Goal. Study of the features of hemogram and biochemical indicators of blood in children with different supply of vitamins.
Materials and methods. The laboratory determination of the content of vitamins A, C, D, E, B6 and B12 in the blood of children attending pre-school educational organizations (hereinafter - OED), where the standard C-vitaminization of the diet was carried out.
The observation group consisted of 146 children with hypovitaminosis in two or more vitamins, the comparison group included 42 children with a physiological level of vitamin supply for all the vitamins studied. An integral evaluation of hematological and biochemical blood indices in children of the compared groups was carried out.
Results. It is shown that 75-85% of the children surveyed have a year-round deficit of vitamins, which has the character of polyhypovitaminosis in 40%. It has been established that in the autumn and winter period, the supply of children with vitamins A and C is characterized as "subnormal", while in spring 70% of children experience a deficiency of vitamin C and 15% of vitamin A. In autumn, every third child has a vitamin B6 deficiency, and each 10 is vitamin D; by spring, the number of children with insufficient availability of these vitamins increases in 1.8-6.3 times. Half of the children attending pre-school educational organizations experience a year-round vitamin B12 deficiency. From September to May, the level of provision of children with vitamin A is reduced by more than 60%, vitamin E - by 55%, vitamin C - by 25%, vitamin D - by 15.
Conclusions. In children with inadequate supply of vitamins, a more intense state of the erytriocyte germ of the hematopoiesis and a decrease in the proliferative activity of the lymphocytic monocystic sprout are observed against a background of a higher activity of allergic cell reactions; there is a lower level of activity of protein, carbohydrate, mineral and energy metabolism in children with insufficient vitamin supply.

Aim. To carry out the comparative analysis of follow-up observation efficiency criteria among patients under medical check-up and persons, who had been followed up from the number of those, dead at home.

Material and methods. The age, duration of disease, duration of follow-up observation, real visits to a doctor, rate of exacerbations, emergency calls, hospitalizations were compared in two groups of patients under medical check-up. Group 1 – “dead” – included 100 persons from the number of those, dead at home; group 2 – “alive” – 400 patients, who at the moment of being studied were under follow-up observation. Medical records of ambulatory patients were used as the source of information. The obtained data were analyzed with the method of descriptive and inductive statistics.

Results. In the studied groups, the difference in patients’ mean age was significant t = 3,7 p = 0,0001, the share of persons of the same gender was similar p < 0,01, the difference in men’s mean age was not significant t = –0,21 p = 0,83. The average number of planned (t = 14,2 p = 0,0001) and real (t = 7,4 p = 0,0001) visits to a doctor, exacerbations (t = 9,6 p = 0,0001), emergency calls (t = 7,6 p = 0,0001), hospitalizations (t = 5,2 p = 0,0001), urgent hospitalizations (t = 6,6 p = 0,0001) was significantly higher in the group of “dead”.

Conclusions. The able-bodied men form the risk group regarding unfavorable outcome of noninfectious chronic diseases; follow-up observation does not promote development of loyalty to treatment.

Aim. To ground the necessity of taking into account the double-component nature of the phenomenon of poor activity of the population in the system of pharmacovigilance so as to work out the measures, aimed at development of UR reporting. The process of formation of a modern system of pharmacovigilance in Russia with appropriate level of reporting on the cases of unfavorable response (UR) to application of drugs is difficult because of the absence of involvement of the population into the system of spontaneous messages.

Materials and methods. The methods of content-analysis of messages and surveys were used; the measures, promoting development of the level of reporting on unfavorable responses to drugs were worked out. The object of the analysis included randomized sampling of 100 tests of messages for the period of 2009–2017, the selection criterion of which was the category “side effects of drugs”. The survey was conducted in direct form among the inhabitants of Kazan in 2018.

Results. Pharmacovigilance of the population in Russia is insufficiently developed and concentrated mainly in metropolitan region (Moscow, Moscow region) and neighboring regions (Republic of Tatarstan, St. Petersburg). Pharmacovigilant culture of the population in Russia has an insufficient level of development and is expressed by lack of correct notions of pharmacovigilance system in this country (responsible state institutions, reporting channels) among the citizens that, probably, makes their participation in active reporting difficult.

Conclusions. When influencing both factors, we can form the basis for working out the measures of efficient development of the proper level of UR reporting among the population of the Russian Federation.

Aim. To study the blood serum interleukin-6 (IL) and circulating immune complexes (CIC) levels in patients with ulcerous colitis (UC), depending on the severity of disease attack, colonic inflammation dissemination, and presence of abenteric manifestations.

Materials and methods. One hundred patients with UC in the phase of active inflammation were examined. Blood serum IL-6 and CIC concentrations were studied with IFA method.

Results. 88,5 % of UC patients in the phase of active inflammation showed an elevated mean IL-6 index, 80 % had increased CIC concentration as compared with normal values. The highest IL-6 and CIC levels were obtained in case of severe forms of disease (11,50 (7,30–23,65) pg/ml and 115,50 (105,00–118,00), respectively); CIC and IL-6 levels were significantly higher in patients with abenteric manifestations and frequently relapsing course in comparison with patients, having rare UC relapses (p < 0,005). Strong direct correlations of IL-6 and CIC with each other (r = 0,65; p = 0,001) as well as with the severity of pathological changes in the colon were established.

Conclusions. Among patients with UC, significantly elevated blood serum IL-6 and CIC concentrations were determined. Patients with severe attack of disease as well as those with abenteric manifestations and frequent relapses demonstrated reliably higher levels of these indices. It is recommended to use determination of blood serum IL-6 and CIC levels as an available and informative method, permitting to estimate the degree of severity of inflammatory process in the colonic wall among patients with ulcerous colitis.

