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A compact random fiber laser based on a short artificial Rayleigh reflector and heavily-doped Er fibers (custom-made and commercial as a reference) has been proposed, characterized and optimized in terms of efficiency, linewidth and noise level. A 10-cm artificial Rayleigh reflector with mean scattering level of +41.3 dB/mm relative to the natural Rayleigh scattering of the host fiber and low insertion loss level (~0.05 dB/cm at 1535 nm) was fabricated using a femtosecond direct writing technique. Its implementation as a distributed output mirror in a half-open cavity of a 980-nm diode pumped Er-doped fiber laser results in random lasing at 1535 nm in single- and few-mode regimes with power up to 100 mW, slope efficiency up to 16.5%, and signal-to-noise ratio up to 60 dB. A single-frequency regime with ~10 KHz linewidth was observed at output power up to 2.5 mW. Tunability potential of such random lasers is also demonstrated.

Background: Currently, training of the gait function for patients with cerebral stroke using the biofeedback technology is an independent, effective, and promising method. The most common training and exposure parameters are the gait speed, cycle length, and cadence. However, the application of basic and more complex types of selective training using wearable sensor technology is rare due to the technological complexity of their use for biofeedback. Aims: To study the possibility of using the biofeedback training technology with a targeted effect on one of the basic parameters characterizing the symmetry of walking, the duration of the support period, in patients in the early recovery period of cerebral stroke. Methods: We examined 12 patients who underwent a course of biofeedback training to harmonize the period of support during the early recovery period of hemispheric cerebral stroke in the middle cerebral artery basin. The biomechanics of voluntary walking was investigated before and after the training. The spatio-temporal parameters of walking, kinematics of movements in the hip, knee, and ankle joints, and the maximum EMG amplitudes of the main muscle groups responsible for walking were recorded. The classical clinical scales were also used. The biofeedback training on a treadmill consisted of 10 sessions; the duration of the support period was the training parameter. Results. As a result of the treatment, a significant improvement was noted according to the UpGo clinical scale and Hausers walking index. The differences in the trained support phase after the treatment are not significant and demonstrate positive changes. The kinematics of movements in the joints also demonstrates relatively small, but significant changes for the knee joint. For the hip joint, no dynamics in the parameters values is observed; the joint function does not change significantly, and the amplitude asymmetry remains unchanged. For the knee joint, the greatest dynamics is observed for the main swing amplitude and its phase. Conclusion: The study has shown that the purposeful biofeedback training of the gait function using the support period to reduce the functional asymmetry in this parameter, and also has a positive effect on other gait parameters.

Consider the setting where multiple parties each hold a multiset of users and the task is to estimate thereach(i.e., the number of distinct users appearing across all parties) and thefrequency histogram(i.e., fraction of users appearing a given number of times across all parties). In this work we introduce a new sketch for this task, based on an exponentially distributed counting Bloom filter. We combine this sketch with a communication-efficient multi-party protocol to solve the task in the multi-worker setting. Our protocol exhibits both differential privacy and security guarantees in the honest-but-curious model and in the presence of large subsets of colluding workers; furthermore, its reach and frequency histogram estimates have a provably small error. Finally, we show the practicality of the protocol by evaluating it on internet-scale audiences.

This article discusses viral pneumonia of various etiologies (influenza, adenovirus, parainfluenza, bocavirus, coronavirus, polyomavirus, metapneumovirus, RSV), which has a decisive impact on the severity, course features and complications. The issues of epidemiology in the Russian Federation and in the world, pathogenesis, clinical picture, laboratory and instrumental diagnostics of this group of pathology are touched upon.

This article focuses on the use of a new generation of drugs to eliminate and prevent dysbiosis in physician practice.

