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The thermal effect of the working environment, leading to overheating of the body of workers, can manifest itself as thermal injuries, accompanied by a deterioration in well-being, a decrease in working capacity, and various health disorders. In addition, an increased air temperature can become a trigger for the activation of biological effects caused by other industrial factors— noise, vibration, harmful chemicals, physical exertion, the combined effect of which has a potentiating effect. The aim of the work was to analyze the literature data on the study of the negative impact of the heating microclimate on the health of workers and to determine measures for its prevention. The analysis of domestic and foreign sources of scientific information and publications contained in Russian and international search systems (databases eLIBRARY, PubMed, etc.) devoted to the study of the features of the formation of a heating environment and its influence on the formation of health disorders of workers in various industries and agriculture. The importance of studies of the heating microclimate as a factor of occupational health risk is shown, the directions of primary prevention of its negative impact, aimed at protecting against overheating and normalizing the thermal state of the workers’ body, are determined. Analysis of literature data allowed us to conclude that the negative health effects of the thermal effects of the working environment are currently insufficiently studied, further research is needed to assess occupational risks associated with its exposure, as well as the processes of adaptation to the thermal load of workers in various industries and agriculture, taking into account their specifics.

BACKGROUND: In 2018, a new form of hereditary angioedema without C1-inhibitor deficiency hereditary angioedema with a mutation in the plasminogen gene was identified. The world scientific literature describes a small number of patients with this form of the disease and, therefore, new research is relevant. AIMS: To identify the sociodemographic and clinical features of patients with hereditary angioedema with plasminogen gene mutation; to evaluate the treatment efficacy; to conduct a comparative analysis in a group of patients with hereditary angioedema type I/II. MATERIAL AND METHODS: 14 patients (1 male and 13 females, mean age 51.6413.55 years) with hereditary angioedema with c.988AG mutation in the plasminogen gene (p.Lys330Glu; K330E) were enrolled in a retrospective study. The comparison group included 194 patients with hereditary angioedema type I/II (56 males and 138 females, mean age 37.0316.23 years). RESULTS: The average age at disease onset in patients with hereditary angioedema with a mutation in the plasminogen gene is 25.0710.46 years, which is significantly higher than in patients with hereditary angioedema type I/II 11.588.92 years (p 0.001). Peripheral angioedema was reported in 21.4% of patients with hereditary angioedema with a mutation in the plasminogen gene, abdominal attacks in 28.6%, which is less common than in patients with hereditary angioedema type I/II (peripheral edema 97.4%, p 0.001; abdominal attacks 86.6%, p 0.001). Face and neck angioedema was observed in all patients with hereditary angioedema with a mutation in the plasminogen gene (100%) and in 72.2% of patients in the group of hereditary angioedema type I/II (p=0.023). 85.7% of patients with hereditary angioedema with a mutation in the plasminogen gene had edema of the tongue. A decrease in the severity and duration of 28 out of 29 attacks by an average of 71.4% was reported by 4/5 of patients who used icatibant (Firazyr); 3/4 of patients reported a decrease in the frequency of attacks during treatment with tranexamic acid. CONCLUSIONS: The diseases manifestation in adulthood, the predominance of face and tongue angioedema are common features of hereditary angioedema with a mutation in the plasminogen gene. The efficacy of tranexamic acid and icatibant was demonstrated in the observed cohort of patients.

Aim: To assess the specificity of COVID-19- associated pneumonia detection by radiologists using a chest CT scan.Materials and methods: From mid-February to early March 2020, 65 patients have been retrospectively selected from the Moscow City Clinical Hospital database; all of them had been treated in an inpatient facility with a verified diagnosis of COVID-19. In addition, 75 patients from the Unified Radiological Information Service have been randomly selected. In December 2019, these outpatients had been sent by an attending physician for a chest CT scan with suspected pneumonia. The imaging studies showed non-specific inflammation signs in the lungs. All 140 scans were analyzed by seven radiologists from different Russian cities, who independently categorized each study as “COVID-19” or “Other pneumonia”.Results: Chest computed tomography had a 92% specificity in the differential diagnosis of COVID-19-associated pneumonia, and its specificity in the general population is expected to be at least 80% with a high probability. The inter-rater variability was low (coefficient of variation for specificity 12.6%). The sensitivity in our study was 76.2%, and the coefficient of variation for sensitivity 23.5%. These findings are generally consistent with other studies. The primary study limitation is the absence of a sample with confirmed pneumonia caused by other viruses.Conclusion: Chest CT is highly specific for the detection of COVID-19-associated pneumonia.