Aim. To study the level of cognitive functions and peculiarities of vegetative regulation in practically healthy young persons.

Materials and methods. The study included 116 practically healthy persons of young age (23,06 ± 2,3), 81 women and 35 men. They were divided into five groups of health according to G.L. Apanasenko; in all the groups of comparison, the following was assessed: vegetative regulation using cardiointervalography, cognitive functions – with Montreal Cognitive Assessment Scale.

Results. Variety of reliable differences among the obtained data permits to consider the principles of vegetative regulation formation and cognitive disorder manifestations in different groups. The scheme, reflecting the depen-dence of manifestation of the studied indices in the comparison groups, was offered as a visual confirmation.

Conclusions. The optimal level of providing cognitive functions in practically healthy young persons was shown to be reached by the balance of sympathetic and parasympathetic effects, more typical for subjects, corresponding to moderate health status.

Aim. To study the changes in nutritive status of HIV-positive patients, hospitalized with community-acquired pneumonias, caused by Streptococcus pneumoniae.

Materials and methods. During 2014–2017, clinicolaboratory examination of 676 HIV-positive patients was carried out on the basis of Perm Regional Clinical Infectious Hospital. There were formed the groups of “observation”, including patients with pneumonias, caused by Streptococcus pneumoniae with lethal outcomes, and groups of “comparison”, including patients, discharged from hospital in satisfactory status.

Results. Negative dynamics of nutritive status, caused by progression of the main disease and addition of bacterial agent was revealed. The moderately severe and severe changes were registered in patients with lethal outcomes already at the moment of hospitalization.

Conclusions. Direct correlation between the protein-energy insufficiency and the number of life-threatening complications was determined.

Aim. To estimate the clinical efficiency of phytocomplex “Flavopersin”.

Materials and methods. Phytotherapy is one of advanced directions in modern medicine. Fifty women with clinicoechographic signs of benign hyperplastic diseases of reproductive system were examined and treated. The methods of study included: registration of complaints and anamnesis data, standard general clinical examination and gynecological study; instrumental methods of investigation included: pelvic and mammary ultrasound using Siemens Sonoline Elegra with vaginal sensor of 6,5 MHz. The methods of study also contained assessment of pelvic pain and mastalgia by Visual Analogue Scale (VAS).

Results. After completing the therapy during six menstrual cycles, a positive effect in treatment of dysmenorrhea, significant reduction of mastalgia manifestation as well as reliable decrease in anterior-posterior uterine size and optimization of endometrial structure by pelvic US data was reached. Besides, phytocomplex permitted to reduce anxiety, tension, to raise activity, mood, psychological stress tolerance and social adaptation that improved the quality of life among patients.

Conclusions. The therapy, including phytocomplex “Flavopersin” is a method, which promotes intensification of the effect of drug therapy, increases the interval between hormonal therapy courses and, thus, reduces the manifestation of its side effects and improves patients’ health status at the expense of optimization of psycho-emotional status.

The paper presents a case of rabies with lethal outcome in a fourteen-year-old adolescent. The child did not undergo postexposure prevention of rabies after a cat’s attack in connection with late addressing for medical care, just after occurrence of clinical symptoms of this disease. The child was not diagnosed “rabies” when was alive. Diagnosis was verified by detection of rabies virus RNA in autopsy material using polymerase chain reaction.

Aim. To improve the results of treatment of periarticular tissue diseases and degenerative arthropathies at the expense of differential use of modern technologies.

Materials and methods. During the period of 2010–2017, examination and treatment of 10608 patients, suffering from the locomotor diseases, was carried out. There were 5792 (54,6 %) patients with degenerative arthropathies and 4816 (45,4 %) patients with tendinites and enthesites of different localization.

Results. The long-term results of treatment with chondroprotector Alflutop, used in complex therapy of 1969 (33,9 %) patients with arthropathies were studied for the period from 1 to 3 years. Pain syndrome was arrested after 4–5 injections. After 8–9 injections of this preparation, no pain syndrome was revealed, movement amplitude in the joint increased, patients returned to their previous work, Lequesne index declined and varied within the range of 3–6 scores. When using hyaluronic acid, pain syndrome was arrested in most cases after 2 injections. After the third injection of preparation, no pain factor was registered, movement amplitude in the joint increased, patients returned to their previous work, Lequesne index declined and varied within 3–6 scores. The long-term results from 1 to 5 years were studied in 1179 (20,3 %) patients.

Conclusions. One-year remission with combined application of chondroprotector and hyaluronic acid was 76,5 %. Two-year and longer remission was 47,6 %. Diagnostic algorithm for locomotor diseases was developed and approach to conservative therapy was differentiated.

Aim. To study the clinical problems and develop the symptomatology of the foreign bodies (FB) of the gastrointestinal tract (GIT).

Materials and methods. Ninety patients with GIT foreign bodies were observed over the period from 1997 to 2017. To diagnose, a complex of endoscopic and radial methods was used. Localization, size and type of the detected foreign bodies were compared with the symptoms revealed.

Results. Fifty patients intentionally swallowed foreign bodies, 40 – accidentally. Altogether, 90 patients swallowed 193 items (nails, needles, pieces of wire etc.). On the basis of the study, three forms of clinical course regarding the swallowed GIT FB were singled out: latent, manifest and complicated. The pathognomonic symptoms of GIT FB are “migrant” abdominal pains associated with migration of FB along the GIT lumen, intensification of pains while moving, exercise stress and palpation, feeling of “heaviness” in epigastric region. Multiple gastric FB cause the auscultative symptom of “ringing”. Pains, available with GIT FB, are not connected with taking food and are not ceased after taking antacids.

Conclusions. Introduction of the developed GIT FB symptomatology into healthcare practice and training of physicians will contribute to earlier and more accurate diagnosis.