zone there were significant changes of a destructive nature. At the same time, in the group of animals of «ischemia-reperfusion» in the reperfusion phase, a pronounced inflammatory reaction develops - the heart tissues are infiltrated by various nonmuscle cells, and the cardiomyocytes themselves undergo contracture changes. At the same time, both irreversible ischemia and ischemia-reperfusion trigger an inflammatory re- action, which is determined by an increase in the number of leukocytes (in particular, neutrophils) and a shift in the leukocyte formula. Also, in the group of modeling total ischemia, on the first day after the onset of myocardial infarction, there was an increase in the corresponding biochemical markers compared to the intact group.Conclusions. The existing arsenal of experimental techniques allows adapting the generally accepted model of acute coronary syndrome for studying ischemic-reperfusion syndrome, which can be used to study the mechanisms of this pathological process, and for preclinical studies of new means of influencing the cardiovascular system.

Purpose: to analyze highlight previous and recent literature studies of chronoadaptation problem of the human body by daily and seasonal cycles.Material and methods. The review examines the results of 11 RSCI and 36 PubMed scientific sources by the role of genetically determined structures that regulate the 12-hour, circadian (daily) and circannual (annual) biorhythms of the human body.Results and discussion. The autonomous cellular regulation is caused by self-regulating molecular rhythm generators (oscillators) - circadian genes. They determine the diurnal and seasonal changes in photoperiod changes under the influence of the hypothalamus and pars tuberaslis of the pituitary gland. Cells-organs-organisms of mammals and humans under the influence of the «biological clock» are able to adapt to cyclic processes and stressors, can anticipate them and reform. The disturbance of the coordinated work of the «biological clock» leads to disorders of adaptation, the formation of metabolic disorders, cardiovascular diseases and pathology of the nervous system.Conclusions. Thus, the study of the influence of the laws of adaptation of physiological functions during a certain period of time(day, seasons), with changes in environment (photoperiod), allows a deeper understanding of the etiopathogenesis of diseases, and, therefore, novel therapeutic opportunities for circadian medicine.

Purpose: to analyze scientific publications on cytoreductive surgery with intra-abdominal hyperthermic chemotherapy (HIPEC)procedure.Material and methods: foreign and domestic scientific publications.Results and discussion. In the foreign literature, the results of clinical studies evaluating the effectiveness of CRS/HIPEC compared to CRS in patients with peritoneal carcinomatosis of various etiologies have been published, while long-term survival rates were higher in the group who underwent CRS/HIPEC. Despite the fact that there is a sufficient variety of multicenter retrospectivestudies on the treatment of peritoneal carcinomatosis of various etiologies, there is still no clear answer defining indications and contraindications for performing CRS/HIPEC.Conclusions. The treatment of peritoneal carcinomatosis and the evolution of the HIPEC procedure is aimed at optimizing different treatment methods at many levels, including patient selection, preoperative preparation, and determining the safest and most effective chemotherapy regimens. More research is needed in the field of CRS/HIPEC, which will undoubtedly help to further standardize this technique.