Background : Since 2017, a pilot project for lung cancer screening by chest low dose computed tomography (LDCT) has been implemented in Moscow. Patients to be included into the screening have risk factors for ischemic heart disease (IHD). The association between epicardial adipose tissue (EAT) volume and coronary artery atherosclerosis, IHD, and atrial fibrillation has been demonstrated previously. Aim : To demonstrate the feasibility of LDCTbased EAT volumetry using a dynamic (contracting) heart phantom. Materials and methods : The study was performed with the designed dynamic heart phantom and chest phantom in two stages. At stage I, two adipose tissue pieces were scanned inside and outside the chest phantom using CT and LDCT. At stage II, the dynamic heart phantom was scanned outside and inside the chest phantom. In addition, we scanned the heart phantom with a coronary calcium phantom. The contracting heart phantom was developed within three months. All scans of the phantom were performed within one day. We determined the adipose tissue thresholds in LDCT and the EAT volumetric error with both chest CT and LDCT. Measurements of the adipose tissue volumes were performed by the radiologist twice with semi-automatic software. Results : The results of stage I helped to identify optimal density thresholds for LDCT-based adipose tissue volumetry in lung cancer screening, ranging from -250 HU to -30 HU. The stage II results showed that for all heart phantom scanning variants, the average EAT volumetry error did not exceed 5%, except for the case of contracting heart phantom with added coronary calcium in a chest phantom with body mass index (BMI) 29 (-5.92%). Adding the coronary calcium phantom to the heart phantom in LDCT increased the error by an average of 4% in BMI 23 and BMI 29 chest phantoms. Conclusion : LDCT-based EAT volumetry with fat density threshold from -250 HU to -30 HU is feasible in lung cancer screening, including patients with coronary calcium. However, considering the phantom design, further patient studies, and correlation of EAT volumes between LDCT for lung cancer screening and сoronary CT angiography are required.

Aim. To study the effectiveness of the use of Neovir (sodium oxodihydroacridinyl acetates) as immunomodulatory and antiviral drug in the comprehensive treatment of various grade cervical intraepithelial neoplasia (CIN). Study design: prospective comparative study. Materials and methods. The study included 60 patients (mean age 34.78.2 years) with morphologically verified various grade CIN, who were received comprehensive treatment, including the use of Neovir (sodium oxodihydroacridinyl acetate) as the drug with immunomodulatory and antiviral activity, 250 mg/2 ml intramuscularly every 48 hours, 10 injections before (group 1) or after (group 2) multi-stage radiosurgical diagnostic and treatment procedure or only a similar surgical intervention (group 3). All patients underwent complete clinical, morphological and laboratory examination with monitoring for the presence of high-risk human papillomavirus (HPV) in the cervical scraping and the dynamics of peripheral blood lymphocyte subpopulations. Results. Dynamic follow-up showed that in a month after surgery, patients who were treated with radiosurgical resection as monotherapy (group 3) had the lowest rate of complete epithelialization of the cervical stump 30.0% vs 55.0 and 65,0% in the group 1 and group 2 respectively. In this group, the proportion of patients with persistent viral infection was 1.52 times higher than in the groups where an antiviral drug was used in combination with radiosurgical intervention 35.7% vs 17.6 and 22.2% in the group 1 and group2, respectively. In 6 months, elimination of high-risk HPV in groups with comprehensive treatment reached 94.5 in the group 1 and 94.1% in the group 2 (p0.05) vs 78.6% in the group 3. The lowest number of TNK- and NK-cells was found in the group of patients who received radiosurgical treatment as monotherapy, which correlated with the highest incidence of high-risk HPV persistence after treatment in this group. Conclusions. In patients with various grade CIN, the use of an immunomodulatory drug with antiviral activity in combination with radiosurgical intervention promotes early epithelialization of the cervix and elimination of high-risk HPV, which is confirmed by significant changes in the lymphocyte subpopulations which provide antiviral immunity.

Introduction. Cancer is one of the most serious and common diseases with a high level of mortality. Due to this reason the searching of new directions and methods of cancer treatment is becoming more and more important with each passing year. Significant advances in cancer immunotherapy have been reached over the past few decades. Moreover, an inhibition of the interaction between the programmed cell death receptor (PD-1) and its ligand (PD-L1), is sure to be perspective direction of the immuno-oncological therapy development.Text. PD-1/PD-L1 interaction plays a pivotal role in negative regulation of immune system, that protects host’s cells and tissues from the excessive immune response. However, it is also used by tumor cells to avoid the host's immune system. The discovery of this mechanism led to the development of inhibiting PD-1 or PD-L1 agents that enhance anti-tumor immunity. Meanwhile, anti-PD-L1 agents provide less toxicity in comparison with anti-PD-1 agents. FDA currently approved Atesolizumab, Durvalumab, and Avelumab PD-L1 inhibitors for cancer treatment. These agents demonstrated effective response during the clinical trials, however, they are used for a limited number of oncological diseases. In addition, BMS-936559 is a promising agent that had passed the first stage of the clinical trials. Nevertheless, immunotherapy involving PD-L1 inhibitors is closely related to a vast number of severe side effects including immune-mediated effects caused by the inhibition of PD-L1 ligands located on healthy cells. In these terms, the development of new agents deprived of these disadvantages is the reason for further studies.Conclusion. Immunotherapy in cancer uncovers new perspectives in treatment of refractory to standard therapies forms of cancer. And the development of new and improvement of existing PD-L1 blocking agents are of great importance in fighting against tumoral diseases.