Background: Tandem Gait (TG) testing is known as a clinical method for studying the walking function with complicated coordination. The precise biomechanical walking parameters in this test remain poorly investigated. Moreover, TG is a modified locomotion of walking. In general, walking is a highly automated movement. TG introduces a component of voluntary control into it. Aims: A study of functional and biomechanical symptoms in children after the treatment for the posterior fossa tumor in the long term. Methods: The study involved 15 healthy subjects aged 12 to 35 years (20.47.2), among them 4 men and 11 women control group. The group of patients comprised 33 children who had a tumor of the posterior cranial fossa (HF) at the age of 7 to 17 years (12.33.1), of these 15 boys and 18 girls, who were admitted for rehabilitation treatment to the "Russkoe pole" Rehabilitation Center. A study on the TG kinematics was performed with the Optitrack system. Results: The results showed asymmetry in the duration of the step cycle and an increase in its duration proportional to the severity of the functional state. The pelvic movements showed different abnormalities. The flexion-extension movements in the hip joints were characterized by an extension lag at the end of the transfer period and a slight decrease in the amplitude, which probably became more pronounced with an increase in the degree of the motor impairment. The movements in the knee joints demonstrated two main phenomena: an increase in the flexion setting of the joint and a decrease in the amplitude of the main swing flexion. In addition, there was a delay in the maximum of the swing flexion. The kinematic parameters of the TG of the examined patients, in contrast to the control group, are not stable. This is, presumably, due to the fact, that normally such a modification of walking is easily automated and does not require voluntary control. In patients with SCF, each step in the TG mode requires additional voluntary control, and under these conditions, the stability and repeatability of a movement are dramatically reduced. Conclusions: In contrast to the routine clinical version of the test, the analysis of the movement biomechanics allows one to present an accurate qualitative and quantitative characterization of functional disorders. According to our research, motor function disorders develop at various levels of the musculoskeletal system. The degree of their severity is in a good agreement with the expert assessment of the patient's functional state.

The definition of gastritis is based on the histological features of the gastric mucosa. This is not the erythema observed during gastroscopy, and there are no specific clinical manifestations or symptoms that determine it. The modern classification of gastritis is based on time (acute and chronic), histological features, anatomical distribution and the main pathological mechanisms. Acute gastritis will develop into chronic if left untreated. Helicobacter pylori (H. pylori) is the most common cause of gastritis worldwide. However, from 60 to 70% H. pylori-negative subjects with functional dyspepsia or non-erosive gastroesophageal reflux were also found to have gastritis. H. pylori-negative gastritis is considered when a person meets all four of these criteria: negative triple staining of biopsies of the gastric mucosa, no history of treatment of H. pylori. In these patients, the cause of gastritis may be associated with tobacco smoking, alcohol consumption and / or the use of nonsteroidal anti-inflammatory drugs (NSAIDs) or steroids. Other causes of gastritis include autoimmune gastritis associated with antibodies of serum anti-parietal and anti-internal factor; organisms other than H. pylori, such as Mycobacterium avium intracellulare, Herpes simplex and Cytomegalovirus; gastritis caused by acid reflux; Rare causes of gastritis include collagen gastritis, sarcoidosis, eosinophilic gastritis and lymphocytic gastritis. The clinical picture, laboratory studies, gastroscopy, as well as histological and microbiological examination of tissue biopsies are important for the diagnosis of gastritis and its causes. Treatment of gastritis caused by H. pylori leads to the rapid disappearance of polymorphic-nuclear infiltration and a decrease in chronic inflammatory infiltrate with gradual normalization of the mucous membrane. Other types of gastritis should be treated based on their etiology.

