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The guidelines describe the management of follow-up monitoring of second health status group persons, who have a high and very high cardiovascular risk. The following are presented: action sequence and follow-up content in this category of patients, recommendations for dealing with patients with risk factors (smoking, sedentary lifestyle, unhealthy diet, excess body weight). Examples of medical records are provided. Reminders for patients are presented, including in the event of acute coronary syndrome and cerebrovascular accident. Recommendations and algorithm for remote questioning and consultation are presented.Guidelines are intended for doctors and paramedics of departments of medical prevention and health centers, paramedics of rural health posts.The materials presented can also be used by local doctors (internists, general practitioners, paramedics at rural health posts and health centers) when conducting preventive counseling for patients with risk factors of nonommunicable diseases, and when working with them to modify risk factors.

Objective. To assess durability of antiretroviral therapy in first line in HIV-infected patients in real clinical practice in the Russian Federation and determine association between basic clinical and demographic characteristics and durability of treatment.Materials and methods. A non-interventional retrospective study was conducted collecting data from primary medical records of HIV-infected patients who signed informed consent form and had started antiretroviral therapy in first line. Patients were enrolled if the third component was a non-nucleoside reverse transcriptase inhibitor (NNRTI) or ritonavir boosted protease inhibitor (PI/r) plus two nucleoside reverse transcriptase inhibitors (NRTIs). Also, patients must have been followed up for at least 96 since start of treatment. Durability of therapy was retrospectively assessed at 48±8 and 96±8.Results. 536 patients were enrolled. Percentage of patients without change of therapy was approximately 76% and 60%, and the mean duration of therapy without changes was approximately 47 and 79 weeks at 48±8 and 96±8 weeks, correspondingly. Durability of treatment was not different for NNRTI+2NRTIs and PI/r+2NRTIs. Only age ≥ 40 years as a basic characteristic was associated with ART change prior to 96 weeks: OR=1.391, 95% CI 1.005-1.925.Conclusions. In real clinical practice in Russia, durability of first-line antiretroviral therapy corresponds published scientific data (in terms of percentage of patients without change of treatment and its duration without change). Durability of treatment and factors associated with its early switch or stop should be investigated in prospective studies further.

Relevance. The problem of vaccine hesitancy is becoming even more urgent in the light of the coronavirus pandemic, which acted as an impetus for increasing public skepticism about vaccination. In 2019, the WHO declared vaccine hesitancy as one of the global health threats. Aims. The purpose of the research is a comprehensive analysis of the factors that cause vaccine hesitancy in Russian Federation, followed by recommendations for increasing population adherence to vaccination. Materials & Methods. Statistical, factual analysis of the research objects, as well as a qualitative and quantitative analysis of open sources data carried out. The main sources of information were anti-vaccination messages on social networks and the media, information from anti-vaccination communities on Vkontakte, official websites and social networks of relevant federal executive authorities of the Russian Federation. Results. Communication space. Social networks are the main source of dissemination of false information about vaccination. The most active platforms for the dissemination of anti-vaccination messages on social networks are Odnoklassniki and Vkontakte. Semantic analysis. Anti-vaccination rhetoric on Facebook, Instagram, Vkontakte, Odnoklassniki, Telegram, Twitter, Tik Tok, You Tube, Live Journal, the media, and forums is generally similar. As the object of anti-vaccination rhetoric, the words “vaccines”, “vaccination”, “vaccinations” most often appear in posts. Such rhetoric is more directed towards childhood vaccinations. The target audience of anti-vaccination propaganda is parents. The target audience. The sample of the target audience of the doubting population, compiled on the basis of social network Vkontakte users, amounted to 90,937 people. A significant part of the doubting population is represented by women (85%). As a result, the average age of target audience representative is 35.4 years. Major part of the audience is married – 83.1% of the total sample. Almost a third (24.1%) of the Russian audience of the anti-vaccination movement are residents of the Central Federal District. Influence groups. The activity of key influence groups members is characterized by a high level of cohesion within the anti-vaccination movement, which is manifested in mutual reposts of information, joint actions, live broadcasts and announcing the events of “comrades-in-arms”. Among the main motives for participating in the anti-vaccination movement are commercial interests in promoting services and products that are alternative to vaccination, as well as attracting the attention of the audience. It is important to note that the most active representatives of the anti-vaccination movement, for the most part, do not have a medical education. Measures to increase adherence. The state policy in relation to increasing the population adherence to population, as well as the activities of the pro-vaccination movement representatives, play an important role in strengthening the public's confidence in immunization. As part of increasing adherence to vaccination, a wide range of methods and means of informational impact on citizens is used - separate information portals, social networking, face-to-face educational events, special projects, organization of hotlines on vaccine prevention. Conclusions. Solving the problem of vaccine hesitancy under the influence of the anti-vaccination movement activities, rhetoric in the media and social networks, distrust of the state and the healthcare system, and personal perception of vaccination risks require an integrated approach to organizing measures for increasing adherence at the federal and regional levels. The immunization system development should be carried out by changing the regulatory legal framework in order to effectively implement such activities at all levels of the country's health care system.