Purpose. The clinical cases of subacute thyroiditis that occurred in patients with COVID-19 demonstrate the difficulties of interpreting clinical and laboratory signs. The importance of multiparametric ultrasound examination in the diagnosis of this pathology is shown. Materials and methods. Two cases of subacute thyroiditis caused by a coronavirus infec-tion are presented. We studied the medical histories and examination data of patients. The clinic of de Quervain's subacute thyroiditis was atypical, since it was leveled by multiple organ changes and clinical manifestations of COVID-19. The results of clinical examination, results of ultrasound exam-ination of the thyroid, sonoelastography, multispiral computed tomography of lungs and laboratory tests were studied. Conclusion. Subacute thyroiditis is one of the variants of manifestation and complication of coronavirus infection. The clinical picture of subacute thyroiditis associated with COVID-19 may have an atypical course due to simultaneous lesions of many organs and systems. The disease may have a blurred picture due to the use of drugs used in the treatment of coronavirus infection. The main method of diagnosis of subacute thyroiditis associated with COVID-19 is ultrasound, which allows to establish structural changes in the thyroid gland, reflecting the nature and localization of the inflammatory process. The severity of changes in the thyroid gland in COVID-associated de Quervain thyroiditis does not correlate with clinical and laboratory data. © 2021 Russian Electronic Journal of Radiology. All rights reserved.

Inthe current conditions of the coronavirus pandemic, the life of society, the functioning of the economy and, in particular, the labor market have changed dramatically. Along with the world labor market, the Russian market has faced new challenges, and timely and efficient response to the challenges will influence not only the success, but also the viability of many companies. The main challenge was the need to carry out work in a remote format. Some organizations that have already used distance employment have been able to adapt relatively easily to the new work format, while others are experiencing difficulties. As the number of incidence continues to grow, it becomes clear that remote work is gaining increasing popularity, which makes this topic especially interesting and relevant.This article presents an analysis of various sources of information about the practices of remote work over the past few years, about the features of the forced remote format over the past few months. As the results, the main opportunities and restrictions for workers and employers were identified, as well as the main challenges for the community of human resources (HR) specialists.

Introduction. The preservation of the health of workers employed in harmful working conditions is one of the essential strategic tasks of the Russian Federation’s policy in the field of protecting public health. Milk processing workers are exposed to many adverse factors in the work environment and the work process that negatively affect their health. However, in previous studies, assessing and managing occupational risk to their health is not adequately addressed. Purpose of the study. Hygienic assessment of working conditions and occupational health risks for workers in the production of dairy products. Material and methods. Authors give the quantitative and qualitative assessment of occupational health risk based on our own hygienic studies results and an in-depth medical examination. Results. During the work, dairy production workers were established to be exposed to a set of factors of the occupational environment (adverse microclimate, noise, vibration, insufficient lighting) and the labor process’s hardness. It forms harmful working conditions of the first and third degrees (classes 3.1 - 3.3), which corresponds to categories of occupational risk from small (moderate) to high (intolerable). The direct moderate (r = 0.53) reliable correlation relationship between the prevalence of chronic pathology in general and female workers’ work experience was revealed. A very high degree of causal relationship between the work, diseases of the ear and mastoid process (RR = 4.3; EF = 76.7%; CI = 1.6-10,93) and a high degree of relation connection of diseases of the musculoskeletal system and connective tissue (RR = 2.22; EF = 55.1%; CI = 1,21-4,08). It indicates their occupational conditionality. It is necessary to develop and implement many organizational, health-improving, and treatment-and-prophylactic measures to prevent the occurrence of work-related health disorders and minimize risk factors for their development. Conclusion. Many harmful factors in occu[ational conditions that create the risk of developing a professionally caused disease characterize modern dairy production. It requires urgent measures to reduce the risk.

Significant changes in the world connected with the introduction of digital technologies, which have led to the development of the economy with new financial instruments, raised the issue of thesubject under consideration. The author analyses the new forms of economic development that allow to expand the range of criminal law effect on persons committing economic crimes in the field of crediting. The mechanism for restoring violated rights, which are considered possible within the framework of the current legislation, is strategically important. The legislative initiatives related to proposals of cryptocurrency legalising have increased in recent years, being a current trend of the existing society development. At the state level, a search for the new ways to maintain business activity and to prevent illegal acts committed in this sphere is being made. Due to the fact that a lot of norms of criminal legislation intended to protect objects of economic activity are of a blanket nature, clarifying the meaning of their features is impossible without referring to civil legislation. Civil regulation is the basis of the economic sector. A new conceptual system is pointed out; it improves the possibility of cryptocurrency turnover, but does not fully regulate it. By analysing the current legislation, the author tries to assess the value of cryptocurrency, digital rights and other property in order to determine the maliciousness of evading accounts payable. Subsequently, the author gives his opinion on the prospect of providing the officers of the enforcement agencies of the Russian Federation with the opportunity to expand the interpretation of the norms of criminal legislation including liability for maliciousness of evading accounts payable (Article 177 of the Criminal Code of the Russian Federation).

The paper reviews the current data on the effect and role of varying intensity physical activity in the prevention of various respiratory virus infections, including influenza virus and SARS-CoV-2 coronavirus. The paper discusses the effect of varying intensity physical activity on antiviral immunity, cellular and cytokine responses to respiratory virus infections, physical activity influence on vaccination effectiveness and the role of regular moderate intensity physical activity in the prevention of viral infection in patients with obesity, overweight, diabetes and other metabolic disorders. The paper analyzes physical activity role in the prevention of SARS-CoV-2 infection, as well as in the conditions of self-isolation and quarantine.

The article shows the need to identify diversification risks and opportunities for their leveling by the state and business, which depends on the state of the Russian defense industry sectors in modern conditions. It has been substantiated that an important role in their leveling is played by a systematic approach to assessing and managing diversifications risks in the medium and long term. The result of leveling diversification risks is assessed in the form of increasing the competitiveness of the defense industry sectors, receiving tax payments and improving the welfare of the population, ensuring the country's economic security.