Introduction. In megacities, the use of organs obtained from those who died as a result of sudden out-of-hospital cardiac arrest (OHCA) for transplantation is one of the promising ways of addressing the problem of organ donor shortage. In St. Petersburg, the model of transition from life support via extracorporeal membrane oxygenation (ECMO) of patients after OHCA to ECMO life support for organs of potential donors was tested for the first time.Materials and methods. In order to implement the program, round-the-clock ECMO and transplantation teams were organized at the inpatient emergency ward of Pavlov First St. Petersburg State Medical University. Interaction with the St. Petersburg City Emergency Station, St. Petersburg was established. The protocol of work with potential donors brought to the hospital after a sudden circulatory arrest was developed, approved by the ethics committee, and implemented in clinical practice. This was the first in Russia and in international practice. Between 2017 and 2020, 67 patients with sudden OHCA were brought to the inpatient emergency ward. In 4 (5.97%) cases, advanced cardiovascular life support was successful, and 11 (16.42%) patients became effective donors. Mortality among this group of patients without subsequent postmortem donation was 77.61% (52 patients).Results. Liver transplantation from non-heart-beating donors (NHBDs) whose blood circulation was restored by ECMO (ECMO NHBD) was performed in 5 recipients who were in severe condition against the background of liver failure. In 1 (20%) case, there was severe liver allograft dysfunction for 33 days with subsequent complete restoration of function. Kidney transplantation was performed in 22 patients. Immediate graft function occurred in 10 (45.45%), while delayed function occurred in 12 (54.55%) patients. Kidney graft survival was 86.4%, kidney graft recipient survival was 95.5%, liver graft recipient survival was 80%, and the follow-up period was 24.1 ± 7.15 months.Conclusion. The use of ECMO to save the lives of patients with sudden OHCA can be implemented in conditions of a high degree of organization and synchronization of the work of the city emergency medical station and the emergency department of a multidisciplinary hospital. If cardiopulmonary resuscitation with ECMO (ECMO CPR) fails, it is possible to launch the ECMO NHBD donor program. Long-term outcomes of liver and kidney transplantation from ECMO NHBD are consistent with those using organs from brain-dead donors. Widespread implementation of the new organ donation model will increase the availability of transplant care.

This article is devoted to the issues of the clinic, diagnosis and treatment of nephrotic syndrome, its complications and the principles of prevention.

A distributed temperature monitoring inside a cavity of ytterbium DFB and holmium fiber lasers has been demonstrated with a spatial resolution of 1 and 5 mm, respectively, for the first time to the best of our knowledge. For this, we use an optical backscatter reflectometer, which measures intracore temperature, and compare it with the data of an IR thermographic camera, which measures temperature from the surface of a fiber. In the case of holmium fiber laser pumped at a wavelength of 1125 nm with a power of 6 W, the maximum temperature variation along the ∼3-m active fiber reaches ∼60 °C. In the case of ytterbium DFB laser, we observe a strong inhomogeneity of the temperature along the DFB cavity, which leads to a significant decrease in the lasing efficiency. When pumped by a single-mode laser diode at a wavelength of 976 nm with a power of up to 526 mW, the maximum temperature difference reaches 37 °C for the 37-mm DBF cavity.

Purpose Treatment of muscle-invasive bladder cancer (MIBC) remains challenging, especially for elderly and/or comorbid patients. Patients who are unfit for or refuse surgery should receive bladder-preserving multimodality treatment (BPMT), consisting of transurethral resection of the bladder tumor (TURB) followed by combined chemoradiotherapy (CRT). We aimed to investigate the effectiveness of vinorelbine, a chemotherapeutic agent not routinely used for MIBC, in patients referred to CRT who are unfit for standard chemotherapy and would thus rely solely on radiotherapy (RT). Methods We retrospectively analyzed 52 consecutive patients with MIBC who received standard CRT with cisplatin (n = 14), CRT with vinorelbine (n = 26), or RT alone (n = 12). Primary endpoints were median overall survival (OS) and median cancer-specific survival (CSS). Secondary endpoints were median local control (LC), median distant control (DC), and OS, CSS, LC, and DC after 1, 2, and 3 years, respectively. Results Median OS and CSS were significantly higher for patients who received vinorelbine as compared to RT alone (OS 8 vs. 22 months, p = 0.003; CSS 11 months vs. not reached, p = 0.001). Median LC and DC did not differ significantly between groups. Vinorelbine was well tolerated with no reported side effects >grade II. Conclusion Our results suggest that CRT with vinorelbine is well tolerated and superior to RT alone in terms of OS and CSS. Therefore, this treatment regime might constitute a new treatment option for patients with MIBC who are unfit for or refuse surgery or standard chemotherapy. This study encourages a randomized controlled trial to compare this new regime to current standard therapies.

