Aim. To study morphological changes in aseptic and purulent soft-tissue wounds using the developed models in animal experiments.

Materials and methods. The study was conducted on 70 white non-linear laboratory male rats aged 5 months and weighing 300–350 g. All the investigations were performed in accordance with ethical norms and documents regulating animal experiments. An experimental wound was simulated with the introduction of an implant into soft tissues using a layer-by-layer incision to the required depth. A sterile hydrophilic polymer implant was used for simulating an aseptic wound. A purulent wound was simulated using a porous polymer implant initially saturated with a suspension of a bacterial pathogen at a concentration of 10 5–10 12 microbial cells per 1 ml of suspension. The wounds were sutured layer by layer to form corresponding models. The implants was removed surgically on the 7th day. Statistical analysis of the study results was carried out by Windows 10 operating system using STATISTICA 6.1 (StatSoft Inc., USA) and Excel (Microsoft Offi ce 2010). The hypothesis of normal cumulative distribution in the samples was verifi ed via the Shapiro — Wilk and Kolmogorov — Smirnov tests. The signifi cance level threshold was set to p<0.05. Differences between quantitative parameters with a normal distribution were evaluated using the Student’s t-test, whereas independent samples were assessed via the non-parametric Mann — Whitney test. In all cases, differences were considered statistically signifi cant at p<0.05. The signifi cance level of the relationship between the two qualitative variables was verifi ed using the Pearson’s chi squared test (χ2 ). The study was approved at a meeting of the Independent Ethics Committee of the Kuban State Medical University (Minutes No. 63 of 21 May 2018).

Results. The analysis of the obtained results has allowed optimal models for the formation of aseptic and purulent soft-tissue wounds in animal experiments to be selected.

Conclusion. The proposed method of modeling aseptic and purulent wounds in animal experiments can be used in clinical and morphological studies of the wound process, as well as in assessing the effectiveness of various wound treatment methods. 

Aim. In this research, we aimed to investigate the caries resistance of permanent teeth in children at different dentition periods on the basis of data obtained on the chemical composition and microstructure of the tooth surface at the stage of tertiary mineralization.

Materials and methods. We examined 34 premolars without signs of carious lesions, which had been extracted from 11–16 old children following indications for orthodontic treatment, using a high-resolution scanning electron microscope JSM-6610LV (JEOL) equipped with a micro X-ray spectrometer INCA Energy 350XT (Oxford Instruments Analytica, UK). The teeth under study were divided into three groups. The 1st, 2nd and 3rd groups comprised teeth extracted from 11–12, 13–14 and 15–16 year-old children, respectively. In these groups, tooth mineralization continues 6–12, 13–36 and 37–60 months after eruption, respectively.

Results. The X-ray microanalysis of the teeth under study in terms of chemical composition (percentage by mass) showed that the surface enamel accumulates increased concentrations of Ca, P, F and demonstrates a higher Ca/P ratio under reduced levels of C, Na, O during mineralization. It is found that, during early stages of physiological maturation, tooth enamel shows morphological signs of hypo-mineralization, as well as a low caries- and acid resistance, due to its insuffi ciently formed prismatic structure, lack of a protective layer, signifi cant permeability and a large number of retention points.

Conclusion. The obtained results demonstrate the possibility of applying high-resolution electron microscopy and X-ray microanalysis for the study of dental hard tissues in dental practice. The development and implementation of personalized approaches to the prevention of caries, which are based on the selective use of remineralizing preparations and vitaminmineral supplements, can increase the caries- and acid resistance of tooth enamel at all stages of its physiological maturation. 

Aim. In this research, we aimed to study echographic characteristics and normal sizes of the vertebrae and intervertebral discs of the cervical region in healthy individuals.

Materials and methods. On the material of 45 healthy volunteers, normal echographic characteristics of the cervical spine were studied using Toshiba Aplio 500 and Toshiba Aplio XG (Japan) scanners equipped with 3.5–5.0 MHz convex sensors and 7.5–12.0 MHz linear sensors.