Introduction. Workers employed at bakeries are exposed to hazardous occupational factors at their workplaces; however, issues related to occupational health disorders occurring in them have not been given sufficient attention.Material and methods. We accomplished complex hygienic research on working conditions and the health of workers employed at a bakery using a procedure for occupational health risk calculation.Results. Workers employed at a bakery are exposed to a set of adverse factors (heating microclimate, flour dust, in-plant noise, poor luminance in work areas, hard labor process) that make their working conditions hazardous (belonging to 3.1 – 3.3 hazard degree). It means their occupational risks rank from insignificant (moderate) to high (intolerable). Heating microclimate and physical overloads were determined as priority risk factors. We revealed a positive average correlation (r=0.56) between chronic somatic pathology prevalence in general and work experience. We also detected direct authentic correlations between work experience under hazardous working conditions and diseases of the musculoskeletal system and connective tissues (r=0.34); upper respiratory tracts (r=0.31); circulatory system (r=0.26) (р

Organic agriculture, based on natural production technologies, obtains a great potential for reversing humanity to a healthy diet and living in harmony with nature by improving the state of the ecosystem. The share of organic food products in the market of the developed countries is already quite high; and various institutional systems of the industry have been introduced and are being improved in the leading countries of the world. Domestic agribusiness is currently lagging behind in these matters, but the situation should be significantly changed by the adopted law and state standard regulating the requirements for the organic sector. In this regard, an objective need arose to substantiate the capabilities and the resource potential of the Saratov region in this sphere. Within the framework of the presented research, an interdisciplinary fundamental platform to develop the theory of the organic food products market was formed. As a result, the elements of the scientific methodology (theories, principles, factors, methods) of its functioning were identified, which made it possible to substantiate the potential capacity of the regional consumer market for organic food. The calculation was made taking into account the rational norms of food consumption that meet modern requirements for a healthy diet, the heterogeneity of consumer preferences, the price gap for the main conventional and organic products in retail and the dispersion of prices for the latter, the implementation of state policy to protect and improve the health of certain population groups. This study is intended for the state management bodies of the agro-industrial sector, the leadership of agricultural, processing and marketing enterprises, the structures of wholesale and retail food products trade and branch research institutions.

In the article the avatar-based learning and teaching (A-BL&T) as a concept of control and managing knowledge in modern socio-economic conditions is proposed to use for assessment a university's economic efficiency. It is shown that all elements, methods and techniques (tools) do not operate in isolation, but rather are interrelated, complementing each other. All of them are used in the process of management and, in a combination, are powerful tools for increasing efficiency of management. Based on the example of avatar-based learning and teaching in Russian universities as modern educational environments, a conceptual model, methodology, and methods have been obtained for the automation of planning and calculation of the academic load in the university.

Introduction. Viral infections are a serious problem that occurs during the use of immunosuppressants in preparation for organ transplantation and in the postoperative period. Cytomegalovirus (CMV) infection is one of the main causes of diseases in people with weakened immune systems. It has a direct impact on one’s body and makes it more likely to reject a transplanted organ. Antiviral drugs are used to treat and prevent this infectious disease. Valganciclovir is a prodrug whose active metabolite is ganciclovir. Valganciclovir is the drug of choice in the treatment of CMV infections. Currently, there are no researches on the matter of simultaneous determination of both valganciclovir and ganciclovir in human blood plasma by means of high-performance liquid chromatography (HPLC) with ultraviolet detection. This research delivers a thorough description of development and validation of a particular method for simultaneous determination of valganciclovir and ganciclovir in the plasma after sample preparation by the method of protein precipitation.Aim. The aim of this study is to develop method for the quantitative determination of valganciclovir and its active metabolite ganciclovir in human plasma by HPLC-UV for pharmacokinetic studies.Materials and methods. Quantitative determination of tadalafil in plasma by HPLC-UV. A sample was prepared using protein precipitation.Results and discussion. This method was validated by next validation parameters: selectivity, matrix effect, calibration curve, accuracy, precision, lower limit of quantification, carry-over and stability.Conclusion. The method of the quantitative determination of valganciclovir and its active metabolite ganciclovir in human plasma was developed and validated by HPLC-UV. The analytical range of the was 5,0–1000,0 ng/ml for valganciclovir and 100,0–10000,0 ng/ml for ganciclovir in plasma. Method could be applied to determination of valganciclovir and ganciclovir in plasma for PK and BE studies.

Organic agriculture is a promising and increasingly demanded direction of “greening” agricultural activity, which has a great potential due to natural production technologies. Significant segments of organic products have been formed in the food markets of the developed countries; various institutional systems of the industry have been functioning for decades. Russian agribusiness is globally lagging behind in these matters, but the development of the economic environment has led to the objective necessity of adopting a law and a state standard that would define the requirements for the organic agriculture. Research on the prospects of the Russian food market in the global organic production system is becoming relevant. This work is a two-sided quantitative and qualitative approach to the study of existing production systems of organic food from the standpoint of the results and dynamics, on the one hand, and their organizational and economic structure, on the other. The findings and results are confirmed by the presented and systematized absolute and relative indicators of land areas certified for organic agriculture, the number of market entities, the consumption of organic food per capita and retail sales in the domestic markets. The qualitative characteristic of organic agriculture systems was reflected in constructing a set of schemes that clearly illustrate national features of the conduct methods, state regulation of production and turnover, research support, regulatory and supervisory support of the business under study. As a result, a comparative analysis of the leading world markets for organic food (USA, Germany, Canada and Austria) in comparison with the emerging market of Russia. The study is addressed to the global business community operating in the organic food market and to special research institutions.