The work is devoted to processes during melting of thin aluminium film on silicon surface in pulse current mode. An experiment was conducted to study the dynamics during the onset of the liquid phase on a metal film. Besides, the process of formation droplet localization zones is considered. The experimental part revealed critical current values ​ during an electrical explosion of thin metal films near the thermal shock source. Using the oscillographic method, the temperature profile of the metallization track is calculated.

The article is devoted to the substantiation of the methodological approach to the evaluation and development of managerial capacity-building components of the organization. For the effective operation of the enterprise must have reliable intelligence, as Wednesday's external and internal Wednesday. Guide only while in possession of all the necessary information about the functioning of the enterprise will be able to objectively evaluate the situation promptly and efficiently take necessary managerial decision objectively commensurate with their capabilities your needs. Studies on the optimal utilization and building management components at enterprises «Bellegprom».

Gallstone disease (choledocholithiasis) is a pathological condition in which stones are formed in the gallbladder. It is caused by a change in the chemical composition of bile with an increase in the concentration of cholesterol in it, hypomotility of the gallbladder, and a number of metabolic disorders. This disease is widespread throughout the world: according to literary sources, about 10% of the population suffers from it. The lowest prevalence of cholelithiasis is noted in the countries of Africa and Asia, which is associated with dietary habits and the absence of high-calorie foods in the diet. In the structure of the overall morbidity, cholelithiasis ranks third after lesions of the cardiovascular system and diabetes mellitus, and exacerbations of cholelithiasis are one of the main reasons for hospitalization with acute surgical pathology. As a rule, women get sick 3-4 times more often than men. If the conservative treatment is ineffective, surgical intervention is necessary; at the present stage, minimally invasive methods with the use of laparoscopic techniques are becoming increasingly popular. To increase the effectiveness of the endoscopic method of treatment, various methods of contact biliary lithotripsy - laser, mechanical, electrohydraulic [2] - are often used.

Itsenko-Cushing’s disease is a disease characterized by dysfunctions of the hypothalamic-pituitary-adrenal system. Without therapy during the first five years, the survival rate is 50 %, and the patient’s condition improves markedly with palliative treatment, increasing the survival rate to 86 %. Today, there are a number of criteria for the diagnosis, diagnosis and treatment of this pathology.

B₁₂-deficiency anemia (megaloblastic anemia, pernicious anemia, Addison-Birmer disease), characterized by progressive hyperchromic, macrocytic anemia, hypersegmentation of neutrophil nuclei, megaloblastic erythropoiesis and morphological abnormalities of other hematopoietic growths in the bone marrow; Unlike other anemias, B₁₂-deficiency anemia is often associated with the development of pathological psycho-neurological symptoms (funicular myelosis).This article deals with problems of etiology, pathogeny, clinical symptomatology, approaches to detection and treatment of B₁₂-deficiency anemia.

Stress-induced cardiomyopathy is a disease that entails a transient violation of the systolic and diastolic functions of the left ventricular myocardium with subsequent enlargement of the heart chambers, akinesia of the apical and middle segments and normo- or hyperkinesia of the basal segments in the absence of pronounced hemodynamic stenosis of the coronary arteries. To date, there is no reliable information about the pathogenesis, methods of therapy and possible prognosis of this disease, so there is a need for further research.

This article provides basic information about the etiology, classification and diagnosis of community-acquired pneumonia. The main approaches to the treatment of this disease are outlined. The modern approaches to the treatment of this disease at the outpatient stage are considered.

This article is devoted to the treatment of isolated systolic arterial hypertension in the elderly, based on the current ESH/ESC recommendations.

The article highlights the issues related to the development of dyscirculatory encephalopathy (DE), in particular, against the background of what diseases this pathology occurs and its social significance. The main issues of its pathogenesis are considered; the parts of the brain that are damaged in the first place and how this affects the manifestations of the disease and the rate of its development are described. The staging of DE development, the main symptoms and problems of its diagnosis are also considered. The basic principles of therapy are presented: the indications for inpatient and outpatient treatment, groups of drugs used to improve the patient’s condition and the mechanisms of their action.