Results. It is found that ultrasound examination from the anterior-lateral access to the right and left allows the C3–C7 vertebral body surfaces facing the sensor to be visualized and their interposition and condition to be evaluated. A new echoanatomical reference point for ultrasonic identifi cation of the level of the cervical vertebra is proposed based on the visualization during the transverse scanning of the carotid artery bifurcation, which corresponds to the C3–C4 intervertebral disc level. The information capacity of the proposed echoanatomical criterion exceeds that for the traditional anatomical criterion used for the C7 vertebra along the sternoclavicular joint by 15.6 ± 5.4%. It is revealed that ultrasound examination provides for a satisfactory visualization of intervertebral discs at a level from C3–C4 to C7–Th1 in the longitudinal and transverse projections, as well as the evaluation of their echostructure and height measurement. The minimum, maximum and average values of the height of intervertebral discs at different levels are given; their dependence on gender, height and body weight of the examined persons is analyzed.

Conclusion. It is established that ultrasound examination from the anterior-lateral access is an informative method for investigating vertebral structures at the C3–C7 level. The proposed echoanatomical reference point for C3 and C4 vertebrae allows the ultrasonic identifi cation of the cervical vertebra level to be improved by 15.6 ± 5.4%. The height of the intervertebral disc in healthy persons averages 4.38 ± 0.51 mm and signifi cantly nonlinearly increases from the C3–C4 to C7–Th1 level. 

Aim. To increase the effectiveness of the differential diagnosis of benign focal lesions of the liver using contrast-enhanced ultrasound (CEUS).

Materials and methods. A retrospective analysis of the examination results of 37 patients with morphologically confi rmed liver benign tumors was carried out. According to the morphological data, the patients were divided into two groups: 22 patients with focal nodular hyperplasia (FNH) and 15 patients with hepatocellular adenoma (HCA). All the patients underwent multiparametric ultrasound examination using CEUS.

Results. According to the obtained data, despite the nearly equal intensity of fi lling FNH and HCA with a contrast agent (96% and 80%, accordingly), FNH is characterized by an earlier contrasting (WASH IN) pattern in the arterial phase (AF), with the ‘onset of contrasting in the focus’ parameter being signifi cantly different from HCA (p<0.05). Specifi c signs of FNH included the following: the spoke-wheel pattern and an increased intensity of ultrasound contrast agent (USCA) accumulation — 96% of cases; ‘center-to-edge’ fi lling — 86% of cases. WASH-OUT is not a typical sign of FNA. A complete (100% of cases) and intensive (80% of cases) centripetal (80% of cases) fi lling is characteristic of HCA. No specifi c types of vascular pattern were observed. In 6 (40%) patients, WASH-OUT and ‘relative hyperechoic’ were detected in the portal phase.

Conclusion. CEUS is established to be an effective method of the differential diagnosis of FNH and HCA. 

Aim. To conduct a clinical assessment of short- and long-term surface sealing in patients having a different hygienic status of the oral cavity.

Materials and methods. For clinical trials, a group of 250 male and female patients aged 25–45 years old and diagnosed with Black’s class III and V carious lesions was selected. All patients were divided into three groups depending on the state of oral hygiene and the applied methods of aesthetic restoration: control group — defect restoration by Filtek Z-250 microhybrid composite (3M ESPE); comparison group — Filtek Z-250 restoration (3M ESPE) + Easy Glaze (Voco) surface sealing on the day of restoration; and the main group with three subgroups: 2α subgroup — Restavrin restoration + Easy Glaze sealant on the day of treatment; 2β subgroup — Restavrin restoration + Easy Glaze sealant on the day of treatment and re-sealing with a frequency of 1 time per year; 2γ subgroup — Restavrin restoration + Easy Glaze sealant on the day of treatment and re-sealing with a frequency of 1 time per 6 months. The quality of caries cavities was assessed by USPHS criteria, including anatomical shape (AS), marginal pigmentation (MP), marginal adaptation (MA), the presence of secondary caries (SC) and sensitivity (S). The evaluation was conducted on the day of the visit and following 6, 12 and 24 months.

Results. A comparison of the clinical evaluation of photocomposite restorations by the Filtek Z-250 (3M ESPE) microhybrid composite in the control group of patients, in comparison group and in the main Restavrin (Technodent) group showed that the Easy Glaze (Voco) surface sealing of the Restavrin composite restorations carried out in the 2α subgroup of the main group onе time on the day of restoration, in the 2β subgroup with re-sealing after 12 months, and in the 2γ subgroup with sealing every 6 months had allowed the maximum number of restorations to be corresponded to the “satisfactory” value according to the AS, MP, MA, SC, S evaluation criteria throughout the entire observation period.