52 patients aged 26 to 54 years (39 women and 13 men) with hypersensitivity of the teeth were examined. Taking into account the individual approach to the examination of patients, the dental status was determined, etiological factors, body features, the presence of somatic pathology, clinical manifestations of hypersensitivity of the teeth were determined, with the determination of the degree, prevalence and intensity of hyperesthesia. The study made it possible to make a rational choice of treatment and prevention measures, taking into account individual General and local manifestations of this pathology.

The objective : to study the frequency and nature of adverse events caused by anti-tuberculosis drugs in pulmonary tuberculosis patients with and without concurrent diabetes mellitus. Subjects and methods . 396 patients with pulmonary tuberculosis were examined: 203 patients who had diabetes were included in the TB + diabetes group; the TB group consisted of 193 patients with pulmonary tuberculosis without diabetes. Results. The incidence of adverse events caused by anti-tuberculosis drugs was analyzed and compared in both groups. Thus, in the TB+diabetes group adverse events developed in 146/203 (71.9%) patients and in 62/193 (32.1%) patients in the TB group ( p < 0.01). Hepatotoxic reactions prevailed in both groups, but in the TB + diabetes group, they were statistically significantly more frequent versus the TB group (55.2 and 27.4%, respectively; p < 0.01). Also, allergic reactions (20.7 and 6.2%, respectively; p < 0.01) and neurotoxic events (13.3 and 5.1%, respectively; p < 0.01) were statistically significantly more frequent in the TB + diabetes group compared to the TB group.

Introduction . HIV infection is one of the most relevant diseases from a medical, epidemiological and social point of view. Timely diagnosis, detection and control of the disease, adequate prescription of antiretroviral therapy can sufficiently reduce the viral load on the patient's body, reduce the risk of transmission of infection. Currently, combinations of various antiretroviral drugs are increasingly being prescribed as therapy. One of the most important is combination of atazanavir and ritonavir. The most important stage for the study of pharmacokinetics, studies of comparative pharmacokinetics and bioequivalence is the development of an analytical method that allows you to determine the investigated substances in human plasma. There are currently no published methods for the determination of atazanavir and ritonavir in human plasma using high performance liquid chromatography with mass selective detection using a single quadrupole mass detector. In this article presents the development and validation of a method for the determination of atazanavir and ritonavir in blood plasma after sample preparation by the method of protein precipitation. Aim . The aim of the study is to develop a method for the quantitative determination of atazanavir and ritonavir in human plasma by HPLC with mass spectrometric detection for performing the analytical part of pharmacokinetic studies. Materials and methods . Determination of atazanavir and ritonavir in human plasma by HPLC with mass spectrometric detection. A sample was prepared using protein deposition. Results and discussion . The method was validated of selectivity, matrix effect, calibration curve, accuracy, precision, limit of quantification, carry-over effect and sample stability. Conclusion . The method of the determination of atazanavir and ritonavir in human plasma was developed and validated by HPLC-MS. The analytical range of the was 50.0–10000.0 ng/mL in plasma for atazanavir and 10.0–2500.0 ng/mL in plasma for ritonavir. Method could be applied to determination of atazanavir and ritonavir in plasma for PK and BE studies.

Summary:. Reconstruction of tissue defects resulting from high-voltage injuries remains a serious issue in plastic surgery. For many years it has been solved by applying autologous reconstruction with rotated and revascularized flaps. We present a series outlining reconstructive practices in treatment of patients with high-voltage “uromanual” injuries. These types of injuries include a group of upper extremities and genitoperineal high-voltage trauma due to urination on an electrical source, which are rarely discussed in the literature. This study aimed to describe the algorithm of perioperative care and surgical treatment in patients with high-voltage uromanual trauma. Three male patients (mean age 26.3 years, range: 20–35 years) with traumatic injury of the genital area and the upper extremities due to high-voltage injury underwent reconstruction with a one-stage repair of defects. In one patient, the defect of the left upper extremity was eliminated by microsurgical autotransplantation of musculocutaneous thoracodorsal artery perforator flap. The genitoperineal region was repaired using rotated scrotal flaps. In two other cases, phalloplasty with a revascularized myocutaneous thoracodorsal artery perforator flap was followed by urethroplasty with a prefabricated radial forearm free flap. Hand deformities were eliminated using split-thickness skin autografts. All flaps survived. No complications were observed in the autograft harvesting areas. All cases showed good aesthetic and functional postoperative outcomes. Management of uromanual injuries should include one-stage reconstruction of upper extremities and genitoperineal defects for restoration of satisfying functional and aesthetic components crucial for patient’s quality of life and socialization.