Abstract Being a global pollutant, mercury can originate from both natural as well as anthropogenic sources. Coastal marine atmospheric fog is considered a potential source of ocean-derived monomethylmercury (MMHg) to coastal terrestrial ecosystems. However, the ratio between mercury appearing through natural processes and that from the results of human activity is unclear. We assumed that the total mercury content in the fur of tigers would differ depending on the distance from the sea. Here we show that the average mercury content in tigers from the coast (0.435 ± 0.062 mg kg−1) is significantly different from tigers from the inland area (0.239 ± 0.075 mg kg−1), (p = 0.02). We found that the content of mercury in the fur of tigers is largely dependent of natural processes rather than human activity. We assume that the levels of mercury in coastal ecosystems in the south of the Russian Far East reflect the position of the region relative to the deep faults of the East Pacific Platform. Obtained data indicate that environmental risks associated with mercury pollution currently exist, but do not pose a serious threat to Siberian tigers.

The purpose of this paper is to calculate the effect of gender balance in management on the economic performance of Russian companies. The relevance of the topic is explained by the fact that in Russia women make up almost 50% of the workforce (that exceeds the indicators of Western Europe and North America) and get a higher education on an equal basis with men, but women’s participation in the governing bodies of companies is insignificant (about 5%). This could result the companies losing the benefits of women’s human capital. The paper hypothesizes that Russian public joint stock companies with gender balanced governing bodies have better financial performance. An econometric model has been used to test this method. Data for the period of 9 years (from 2010 to 2018) for 44 non-financial companies whose shares were traded on the stock exchange during this period are taken. There has been applied Tobin’s Q as an indicator of the financial performance. Since there is a two-tier management system in public joint-stock companies in Russia. Two councils are considered as the governing bodies of the company — the supervisory board and the board of directors. The result of the study is the absence of a significant relationship between the gender balance in the governing bodies and the financial success of the companies. The main reasons for the lack of significant results include a special industry profile of Russian companies. The recommendation for the following studies is to focus not just on the firm’s financial performance but on the corporate and social impact of gender balance either.

We herein present our initial report from «ROKKOR-recipient», a national multicenter observational study. The prevalence, risk factors, clinical manifestations and outcomes of the novel coronavirus disease 2019 (COVID-19) in solid organ transplant recipients receiving immunosuppressive therapy were investigated. The study enrolled 251 COVID-19 patients (220 kidney recipients, 7 liver recipients, 1 liver-kidney recipient, and 23 heart recipients). The subjects came from 20 regions in Russia. The symptoms, clinical presentation, imaging and lab test results, therapy and outcomes of COVID-19 were described. It was established that solid organ transplant recipients with COVID-19 have a higher risk of developing adverse events. Predictors of adverse events include associated cardiovascular diseases, pulmonary diseases, diabetes, and kidney failure. Symptoms of the disease include dyspnea, rash and catarrhal signs, as well as initial low blood oxygen saturation (SpO2 10 × 109/L), elevated creatinine levels (>130 μmol/L) and a marked decrease in glomerular filtration rate, requiring hemodialysis. Performing organ transplant surgery in COVID-19 does not increase the risk of adverse events but could save the lives of waitlisted terminally ill patients.

Methods for the synthesis of hybrid molecules that combine the structure of a highly active antimicrobial compounds - tris(1-alkylindol-3-yl)methylium as well as 3-(indol-1-yl)maleimides that previously showed activity against some protein kinases have been developed. The main purpose of this study was to investigate the influence of substituents on the activity of compounds against different test microorganisms, as well as their toxicity on human cells. For example, with the introduction of a fragment of maleimide, it was possible to reduce cytotoxicity by almost 40 times compared to the original prototype in some cases. At the same time, antimicrobial activity of the new substance remained approximately at the same level.