Conclusion. The Restavrin (Technodent, Russia) polymeric nanohybrid fi lling material is shown to produce the most effective and durable restorations compared to other materials under study. The applicatiyon of Restavrin followed by the Easy Glaze (Voco) sealing protective system with a frequency dependent on the hygienic status of the oral cavity allows therapeutic methods for dentin caries treatment to be optimized. 

Aim. The study was performed in order to assess the size, structure and chewing ability of the maxillary ridge reconstructed using autologous adipose-tissue derived stromal vascular fraction (ATD SVF) in a long-term study (10 years).

Materials and methods. The study involved 141 patients (61 men, 80 women) aged from 45 to 78 years (mean age 57 years) with a regression transformation of the alveolar ridge of the upper and lower jaw. In the test group (TG), 112 osteoplastic surgeries were performed using autologous adipose-tissue derived stromal vascular fraction (ATD SVF) followed by the installation of 297 dental implants into the reconstructed ridge to restore the chewing function. The control group (CG) comprised 117 surgeries performed according to generally accepted methods followed by the installation of 323 artifi cial supports. The size of the alveolar ridge and the support function of the reconstructed bone were evaluated during the period of up to 10 years. In the histological and histomorphometric study, 27 trephine biopsy specimens of reconstructed bone obtained during dental implantation were studied. The resulting digital material was processed by conventional methods of variation statistics.

Results. The results of a comparative study have confi rmed the advantages of the proposed approach with the use of ATD SVF over current generally accepted methods for the reconstruction of the jaw alveolar ridge. The use of ATD SVF in the composition of osteoplastic material allows the required degree of augmentation of the atrophied bone area to be achieved with a minimal risk of complications and reoperations (8% and 21% of cases in TG and CG, respectively, p = 0.231), along with the optimal morphological characteristics of the regenerate (40.14 ± 3.36 and 24.23 ± 2.63 percent of viable mineralized bone tissue on sections of trephine biopsy specimens from TG and KG, p = 0.001). These results ensure reliable osseointegration of artifi cial supports in the reconstructed alveolar ridge and a high effi ciency of orthopedic treatment with implant supports during the period of up to 10 years (97% and 88% in TG and CG, respectively, r˂0.001).

Conclusion. The proposed innovative approach can be recommended as a basis for a surgical protocol with a pronounced regression transformation of the jaw alveolar ridge. This will allow the chewing function to be restored more successfully and predictably with the use of artifi cial supports in the reconstructed bone in this category of patients. 

Aim: Our aim was to study and analyze the level of the annexin V apoptosis marker in the oral fluid in patients with generalized periodontitis without general somatic pathology and against the background of bronchiectasis.

Materials and methods. 40 patients diagnosed with generalized periodontitis without somatic pathology and 50 patients diagnosed with generalized periodontitis and bronchiectasis were examined. The control group included 40 somatically healthy individuals with intact periodont. Indices characterizing the state of periodontal tissues, such as PMA, PI, Muhlemann, OHI-s were determined for all the examined persons. The level of the annexin V apoptosis marker was determined in the oral fluid by enzyme immunoassay.

Results. It was established that the value of the indices of periodontal tissues (PMA, PI, Muhlemann, OHI-s) was statistically signifi cantly higher in the group of patients with generalized periodontitis against the background of bronchiectasis both in comparison with the control group and with the group of patients without general somatic pathology. The level of the annexin V apoptosis marker was also statistically signifi cantly higher in patients with generalized periodontitis against the background of bronchiectasis as compared with the control group and the group of patients without general somatic pathology (p<0.001). According to the correlation analysis, statistically signifi cant relationships of the moderate strength between the level of annexin V and the value of the indices of periodontal tissues were found both in the group of patients without general somatic pathology and in the group of patients with generalized periodontitis against the background of bronchiectasis. At the same time, the strength of these relationships in patients with generalized periodontitis against the background of bronchiectasis was greater as compared to the group of patients without general somatic pathology.

Conclusion. The level of the annexin V apoptosis marker in the oral fluid of patients with generalized periodontitis against the background of bronchiectasis is statistically signifi cantly higher (p<0.001) than in patients with generalized periodontitis without general somatic pathology. The results of the correlation analysis indicate the presence of relationships between the level of annexin V and the value of periodontal tissue condition indices (PMA, PI, Muhlemann, OHI-s). Thus, increased apoptosis in generalized periodontitis against the background of bronchiectasis can act as a factor aggravating the damage to periodontal tissues.