Background: According to numerous studies, from 30% to 50% of patients with chronic heart failure (CHF) are resistant to cardiac resynchronization therapy (CRT) and cardiac contractility modulation (CCM), despite their careful selection in accordance with current guidelines. It is of interest to study neurohormones characterizing myocardial (NT-proBNP) and fibrosis (sST2) as potential additional markers of CHF patients' “response” to CRT and CCM.Aim: To evaluate the potential to use NT-proBNP and sST2 biomarkers in CHF patients combined with transthoracic echocardiography (Echo) and contrast magnetic resonance imaging (MRI) parameters of the heart to predict a positive response to CRT and CCM devices.Materials and methods: The study included 51 patients (41 men, 10 women) aged 58 ± 12 years (26 to 79 years) with ischemic heart disease post acute myocardial infarction (n = 22) or non-ischemic cardiomyopathy (n = 29), left ventricle (LV) ejection fraction (EF) < 35%, and CHF II–III NYHA functional class despite ≥ 3 months of optimized medical therapy. The patients were assessed by serum biomarkers NT-proBNP and sST2 measurements, transthoracic Echo, and contrast- enhanced cardiac MRI. After the diagnostic assessment, CRT defibrillators (CRT-D) were implanted to 39 patients and CCM to 12 patients. After prospective follow-up of the patients for 18 to 24 months, predictors of the response to each device type were analyzed in univariate, multivariate, and ROC analysis.Results: The response to CRT-D was found in 21 (54%) patients, to CCM in 7 (58%) patients. Multivariate analysis showed the following predictors of the response of patients to CRT-D were: 1) sST2 < 50 ng/mL, 2) NT-proBNP < 3900 pg/mL, 3) < 3 LV segments with fibrosis (by MRI) and 4) anteroposterior dimension of the left atrium < 4.8 cm (by Echo). Any 2 of these 4 characteristics made it possible to predict the response to CRT with an accuracy of 87% (sensitivity 90%, specificity 83%). The predictors of the response to CCM were: 1) sST2 < 30 ng/ml, 2) LV end diastolic diameter < 78 mm (Echo), 3) age < 56 years, 4) body mass index < 27 kg/m2. Any 2 of these 4 characteristics predicted the positive response to CCM with an accuracy of 92% (sensitivity 86%, specificity 100%).Conclusion: The preoperative sST2 level was the only universal marker of the response to either CRT (< 50 ng/mL) or CCM (< 30 ng/mL) devices in CHF patients with reduced LVEF. The results indicate the potential for improved efficacy of these devices with their earlier implantation after the onset of the heart disease, as well as provided that maximal control CHF in these patients has been achieved.

The World Health Organization (WHO) as a pandemic recognized the outbreak of the novel coronavirus COVID-19, which was first reported on December 8, 2019 in Hubei Province in China, on March 11, 2020. This disease was recognized as an infection with a new beta-coronavirus. Today, the current problem is COVID-19 and its effect on blood vessels and blood. Although COVID-19 primarily affects the lungs, causing interstitial pneumonitis and severe acute respiratory distress syndrome (ARDS), it also affects other organ systems. COVID-19 is manifested by hypercoagulation, pulmonary intravascular coagulation, microangiopathy, and venous thromboembolism (VTE) or arterial thrombosis. Clinically, the vascular dysfunction associated with COVID-19 manifests itself outside the lungs in various ways, including deep vein thrombosis, pulmonary embolism, large artery thrombosis, and multiple organ venous and arterial thrombosis, and these manifestations are attributed to factors such as hypoxemia, viral sepsis, immobility, and sometimes vasculitis. In some cases, DIC syndrome (which is a simulator of vasculitis) can occur with the lightning-fast lung disease COVID-19, and is also characterized by diffuse thrombosis and bleeding. If you exclude DIC and large vessel thrombosis, it is clear that patients with severe COVID-19 pneumonia may also have severe changes such as skin vasculitis, suspected cerebral vasculitis, and multiple organ failure, resulting in suspected viral endothelitis, direct viral infection, or vasculitis. Understanding the vascular effects of COVID-19 is essential for comprehensive medical care.