Our research project was aimed at studying the effects of an electromagnetic field of industrial frequency (EMF-IF) on employees of an energy company in Kazakhstan. Material and Methods — The object of our study was the health status of electricians (morbidity with temporary disability – MTD), engaged in the maintenance of power lines, relay protection systems and substations (220 and 500 kV) at an energy enterprise in Kazakhstan. The interrelation and dependence of the intensive MTD indicators on the hygienic factors at the workplace were determined, and the risks were calculated from the obtained data. Results — Unfavorable workplace conditions caused an increase in disorders of the musculoskeletal system (up to 77%), blood circulation (up to 65%), nervous system (up to 52%), skin diseases (up to 46.4%), as well as the manifold rise of the likelihood of neoplasm growth and respiratory diseases. For electricians, the relationships between the nervous system disorders (r=0.792), the circulatory system diseases (r=0.573), the musculoskeletal system ailments (r=0.672) and the EMF-IF parameters were discovered. At the same time, the dependence of the incidence rates of various diseases in workers on EMF, as well as moderate to high computed relative risks, implied the occupational genesis of worklace ailments: for nervous system – R2=0.628, cardiovascular system – R2=0.709, skin – R2=0.729, and musculoskeletal system – R2=0.413. Conclusion — As preventive measures for electricians, we recommended to wear individual exposure meters, to limit work in contact with EMF, to include an oncologist in the medical commission, and for trainees, to screen for oxidative stress proteins and chaperone proteins to exclude a predisposition to oncogenesis.

Relevance . Whether it comes under microbial plaque to demineralization of enamel depends on the presence of cariesogenic bacteria that exhibit proteolytic activity in relation to the organic components of the interdigital spaces of enamel, easily digestible carbohydrates that enter the oral cavity when eating, the buffer capacity of saliva, capable of neutralizing the pH of plaque within an hour to neutral values after eating. On the knowledge of these factors is based the strategy of prevention of dental caries, based on nutrition management. Of all the above, the optimal factor of influence on the cariesogenic situation in the oral cavity is the time factor – the frequency of consumption of easily digestible carbohydrates during the day. Eating easily digestible carbohydrates that can be a nutrient medium for the oral microflora is recommended only during Breakfast, lunch and dinner, but not during snacks. Purpose . To determine the value of the time factor to change the qualitative composition of plaque. Materials and methods . In a series of clinical-anamnestic and clinical-laboratory studies studied the material-plaque obtained during the examination of 137 adult young people-students aged 18 to 20 years. Plaque sampling was performed immediately after the determination of its cariesogenicity by colometric method by J. L. Hardwick and E. B. Manlay, and after 60 minutes a clinical micrometer was used to determine the short-chain fatty acids in this plaque. Results. The proposed clinical micrometod for determination of short-chain fatty acids in dental plaque stated an increase in the optical density of smears in persons with high caries resistance with a decrease in the optical density in smears in the presence of a carious process in the oral cavity. The obtained data correlate well with the indicators of cariesogenicity in plaque, which increases with a decrease in the content of short-chain fatty acids. Therefore, the content of short-chain fatty acids and dental plaque caries require an individual approach to oral hygiene in different patients. Conclusion. The optimal factor of influence on the cariesogenic situation in the oral cavity is the time factor - the frequency of consumption of easily digestible carbohydrates during the day. Eating easily digestible carbohydrates that can be a nutrient medium for the oral microflora is recommended only during breakfast, lunch and dinner.

The researchers elaborated pharmacological complex of SM at the Chair of Morphology, Physiology and Pharmacology atSouth-UralStateAgrarianUniversity. The complex contains butafosfan, vitamins, vitamin-like substances, selected on the basis of synergistic effect on the body. The parameters of acute toxicity of the SM-complex were explored in the experiment on clinically healthy adult white mice of both genders by a single injection of the solution in the maximum permissible dose according to GOST 31926-2013. Intolerance on the skin of animals was detected in line with GOST R ISO 10993.10-2009. GOST R ISO 10993.10-99 became a guideline for evaluating SM-complex intolerance on the eye conjunctiva. Chronic toxicity was investigated on non-linear rats; the rates were divided into 4 groups of 6. The first group became a control group, the second group received the SM-complex in a therapeutic dose (255mg/kg), the third group - in a 5 -fold therapeutic dose (1275mg/kg), the fourth group - in a 10-fold dose (2550mg/kg). Pharmacological substance was applied through the probe in the form of an aqueous solution for 30 days. The researchers found out that at single oral introduction of SM-complex in the maximum possible doses it does not affect mice organism and it is referred to the 4th class of danger according to GOST 12.1.007-76. Local application in the form of applications on the skin and mucous membranes of rabbits, the complex does not have a local irritant effect. Long-term application of pharmacological composition (30 days) in high doses causes functional and morphological changes of the liver in the form of gray foci and flabbiness, as well as it increases the volume of the organ. Due to the fact that the therapeutic doses are 5 and 10 times lower than the toxic ones and the period of application does not exceed 7-14 days, the authors make a conclusion that SM-complex is safe and secure and can be used in the recommended doses.