Aim. To evaluate the effi cacy of hyperbaric oxygenation (HBO) in patients with a different functional status (FS) after the elimination of acute colonic obstruction (ACO).

Materials and methods. A retrospective analysis of 210 medical records of patients who had undergone emergency surgical interventions aimed at ACO elimination was carried out. Based on the value of the direct current potential (DCP), the patients were divided into three groups: 1st (n = 96) with the DCP value from –30 mV and below — FS subcompensation; 2nd (n = 60) with average negative DCP values from –15 to –29.9 mV — FS compensation; 3rd (n = 54) with low negative and positive DCP values from –14.9 mV and higher — FS decompensation. The correlation between patients’ FS and the incidence of postoperative complications was studied, and independent predictors of fatal outcomes were identifi ed. Subsequently, a quantitative analysis of complications and mortality was carried out in each group depending on the use of HBO sessions in the postoperative period, followed by an assessment of their effi cacy.

Results. According to the number of perioperative complications and mortality, risk groups in terms of the unfavourable course of the postoperative period were identifi ed: patients with high negative DCP values, for whom the arterial hypotension and acute kidney injury (AKI) could serve as the independent predictors of death; and patients with low negative and positive DCP values, for whom the statistically signifi cant predictors of mortality were shown to be the DCP level, hypotension, AKI and pneumonia. HBO sessions in the postoperative period allow the number of complications in the general population to be reduced: pneumonia by 7%, delirium by 8.8%, AKI by 6.3%, intestinal dysfunction for more than 3 days by 7.3%. In addition, HBO contributed to a 2.9% decrease in suppurative diseases. The analysis of the data on the HBO application in the general population and FS information showed HBO to have a positive effect on the general somatic status of ACO patients. In addition, HBO treatment is shown to decrease the incidence of complications in the early postoperative period. The effi cacy of HBO is found to be higher in the cohort of the most severe patients with decompensated FS, where such complications as delirium, pneumonia and gastrointestinal paresis were decreased by 22.2%, 13% and 18.5%, respectively. As a result, in this group of patients, a signifi cant decrease of 11.1% in 30-day mortality was achieved.

Conclusion. The postoperative period depends on the actual FS. The conducted analysis of HBO therapy has convincingly confi rmed its effi cacy in the combined treatment of patients after the elimination of ACO. 

Aim. In this research, we studied the parameters of blood biochemical analysis in rats with combined paracetamol-alcoholic liver injury after its pharmacological correction by newly synthesized partially hydrogenated pyridines (cyanothioacetamide derivatives).

Materials and methods. 50 samples of new derivatives of partially hydrogenated pyridines synthesized on the basis of the “Chemex” Research Laboratory of the Vladimir Dal’ Lugansk National University underwent virtual bioscreening, which allowed the selection of 4 compounds, the biological activity of which may be associated with the effect on the protein synthesis and detoxifi cation function of the liver. The experiment was conducted on 48 white outbred male rats. For 14 days, the rats of the control and experimental groups were intragastrically injected with 1 ml of 40% ethanol and paracetamol at a dose of 500 mg/kg once a day. Pharmacocorrection with a thiotriazoline reference drug (50 mg/kg) and pyridine derivatives at a dose of 5 mg/kg was performed from the fourth day. On the 15th day, blood was sampled to determine the level of total bilirubin, alanine aminotransferase, aspartate aminotransferase and thymol turbidity test.

Results. The value of total bilirubin in the blood of the rats treated with CV046 compounds was 34.88% lower than that in the control group. The animals of the test groups receiving CV047 also showed signifi cant differences with the control group in terms of bilirubin level (a decrease of 31.78%). The AST values in the blood of rats in the test groups had no signifi cant differences as compared with intact animals. Following 10 days of pharmacological correction of combined paracetamol-alcoholic liver injury with CV146, the total bilirubin level in the blood decreased by 26.36% in comparison with the control group, with the activity of ALT and AST demonstrating the levels of intact values.

Conclusions. The conducted screening studies of four partially hydrogenated pyridines — cyanothioacetamide derivatives — using the model of combined paracetamol-alcoholic liver injury when used at a dose of 5 mg/kg during ten days have shown a high hepatoprotective and detoxifying activity of the following three compounds: СV046 (2-[(9-tert-butyl-1,5-dicyano4-oxo-3-azaspiro[5,5]undec-1-en-2-yl)thio]-N-(2-ethylphenyl)acetamide — IUPAC), СV047 (2-[(9-tert-butyl-1,5-dicyano-4-oxo-3-azaspiro[5,5]undec-1-en-2-yl)thio]-N-(4-fl uorophenyl) acetamide) and СV146 (benzyl 4-(4-chlorophenyl)-5-cyano-6-({2-[(3,4-dimethylphenyl)amino]-2-oxoethyl}thio)-2-methyl-1,4-dihydropyridine-3-carboxylate). 