Introduction. The problem of gastric ulcer is of particular socio-economic importance and has a tremendous impact on the quality of life of people. The relevance of our study is due to an increase in the incidence of peptic ulcer in the population, the variability of the clinical picture depending on the age category of patients, and the peculiarities of the treatment of this gastrointestinal pathology.The aim of the study is to study the features of the course of gastric ulcer in different age groups of patients under dispensary supervision in the outpatient department of the State Budgetary Healthcare Institution of the Republic of Moldova “Republican Clinical Hospital No. 5” in the period from 2017 to 2020.Materials and methods. A retrospective analysis of outpatient records of 100 patients of different age groups with gastric ulcer who were under dispensary observation at the outpatient clinic of the Republican Clinical Hospital No. 5 in Saransk in 2017– 2020 was carried out. Statistical analysis of the data obtained was carried out using the Microsoft Office Excel program.Results and discussion. It was found that gastric ulcer is more often observed in middle-aged and elderly patients and is accompanied by blurring of the clinical picture of the disease, in contrast to young people, who have vivid clinical manifestations of this disease. Ulcerative defects in young and middle-aged patients are more often small in size and are located mainly in the area of the stomach angle, and in elderly and senile patients, ulcers are localized mainly in the cardiac region, can be gigantic and often lead to the development of complications (primarily gastrointestinal intestinal bleeding).Conclusions. The blurring of the clinical picture, the absence of pathognomonic symptoms in elderly patients determine the late diagnosis of gastric ulcer, which ultimately leads to a high incidence of complications requiring surgical intervention. In clinical practice, it is necessary to take into account these features of the course of peptic ulcer disease in elderly patients and to prescribe the necessary complex of laboratory and instrumental studies and preventive therapy in a timely manner.

This article presents information on the main pathological processes developing in the liver in diabetes mellitus. Non-alcoholic fatty liver disease (NAFLD) is an independent nosological unit that includes a spectrum of clinical and morphological changes in the liver parenchyma: steatosis (fatty degeneration) and non-alcoholic steatohepatitis (NASH), the natural course of which can lead to the development of terminal stages of the disease: cirrhosis and liver cancer. This article is devoted to the etiology, pathogenesis, clinical picture, diagnosis and treatment of fatty liver disease in patients with diabetes mellitus.

Industry is one of the important sectors of the economy of any country in the world. At the same time, statistics show that the industrial complexes of many countries are developing unevenly, with periodic changes in the structure and volume of production under the influence of many internal and external factors. Ukraine's industrial complex is also undergoing spatial and structural distortions, but these trends do not always correspond to those formed in the world's leading countries in the direction and pace of change, although today the industrial complex of Ukraine is the most important structural part of Ukraine's economy, a third of fixed assets and more than 30% of the employed population. As one of the largest spheres of social production in the country, industrial production determines the level of its socio-economic development, the specialization of the economy and the extent of participation in the territorial division of labor. Properly chosen strategy for the development of industrial production, the appropriate volume and structure of production, a reasonable volume of sales allows all participants in production to achieve their financial goals. This is due to the importance of studying the activities of industrial enterprises. The article constructs nonlinear models of multiple regression, which describe the main trends in industrial production, the effect of external and internal factors on the economic performance of industry in general and industrial enterprises in the western region of Ukraine. It is established that innovative transformations in industrial production have led to the renewal of fixed assets and have had a positive effect on the dynamics of economic results. At the same time, this process was accompanied by a reduction in the number of people employed in industry. It is revealed that the influential factors of the external environment include economic conditions of management, and among the factors of the internal environment – the management of innovation and innovation activity of economic entities. It is recommended to expand the set of tools at the expense of distribution-lag, autoregressive, simulative and other econometric models to describe the relationship between the economic performance of enterprises and factor characteristics.

Gastroesophageal reflux disease is a condition that develops when reflux of stomach contents causes disturbing symptoms and / or complications. Its typical symptoms are heartburn and regurgitation (belching sour, bitter, stomach contents), which worsen the well-being of patients. One of the main tasks of medical treatment is the rapid elimination and control of symptoms. Complications of GERD include reflux esophagitis, Barrett’s esophagus, and esophageal adenocarcinoma. This article highlights the use of alginates in the treatment of gastroesophageal reflux disease (GERD) in accordance with modern concepts of this condition and approaches to its treatment.