The paper gives a complex hygienic characteristics of working conditions at typical contemporary flour-grinding productions which deal with grain processing. It is shown that workers who are employed at flour-grinding production and perform their work tasks at all the stages of technological cycle on grain processing are exposed to a set of adverse industrial factors related to their labor process. These factors create hazardous working conditions which are ranked as having the 2nd and the 3rd hazard degree (3.2 and 3.3 categories) as per the Guide Р 2.2.2006-05. Among primary factors which create hazardous working conditions we can mention flour dust; grain dust; industrial noise; adverse microclimate; labor hardness caused by overall high physical dynamic loads borne by arms, body, and legs; a necessity to stay in an inconvenient and forced working posture; constant moving related to maintenance of equipment and control over production processes. According to the Guide Р 2.2.1766-03, categories of expected occupational health risk for workers are estimated to vary from average (substantial) risk to high (intolerable) one depending on functions performed by a worker. Working area air con-tamination with grain dust and flour dust are considered to be a priority health risk factor for workers employed at flour-grinding production. As we assessed occupational risks as per data obtained during periodical medical examinations, we detected an average authentic cause-and-effect relationship between working conditions factors and respiratory organs diseases (RR = 1.64; EF = 39 %, CI = 0.5–4.5), which meant such diseases were occupationally induced. Basing on the performed research, we developed priority measures which can help to reduce occupational health risks for workers employed at flour-grinding production.

The objective of the study : to study markers of carbohydrate metabolism in pulmonary tuberculosis patients with concurrent diabetes during treatment of tuberculosis. Subjects and methods . 156 pulmonary tuberculosis patients, divided into 2 groups, were examined. Group 1 included 69 (44.2%) pulmonary tuberculosis patients with concurrent type 1 diabetes. Group 2 included 87 (55.8%) pulmonary tuberculosis patients with concurrent type 2 diabetes. Results. Prior to the start of anti-tuberculosis treatment, disorders of carbohydrate metabolism in type 1 diabetes patients were more expressed: there were the statistically significant higher level of glycated hemoglobin and glucosuria severity during the daytime (within 8-14 hour interval). Analysis of changes in carbohydrate metabolism markers showed that there was a gradual trend for their improvement if the treatment was effective and should treatment be failing, the disorders of carbohydrate metabolism were deteriorating. Conclusion. Tuberculosis deteriorated the severity of diabetes, especially of type 1, compromising the efficacy of antihyperglycemic therapy. A significant part of treatment failures among type 1 diabetes patients was potentially associated with the negative impact of poorly compensated diabetes.

To develop the algorithm for correction of defects following high-voltage electrical trauma with revascularized autografts, to assess the incidence and risk factors of postoperative complications.Surgical interventions were performed in 16 men. Autografts were selected considering localization of defect and preoperative ultrasound data on perfusion of donor and recipient areas. We applied a sample with temporary compression of the vessels and ultrasound scanning of arteries and veins (a small-sized Doppler sound indicator of blood flow velocity - MINIDOP, BIOSS).Nine patients underwent microsurgical transplantation of revascularized flaps. Six patients with electrical trauma of the upper extremities underwent transplantation of free skin autografts and transposition of flexor and extensor muscles of the fingers in various combinations. In 1 patient, simultaneous microsurgical graft transplantation and plasty with local tissues were carried out. Microsurgical transplantation of thoracodorsal flap was performed in 2 patients with maxillofacial defect (with preliminary deepidermization of the flap in one case). In 3 patients with traumatic amputation of the penis, 2 patients underwent phalloplasty with a thoracodorsal flap and prefabrication of a radial forearm graft at the first stage. At the next stage, urethroplasty with a prefabricated radial forearm graft was performed. In 1 patient, closure of the penis defect was carried out using scrotal flaps.An integrated surgical approach, the use of free revascularized autografts and adequate postoperative management ensure high-quality aesthetic and functional restoration, improvement of the quality of life and social adaptation of patients with defects and deformations following high-voltage electrical injury.Наличие у выживших пациентов обширных дефектов и деформаций, полученных в результате высоковольтной электротравмы, делает актуальным вопрос комплексного хирургического лечения пораженных в рамках одного хирургического вмешательства.Разработка алгоритма устранения дефектов в результате высоковольтной электротравмы с использованием реваскуляризированных аутотрансплантатов с оценкой частоты и факторов риска перфузионных осложнений в послеоперационном периоде.Оперативные вмешательства выполнены 16 пациентам мужского пола. Тактику выбора аутотрансплантатов основывали на локализации дефектов, а также определяли с помощью предоперационной оценки перфузионных характеристик тканей в донорской и реципиентной областях (проба с временным пережатием сосудов и ультразвуковое дуплексное сканирование артерий и вен с использованием малогабаритного доплеровского звукового индикатора скорости кровотока МИНИДОП, «БИОСС»).У 9 пациентов выполнена микрохирургическая пересадка реваскуляризированных лоскутов, у 6 пациентов с электротравмой верхних конечностей произведена пересадка свободных кожных аутотрансплантатов и транспозиция мышц сгибателей и разгибателей пальцев кистей в различных комбинациях, у 1 пациента выполнена одномоментная микрохирургическая пересадка лоскута и пластика местными тканями, у 2 пациентов с локализацией дефекта в челюстно-лицевой области осуществлена микрохирургическая пересадка торакодорсального лоскута, в одном случае — с предварительной деэпидермизацией лоскута. В случаях травматической ампутации полового члена (Комплексный подход в планировании оперативного вмешательства, использование свободных реваскуляризированных аутотрансплантатов, полноценное ведение послеоперационного периода позволяют получить качественное восстановление эстетической и функциональной составляющей, повысить качество жизни и стабилизировать социальную адаптацию пациентов, имеющих дефекты и деформации в результате высоковольтной электротравмы.