Guidelines were approved at the meeting of the academic council of the National Medical Research Center for Therapy and Preventive Medicine, Moscow (Protocol No. 10 of 19.10.2021).The aim of these guidelines is to provide primary care physicians with scientifically based algorithms for the implementation of dispensary monitoring in patients with chronic non-communicable diseases in the conditions of the new coronavirus infection (COVID-19) pandemic, including the use of telemedicine technologies.The organization and conduct of high-quality medical follow-up are the most important tasks aimed at both reducing the risks of developing complications of chronic non-communicable diseases and reducing overall mortality, especially in the current conditions of the COVID-19 pandemic. The guidelines contain clinical aspects of dispensary follow-up, general principles of tactics for managing patients with various chronic non-communicable diseases in COVID-19 conditions, in addition, brief checklists with options for interviewing patients with various chronic non-communicable diseases are presented, topical aspects of the interaction of drugs used in the treatment of chronic non-communicable diseases with antiviral drugs are considered.The guidelines are intended for general practitioners, district therapists, general practitioners (family doctors), as well as doctors of other specialties providing primary health care.

Mercury (Hg) and its compounds are among the most hazardous environmental pollutants with a high cumulative potential and they can have toxic effects on human and animal health even in low concentrations. Due to the increasing rate of human economic activity and the increase in the amount of Hg in the total cycling of matter, the study of its distribution, transformation, redistribution and accumulation in the abiotic and biotic components of various ecosystems remains important up to the present time. We assessed the content of metal in organs and tissues of the bank vole Myodes (Clethrionomys) glareolus Schreber, 1780 (Rodentia, Cricetidae), a widespread small rodent, caught in different biotopes of forest-steppe and steppe zones of Voronezh region. Measurements of Hg in samples were carried out with a mercury analyzer RA-915+ with the accessory PYRO (Lumex) using the atomic absorption method of cold steam without preliminary sample preparation (the lower limit of mercury detection in samples was 0.001 mg/kg). The sample size was 344 specimens. Mean Hg concentrations ranged from values below the analytical determination threshold to 0.887 mg/kg dry weight in the kidneys, 0.411 in the liver, 0.031 in the muscle tissue, and 0.040 in the brain. A positive correlation was found between the metal content in all possible pairs of organs (except for the “muscle – brain” pair) and a weak negative correlation was found between the Hg level and the mass of the animals. Hg concentrations in the studied organs did not differ between males and females. The metal content in the liver and kidneys of voles from the forest-steppe zone was significantly higher than in those from the steppe zone. Among all studied biotopes (meadow, pine and mixed forest, shrub thickets), the lowest concentrations were observed in animals living in pine forests, while the highest one – in more humidified bush thickets. During the vegetation season, there was a decrease in the average values of animal body mass in the samples and an increase in the content of Hg in the liver and kidneys. The results of the study are relevant in the assessment of atmospheric mercury pollution of terrestrial ecosystems using small mammals, such as Myodes glareolus, as a model object.

Aim. To perform an arterial hypertension (HT) screening for assessing the awareness of Moscow Region citizens about high blood pressure (BP) and draw their attention to this important risk factor.Material and methods. The screening was performed as a part of Standardized International Screening Study "May Measurement Month 2018” in five towns of Moscow Region: Domodedovo, Balashikha, Mytishchi, Solnechnogorsk, Klin. 510 participants (324 females, 186 males) were involved, aged from 18 to 86 years (median age 42 [28;57] years). People over 1 8 years were asked to measure BP levels and fill out a questionnaire: age, gender, height and weight, previous BP measurement date, bad habit (tobacco smoking, alcohol consumption), cardiovascular diseases and type 2 diabetes history, previous high BP levels and antihypertensive drugs taking. Elevated BP was considered systolic BP (SBP) ≥140 mm Hg and/or diastolic BP (DBP) ≥90 mm Hg. Mechanical and automatic tonometers were used.Results. Increased BP was registered in 24% of participants. High BP levels were more common among men of working age and women older than working age. Increased BP was registered for the first time in 7% of the participants, and half of the participants who had previously taken antihypertensive therapy had increased BP levels. The highest prevalence of elevated BP levels was detected in obese men (55%).Conclusion. Regular preventive medical examinations have the task of health keeping and timely disease prevention. The continuity in the medical care may reduce the incidence of socially significant diseases.