Background: The standard of the surgical treatment for arthrosis of the knee joint (KJ) at the later stages is total arthroplasty, which allows relieving the pain and eliminating the existing deformity. However, there are not enough data on the long-term results after the surgery that is important for understanding the dynamics of the recovery and predicting the result. Aims: Study of clinical, functional, and biomechanical symptoms in patients after total arthroplasty of the knee joint in the long-term period. Methods: 22 patients after knee joint replacement and 20 relatively healthy adults (control group) were examined in long-term periods. The biomechanics of walking was studied at an arbitrary pace. The temporal characteristics of the gait cycle, shock loads and movements in the hip joints (HJ) and KJ were recorded. We recorded the time characteristics of the walking cycle, shock loads and movements in the hip joint (HJ) and KJ. The patients were divided into two subgroups according to the results of the biomechanical study. The patients from subgroup 1 had good functionality with a swing amplitude of the knee joint of 50 degrees or more, the movement algorithm was preserved. The patients from subgroup 2 had a swing amplitude of up to 50 degrees, the movement algorithm was impaired. Results: The temporal characteristics of the waking cycle of knee arthroplasty patients did not differ significantly from the control group in the long term. Abduction-adduction and rotation movements in HJ and KJ show a decrease in the amplitudes, more pronounced in the second subgroup. The main changes in the kinematics of the hip joint are characterized by a decrease in the range of motion and a longer extension time during the support period, which was found for both sides, especially in the second subgroup. The greatest changes were observed in the kinematics of the knee joints movements. They included a decrease in the amplitude of all the movements, not only on the endoprosthesis side, but also on the opposite side. Conclusions: There is no complete restoration of the knee joint function after total arthroplasty in the long term. The function of both lower limbs is symmetrically decreased. The fact of functionally different (less severe and more severe) results may be associated with the initial functional state of the joint before arthroplasty or with the subsequent period of rehabilitation.

Vascular stiffness is an independent prognostic parameter for the development of cardiac pathology and cardiovascular mortality. The predictive value is high at the preclinical stages of the development of the disease, since blood vessels are an integral marker of cardiovascular pathology, through which classic risk factors for cardiovascular diseases (CVD) are realized. Vascular stiffness increases due to cholesterol deposits and calcification of the vessel wall. On the other hand, an increase in blood pressure (BP) causes changes in the vascular wall, including with the development of arteriolosclerosis, which can also lead to an increase in vascular stiffness.

Important in the pathogenesis of many diseases of the cardiovascular system plays a decrease in elasticity and stiffening of the large arteries. Currently, one of the leading places is devoted to the study of the role of the vascular wall in the pathogenesis of hypertension. A number of studies indicate that an increase in the rigidity of the arterial bed is an independent factor of cardiovascular risk: at the same time, the risk of coronary artery disease, stroke, dissecting aortic aneurysms, and overall mortality from cardiovascular diseases is higher.

Acute intermittent porphyria is a rare autosomal dominant disorder characterized by excessive accumulation and excretion of porphyrins and their precursors, repeated attacks of neurological and mental symptoms. Due to the rarity of this pathology and the atypical course in the onset, certain difficulties often arise during the initial diagnosis. The main pathogenetic drug is gemin (Normosang), which allows obtaining a stable clinical response and preventing the development of severe changes in the nervous system. This article presents an analysis of a clinical case of acute intermittent porphyria among blood relatives and discusses the effectiveness of targeted therapy.

Wolff — Parkinson — White syndrome (WPWS) is still the leading cause of supraventricular tachycardia in the world. The frequency of WPWS ranges from 0.1 to 0.3 % per 1000 people. It is worth noting that in patients with congenital heart defects, it increases to 0.5 %. The article highlights the main criteria of Wolff — Parkinson — White syndrome, its morphological justification, and the features of modern topical diagnosis. Also, the review of the main methods of treatment and rehabilitation of patients is presented.