Aim. In this research, we compare the antemortem and postmortem diagnosis in fatal head injury cases with the purpose of establishing the structure and causes of incorrect diagnoses.

Material and methods. 1223 cases of fatal outcomes with the clinical diagnosis of death from head trauma were examined. In each case, we carried out a comparison of the clinical and autopsy diagnosis in terms of all report headings in order to establish reasons for divergence in the antemortem and postmortem diagnoses and the role of incorrect clinical diagnostics in the onset of death.

Results. In 35% of cases, the clinical head trauma diagnoses were incorrectly categorized. In 22.6% cases, the antemortem diagnoses were formulated not in correspondence with the modern classifi cation and terms of ICD-10. In 11.7% cases, the violation of the etiopathogenesis principle was observed. Clinical diagnoses were not supported by objective data and examination results in 4.5% cases. The discrepancy between the clinical and autopsy diagnoses in terms of the ‘underlying disease’, ‘complications’ and ‘concomitant’ headings was 15.6%, 10.1% and 14.0% from all the studied cases, respectively. Subjective reasons are found to statistically predominate among the identifi ed reasons for the divergence of diagnoses.

Conclusion. It is established that fi nal clinical diagnoses in fatal head injury cases fail to fully meet the criteria of structure, nosology, etiopathogenesis and reliability. Erroneous diagnoses are found to result from underestimation of clinical data, insuffi cient observation and instrumental examination of patients, incorrect formulation of the fi nal clinical diagnosis. 

Aim. This study was aimed at searching and investigating new substances among phenylethyl derivatives of 3-hydroxypyridine, which exhibit a high actoprotective activity under the conditions of normoxia and acute hypobaric hypoxia.

Materials and methods. New compounds of phenylethyl derivatives of 3-hydroxypyridine under the SC code (n = 23) were investigated in comparison with bemethyl and bromantane. The actoprotective activity of new compounds was assessed in experimental animals using a treadmill running test under the conditions of normoxia and acute hypobaric hypoxia. The studied chemical substances and comparative drugs were administered 1 hour prior to exposure of animals to the test. Statistical processing of the obtained experimental results was performed using Microsoft Excel and Statistica for Windows 6.0 software.

Results. Among the studied substances, active compounds exhibiting an actoprotective effect have been distinguished. SC-119 chemical substance was revealed, which exceeds the other studied chemicals and bemethyl and bromantane reference actoprotectors in terms of the range of effective doses and actoprotective activity under the conditions of normoxia and acute hypobaric hypoxia.

Conclusion. According to the results of the study, the SC-119 compound seems to be a prospective candidate for further research into highly effective actoprotective drugs. 

The aim is to assess the health status (morbidity and disability) of adolescents in Krasnodar Krai.

Materials and methods. We analysed the offi cial statistical data on the health state of 10– 18 year-old children in Krasnodar Krai during the 2013–2017 period using Form 12 “Information on the number of diseases registered in patients living in the service area of the medical organization” and Form 19 “Information on disabled children”. In addition, the data presented in the report “On medical support of citizens before their initial military registration in Krasnodar Krai in 2017” was analysed.

Results. Diseases of the respiratory tract, digestive system, musculoskeletal system and connective tissue, as well as traumas and poisoning, are shown to be leading conditions in the structure of adolescents’ general and primary morbidity. Over the past fi ve years, a decrease in the overall and primary morbidity in 10–14 year-old children has been recorded, although these indicators have shown a growing trend in children aged 15–18 years old. An increase in general and primary disabilities across all age groups in Krasnodar Krai was revealed.

Conclusion. An increase in the primary and overall morbidity in 15–18 year-old adolescents, as well as an increase in primary and general disabilities in 10–18 year-old adolescents has been observed. The problem of adolescent health can be solved using an integrated approach. Positive dynamics can only be achieved by oncerted efforts of medical, public and scientifi c organizations. 

Aim. In this study, we carry out a problem and critical analysis of the process of implementing the 5S lean manufacturing methodology in the Healthcare System of the Russian Federation.