An analysis of published literature data on the relationship of parasitic diseases and oncogenesis is carried out. Current knowledge about the association of parasitic infections and cancer formation has revealed several carcinogenic mechanisms, but the severity of the relationship between parasites and cancer formation (except for schistosome, opisthorchis and clonorchis) should be confirmed in future experimental and population studies.Проведен анализ опубликованных данных о взаимосвязи паразитарных заболеваний и онкопатологий. Современные знания об ассоциации паразитарных инфекций и онкогенеза выявили несколько канцерогенных механизмов, но выраженность связи между паразитами и формированием рака (кроме шистосомы, описторхиса и клонорхиса) должна быть подтверждена в будущих экспериментальных и популяционных исследованиях.

Background Due to its arterial vasculature, the nasolabial sulcus is one of the most challenging facial regions to treat when trying to ameliorate the signs of facial aging. Objectives The aim of the present study was to provide data on the 3-dimensional course of the angular artery within the nasolabial sulcus in relation to age, gender, and body mass index to increase safety during minimally invasive treatments. Methods Thee hundred nasolabial sulci from 75 males and 75 females of Russian Caucasian ethnic background (mean [standard deviation] age, 45.7 [18.7] years; mean body mass index, 25.14 [4.9] kg/m2) were analyzed. Bilateral multiplanar measurements were based on contrast-enhanced computed tomography cranial scans. Results Up to 3 arteries could be identified within the nasolabial sulcus: ~90% contained 1 arterial trunk, ~9% had 2 trunks, and ~1% had 3 trunks; females had more arteries than men. The artery is located at mean depths of 21.6 mm at the oral commissure and 8.9 mm at the nasal ala. The angular artery was lateral to the nasolabial sulcus in 100% of cases; the smallest distance between the artery and the nasolabial sulcus was at the oral commissure (11.91 [7.9] mm) and the greatest was at the nasal ala (13.73 [3.9] mm). Conclusions In contrast to current concepts, the angular artery is not located strictly subdermal to the nasolabial sulcus but at a variable depth, and in 100% of the investigated cases lateral to the nasolabial sulcus. With increasing age, the depth and lateral distance between arteries and sulci reduces significantly, underscoring the need for special caution when injecting this site.

The aim of the study was to study the clinical manifestations and effectiveness of treatment of pulmonary tuberculosis with multidrug-resistant (MDR M. tuberculosis (MTB) in patients with different types of diabetes mellitus (DM). 66 patients with pulmonary tuberculosis combined with type 1 diabetes mellitus and 48 patients with pulmonary tuberculosis combined with type 2 diabetes were examined. It was found that in patients with type 1 DM, MDR tuberculosis was more often observed in men under 40 years of age, in the form of infiltrative pulmonary tuberculosis with the presence of destruction in lung tissue up to 2 cm in diameter with positive sputum and acute intoxication. In patients with type 2 DM, MDR tuberculosis was more often observed in men over the age of 40 in the form of fibrous-cavernous tuberculosis with the presence of destruction in lung tissue larger than 2 cm in diameter, with positive sputum and moderately severe intoxication. The effectiveness of treatment for negativation sputum in the compared groups did not differ significantly and amounted to 71,2% and 64,7%, respectively. However, to close the caverns in the lung, the treatment was more effective in patients with type 1 diabetes, which is probably due to the peculiarities of the tuberculosis process in this category of patients.

Context: It is well known that measurable residual disease (MRD) has a significant prognostic impact in patients with acute leukemia. However, the effect of the immunophenotype of MRD cells has not been studied yet. Objective: The aim of the study was to assess the significance of CD38 and CD58 expression for relapse-free survival (RFS) in B-ALL patients. Design: This study included data from 2016 to 2020 for patients enrolled in the Russian multicenter study RALL-2016 (NCT03462095). MRD was assessed in the bone marrow at the end of induction (day +70) in patients who achieved a complete remission. Patients and Methods: The RALL-2016 study included 207 adult patients. The MRD was assessed in 150 patients (80 B-ALL patients and 70 T-ALL patients). Analysis of MRD was performed by 6- or 10-color flow cytometry. The sensitivity was at least 0.01%. CD19, CD34, CD10, CD20, CD38, CD45, and CD58 were analyzed to detect MRD. The main immunophenotypic features of B-ALL blasts are low CD38 expression and high CD58 expression. CD38 expression in MRD cells was considered low if it was lower than that on normal B-cell progenitors. CD58 expression was considered high if it was equal to or higher than that on plasma cells. The RFS was estimated with the Kaplan–Meier method, and comparisons were assessed using the log-rank test. Results: Among B-ALL patients, 48 (60%) patients were MRD-negative, and 32 (40%) patients remained MRD-positive at the end of induction. The duration of RFS was lower in MRD-positive patients (median 29.5 months vs median undefined, p=0.004). Among MRD cells, high CD38 expression was found in 8 patients, and 7 (87.5%) of these relapsed or died. RFS was shorter in CD38-high-MRD patients than in CD38-low-MRD (median 5.2 months vs median undefined, p Conclusion: MRD at the end of induction was confirmed as an important prognostic factor in the RALL-2016 study. However, immunophenotyping residual blasts could improve the prognostic impact of MRD. High expression of CD58 and CD38 on MRD cells dramatically decreases the duration of RFS in B-ALL patients.