The International Society of Hypertension and the World Hypertension League initiated a blood pressure screening study called May Measurement Month 2019 (MMM19) to improve the detection of elevated blood pressure (BP) and to assess BP control in patients with hypertension (HTN).Aim. To assess adherence to treatment of the hypertensive population according to MMM19 campaign in Russia.Material and methods. During May 2019, 5394 people from 21 regions of Russia took part in the screening. Participation was voluntary and did not imply gender restrictions; all subjects were over 18 years of age. During the screening, BP was measured three times using electronic and mechanical sphygmomanometers, as well as a questionnaire on the diabetes, history of cardiovascular events, smoking, and alcohol consumption was filled. Information was also collected on the date of last BP check and the administration of statins, acetylsalicylic acid and antihypertensive drugs. Data on height and body weight was obtained from respondents.Results. The analysis included data from 5274 participants aged 18 to 96 years (men — 1834 (34,8%)). Median age was 25 years, quartiles — 20 and 49 years. According to MMM19 data, the proportion of HTN patients in the Russian population was 31,9%, and with the exception of participants under 25 years old — 51,5%. Patients with HTN over 25 years old take antihypertensive therapy in 73,6%; 38,6% are characterized by irregular drug intake. Only 11,8% of men and 17,2% of women reach the target blood pressure

The aim of the study was to compare the efficacy and safety of ART regimens, which included TDF or PhAZT, in patients with HIV infection who had not received treatment previously. Patients. The study included 85 adult patients with HIV infection. Group 1 consisted of 60 patients who received TDF/FTC + EFV. The second group included 25 patients who received PhAZT + 3TC + EFV. The study was not randomized, comparative, patient groups were similar in terms of the main indicators. The efficacy and safety of the treatment was assessed during the first 24 weeks of therapy. Results. After 24 weeks of therapy, 74,5% of patients in Group 1 and 87,5% of patients in Group 2 had less than 50 copies/ml of HIV RNA (MITT analysis). The increase in the median CD4 + lymphocytes after 24 weeks of treatment was 143 and 135 cells/μl, respectively. Most of the AE (including all AE that caused change or cancellation of the treatment regimen) were associated with the use of EFV. In 22,4% of patients receiving TDF, transient proteinuria was noted, and in 17,2% – deviation of blood creatinine level deviation of mild severity. The safest drugs included PhAZT, FTC and 3TC. The most frequent AE associated with the use of PhAZT, there was a slight decrease in hemoglobin and red blood cell count. Conclusion. The study conducted in the conditions close to real clinical practice showed that both first-line ART regimens, including TDF or Phosphazide in addition to 3TC (FTC) and EFV antiretroviral drugs, were highly effective and safe during the first 24 weeks of treatment. PhAZT is a drug of choice in the schemes of ART of the first line in the presence of contraindications to the prescription of TDF and/or ABC.

One approach to assessing the competitiveness of invasive species is a comparative analysis of the morphological, physiological, and reproductive traits of this species with native species of the same genus. The invasive species Bidens frondosa L. from the Asteraceae family, included in the list of the 50 most common and most aggressive invasive species in Europe, occupies the same ecological niche as the native species B. tripartita L., and displaces it from natural habitats. There is an obvious and growing interest in the sustainability of B. tripartita and B. frondosa in extreme conditions of existence, one of which is the action of heavy metals. Our research was performed in laboratory conditions with seedlings that developed from seeds collected from populations of the Upper and Middle Volga region. The seeds were germinated in Ni2+ and Cu2+ solutions at various concentrations. At the end of the experiment, morphometric parameters were measured and the index of tolerance was determined. Seedlings from different populations under the influence of nickel ions developed at concentrations of 1–50 mg/l, under the influence of copper ions – at 1–100 mg/l. The nickel and copper ions had the greatest toxic effect on the growth and development of the root system – at 25 mg/l and above, the main root was completely necrotic, while the action of copper ions simultaneously increased the number of adventitious roots. The tolerance index (“root test”) under the action of nickel ions was higher among the seedlings from the population of the Middle Volga region, while under the action of copper ions there were no significant differences among the seedlings from different populations. However, it decreased with the action of both heavy metals at a concentration of 10 mg/l. High concentrations of both metals significantly reduced the length of the hypocotyl, cotyledon, and the true leaf. It was also found that copper ions are more toxic for the root system (main root and adventitious roots), nickel ions – for above-ground organs (hypocotyl, cotyledons, and true leaves). We noted differences between the populations to the action of nickel and copper. From the population of the Upper Volga region, the seedlings of B. frondosa were more stable. For seedlings from the population of the Middle Volga, a smaller toxic effect was confirmed for B. tripartita. It can be assumed that the resistance of B. frondosa to the action of heavy metals as a stress factor in the Upper Volga region is one of the reasons for the suppression of B. tripartita by the invasive species.