Materials. 33 Russian and foreign literature sources indexed in the RSCI, Scopus, Web of Science and PubMed databases were reviewed.

Results. This article scrutinizes 5 consecutive steps of the 5S lean manufacturing method for organizing a workplace. This method, which is based on interrelated principles, is being actively introduced into the Russian Healthcare System with the purpose of identifying, reducing and preventing various types of losses.

Conclusion. It is shown that the practical realization of the 5S method is hampered by the specifi cs of medical personnel work and the peculiarities of legislative regulation in RF medical organizations. The application of the 5S methodology, taking into account the existing regulatory framework in the fi eld of healthcare, can increase the manageability of workplaces and create conditions for the effective work of medical personnel. 

Acute infl ammatory polyneuropathy is an important research problem of modern neurology. Guillain — Barré syndrome is a severe form of acute polyneuropathy, which is based on autoimmune infl ammation of the myelin sheath of roots and peripheral nerves. Guillain — Barré syndrome is an example of one of the most severe diseases of the nervous system, in which timely diagnosis, proper therapy and qualifi ed care facilitate the achievement of the full recovery of lost functions in most patients. Following an extensive review of Russian and foreign literature, this article discusses modern concepts of Guillain — Barré syndrome, in particular questions related to its epidemiology, etiopathogenesis, classifi cation, clinical features, diagnosis, treatment and prognosis.

Aim. The aim of this work was to analyze recently published data on the risk factors and pathogenetic aspects of metabolic syndrome (MS) in women of reproductive age.

Materials and methods. This review covers data presented in foreign and Russian literature, which has been published in electronic bibliographic databases Pubmed and the Cochrane Library over the past 10 years. Specifi cally, we carried out an analysis of works containing information on risk factors, pathogenetic aspects and diagnostic criteria of MS in women of reproductive age, as well as on methods currently used for the treatment of this condition.

Results. We characterize modern theories that explain mechanisms triggering the development of MS complicated with diabetes 2 type and polycystic ovary syndrome (PCOS). Data on proteomic markers refl ecting the complex pathogenesis of PCOS is generalized, along with their role in the diagnosis and treatment of this disease. The possibility of using these markers for predicting pregnancy outcomes is shown. The importance of regulating metabolic processes for the preparation of women for pregnancy and fertility recovery is emphasized.

Conclusion. Hyperandrogenism, insulin resistance, obesity, diabetes 2 type, dyslipidemia, PCOS are shown to be the most signifi cant factors determining pathological changes in fertile age women with metabolic syndrome. The correction of these factors should be included in the course of pregravid preparation for the prevention of adverse pregnancy outcomes. 

Aim. The aim is to analyze the data thus far published on the radiologic diagnosis of adenomyosis in patients with reproductive problems in order to determine promising areas for further scientifi c research.

Materials and methods. An information search for subsequent analysis was performed using E-Library, PubMed and CochraneLibrary electronic bibliographic databases with the following keywords: “ultrasound diagnosis of adenomyosis”, “MRI adenomyosis”, “junctional zone adenomyosis”, “ultrasound adenomyosis”, “diagnosis adenomyosis”, “magnetic resonance imaging adenomyosis”, “adenomyosis junction”.

Results. Imaging techniques are prioritized in diagnosing the initial incidence of adenomyosis. The value of such techniques increases when analyzing the causes of implantation failures. Key issues associated with the modern radiologic diagnosis and monitoring of adenomyosis during treatment have been considered on the basis of the standardization of studies, classifi cation of the disease, assessment of the diagnostic accuracy and prognostic value of imaging techniques in patients with reproductive losses and infertility.

Conclusion. Promising areas of scientifi c research are found to be the specifi cation of optimal diagnostic timeframes, informativity of diagnostic criteria for 3D reconstruction, MRI, elastography, angiography, as well as the development of prediction methods for healthy childbearing and monitoring the treatment effectiveness. 

Aim. To review Russian and foreign literature on modern methods of diagnosis and treatment of patients with analgesic nephropathy.

Materials and methods. Russian and foreign literature sources published in recent years on the aforementioned problem were analyzed.

Results. This article presents the concept of analgesic nephropathy (AN) and discusses causes and mechanisms of its development. The pathogenic effect of non-steroidal antiinfl ammatory drugs on renal tissue is indicated. Key stages of the disease and its clinical features are determined. An algorithm of diagnosis is proposed. The importance of a patient’s detailed medical history is emphasized, including the duration, multiplicity and reasons for taking analgesics. A particular attention is paid to questions of AN therapy and its prevention. Provided timely diagnosis and analgesics withdrawal, the possibility of reverting tubulointerstitial infl ammation is shown.