Goal. Analysis of hospital and long-term results with the identification of predictors of complications after combined interventions on the coronary and carotid arteries in the volume of percutaneous coronary intervention + carotid endarterectomy (PCI + CEE). Materials and methods. From 2010 to 2016, 64 patients underwent hybrid revascularization of the brain and myocardium in the volume of PCI + CEE. Initially, PCI was performed, then the patient was transported to the vascular operating room, where he underwent CEE was performed according to the classical technique with modeling the reconstruction zone with a patch made of diepoxy-treated xenopericardium. Brain protection was achieved by invasive measurement of retrograde pressure. After CEE, the patient received a loading dose of clopidogrel 600 mg. The average follow-up period in the long-term period was 53.04 ± 17.1 months. Results. In the hospital period, only hemorrhagic complications were noted (n = 3; 4.68 %) while taking double antiplatelet therapy (acetylsalicylic acid + clopidogrel) and intraoperative heparin. In the long-term period, the leading position was occupied by a lethal outcome (n = 9; 16.6 %). Despite taking double antiplatelet therapy, in 6 (11.1 %) cases, stroke development was noted, in 1 (1.8 %) — MI. In 3 (5.5 %) patients, repeated unplanned revascularization was performed — CABG as a result of restenosis in the stent. The combined endpoint (death + stroke + myocardial infarction) was 29.6 % (n = 16). Significant risk factors for the development of complications in the hospital postoperative period were chronic renal failure (OR 3.7165; 95 % CI 1.2032–11.4800), III–IV functional class of angina (OR 21.9; 95 % CI 2.29–208, 8), a history of stroke (OR 6.82; 95 % CI 1.04–44.7). In the long term, the predictors of adverse events were bleeding (OR 2.02; 95 % CI 1.15–3.55), ejection fraction less than 50 % (OR 2.9; 95 % CI 1.47–5.7) and lesion trunk of the left coronary artery and more than three additional coronary arteries (OR 2.67; 95 % CI 1.27–5.59), and two or less affected coronary arteries (OR 0.34; 95 % CI 0.19–0.62). Conclusion. The efficiency and safety of hybrid revascularization in the volume of PCI + CEE has been proven in view of the minimum number of complications at different stages of follow-up.

The article examines the problems of job satisfaction of agricultural workers in the context of digital transformation, in particular, the introduction of robotics into production. The main hypothesis of the study is that the use of robotics in agriculture will increase the job satisfaction of workers interacting with robots. The results of a questionnaire survey of job satisfaction of operators of machine and robotic milking are presented. The respondents were most satisfied with the operation of the equipment (8.7 points), the work schedule (8.1 points), the level of supply of consumables (7.8 points). The smallest value of job satisfaction was found in terms of sanitary and hygienic conditions – 6.21 points. Robotic milking operators are more satisfied with the work schedule and work safety than their counterparts on farms without robots. Overall satisfaction with the work of milking machine operators is 6.9 points, and for robotic milking operators – 8.07 points, which is 1.17 points higher. Specific recommendations are given on the use of robotics in agricultural production, which can significantly increase the indicators of job satisfaction.

Diseases of microbial aetiology namely colibacillosis and staphylococcosis are prevalent in poultry farming as asymptomatic carriers of these bacteria among birds are common. Besides microorganisms upon penetrating the organism harm it in multiple ways such as by creating a host of toxins which helps evade the immune response. To evaluate effector mechanisms of the immune system and the level of immune reactivity we suggested employing leukocytic indices, whereupon we analysed leukocytic indices in experimentally infected chickens and used them as diagnostic criteria for controlling the state of organism in developing pathology. In the course of our research we conducted two experiments. For the first experiment we divided chickens into two groups: Group I – control, Group II – chickens challenged intraperitoneally with Staphylococcus aureus (2 McFarland units). In the second experiment Group III was control, while Group IV was challenged in the same way with Escherichia coli. Blood samples were collected on Day 1, Day 3, Day 5 and Day 7 after the challenge. The following indicators were studied: leukogram and dynamics of leukocytic indices. We observed reliable changes in indicators of each experimental group, but the challenge with E. coli caused a less pronounced endotoxic effect on the organism of male chicks.