Conclusion. It is shown that optimal solutions with regard to AN diagnosis and its treatment are yet to be found. A timely diagnosis inhibits the development of chronic renal failure, which early detection provides for a higher treatment effi ciency and improved prognosis. 

Introduction. The importance of investigating the problem of toenail onychomycosis is associated not only with its widespread prevalence among the population and negative effects on the patient life quality, but also with signifi cant diffi culties arising during its therapy. At the moment, a large number of systemic and local antifungal drugs are successfully applied for treating this pathology. Moreover, new physiotherapeutic methods are being developed and introduced into clinical practice. These treatment approaches are based on different action mechanisms, thus demonstrating certain advantages and disadvantages.

Discussion. This article sets out to provide a review of antifungal drugs recommended for use in the Russian Federation in patients suffering from onychomycosis of the feet. The results of studies aimed at establishing the clinical effi cacy and application of azole, allylamine, morpholine and ciclopirox derivatives are summarized. Criteria for the selection of these drugs for systemic and local therapy are given. Both Russian and foreign recent publications devoted to physical factors in the treatment of fungal nail infections are analyzed. The action mechanisms, clinical effi cacy, application methods, signifi cant adverse effects of laser and photodynamic methods, as well as ultrasound, magnetic and electric fi elds, are described.

Conclusion. Modern approaches to the treatment of toenail onychomycosis are shown to use a large selection of systemic and local antifungal drugs, as well as physiotherapeutic methods for correcting this pathology. All of them have different action mechanisms characterized by particular advantages and disadvantages. To date, there is no universal drug for the treatment of toenail onychomycosis, which would affect all parts of the mycotic process. Following the analysis of recently published literature, it is shown that the use of topical medications and physiotherapy in combination not only signifi cantly reduces the duration of the application of systemic antimycotic drugs, but also expands the etiological indications and their adverse effects. Therefore, such a therapy is established to be the most effective approach to the treatment of toenail onychomycosis at the present stage. 

There have been a growing number of the outbreaks of human diseases with typical zoonotic infections, which have previously occurred exclusively in veterinary practice. Among them is monkeypox, whose first occurrence outside the African continent was registered in the USA in the spring of 2003. An important factor contributing to the penetration of infections into the human population is a close contact of people with fauna representatives in the context of intensively growing cities. Therefore, research into new zoonotic diseases, which are potentially dangerous to humans, seems to be critically important. Thus, retrospective studies carried out among the Peru population in 2009 revealed the cases of the encephalomyocarditis virus (EMCV) (Picornaviridae family, Cardiovirus genus) infection in people having suffered from acute febrile illness. A new virus strain belonging to the same genus was described during the infection outbreak among primates of the Sukhumi Monkey nursery (Republic of Abkhazia) in 1990–1999. This strain was also identified during the outbreak among the monkeys of the Primatological Centre in the Krasnodar Krai in 2012. In this review, we generalize the data available on the structure, virulence factors and distribution of EMCV.

Aim. This paper is aimed at investigating the possibility of preventing an adverse outcome of acute viral myocarditis by means of optimal pharmacotherapy without the use of surgical treatment methods.

Results. We describe a clinical case of acute viral myocarditis in a 60-year old female patient. According to the conducted echocardioscopy, the dilatation of the heart cavities and the complete insufficiency of the mitral and tricuspid valves were identified. A cumulative effect of the chosen optimal pharmacotherapy, which included an angiotensin converting enzyme inhibitor, a beta-blocker, a mineralocorticoid receptor antagonist and a loopback diuretic with neurohumoral properties taken in optimal doses, allowed congestion signs to be rapidly eliminated, a reverse remodeling of the heart to be achieved and the heart size to be returned normal values. The double blockade of aldosterone receptors using eplerenone and torasemide prevented both the development of fibrosis in the myocardium and the formation of irreversible dilated cardiomyopathy.

Conclusion. The application of antiviral and immunomodulatory therapy, along with the maximum possible doses of drugs used to treat chronic heart failure, allowed the patient’s cardiohemodynamic parameters to be returned to normal values. A timely combination therapy should be used to avoid the formation of dilated cardiomyopathy, thus improving the prognosis of the disease.