Objective. The goal of this work was to study the immunological and virological efficacy of the domestic antiretroviral drug nicavir (at the optimal dose, as proven by previous clinical studies) with lamivudine, in comparison with other drugs of the group of nucleoside reverse transcriptase inhibitors in combination with kaletra in perinatal HIV chemoprophylaxis regimens. Methods. 658 pregnant women aged 16-39 years and children born to them were examined. The first group (281 people) and the third group (66 people) received the nicavir (manufactured by AZT PHARMA KB LLC) with lamivudine in combination with calyx; the second (281 people) and the fourth (30 people) of the comparison group, stag and zidovudine, respectively, with lamivudine in combination with calyx. The effectiveness of CP was assessed from the increase in the number of CD4 lymphocytes, reduction of the viral load, and the number of children born without HIV DNA in the blood. Results. Against the backdrop of the therapy, the viral load below the detectable level and the positive dynamics of CD4 lymphocytes were registered in all examined women prior to childbirth. When applying the scheme of niacavir + lamivudine + kaletra, a more rapid decrease in the level of BH, most pronounced by week 4 of therapy, was found, as compared with the rate of decline of the same index in pregnant comparison groups. Conclusions. The obtained results allow us to consider ART with the inclusion of nicavir effective and recommend its priority use in perinatal prevention of mother-to-child transmission of HIV.

A randomized multicenter 96-week study of an elsulfavirine (ESV), non-nucleoside reverse transcriptase inhibitor (NNRTI) of novel generation, in combination with 2 nucleoside/ nucleotide reverse transcriptase inhibitors (NRTIs) was conducted in naive HIV adult patients, divided by 2 parts: 1) partially blind comparative to efavirenz (EFV) 48-week study, 2) open-label observational study during additional 48 weeks. High virological and immunological effectiveness maintained during the study: proportion of patients with HIV RNA

For the first time a study was conducted of the effects of the change in the concentration of sodium chloride in water on the biomarkers of oxidative stress (enzymes: catalase (CAT), glutathione reductase (GR), glutathione-S-transferase (GST), and the levels of reduced glutathione (GSH), and a marker of peroxidation lipids (LPO) – malonic dialdehyde (MDA)) in the gills of the freshwater mollusc Anodonta cygnea. Adult specimens of A. cygnea of both sexes with a shell length of 70–100 mm were selected for the study, a total of 36 individuals. The molluscs were collected in one of the bays on the southwestern coast of the Volga reaches of the Rybinsk Reservoir (reservoir of the cascade of the upper Volga). The molluscs were kept in the laboratory in aquariums with river water and sand collected from the place of the molluscs' collection. During the experiment, a solution of NaCl 3 g/l in river water was introduced into the container with molluscs. Samples of molluscs’ tissues were taken before application of the saline solution, 40 and 120 min after changing the salt concentration to 3 g/l, and 20 and 60 min after changing the NaCl solution to river water. The change in the concentration of NaCl in water (0–3 g/l) did not affect the content of water-soluble protein in the gills of molluscs during short-term exposure. The change in NaCl concentration in water caused the intensification of LPO processes in the gills of A. cygnea. The change in the activity of the enzymes of the antioxidant system and the increase in the concentration of GSH in A. cygnea gills, indicates their involvement in protecting freshwater molluscs from NaCl-induced oxidative stress. The change in the functioning of the glutathione system may be a compensatory mechanism for changing the NaCl concentration in water. Such biomarkers of oxidative stress as malonic dialdehyde and enzymes of the antioxidant system are sensitive indicators of changes in NaCl concentration in water in freshwater bivalve molluscs, for example A. cygnea.

During fluctuating water levels in the lower reaches of rivers, large areas of shallow water are exposed, forming a zone of temporary flooding (TFZ). The level regime of the water body determines the conditions for the growth of plants, the period available for vegetation of species and the path of seed migration. The seed bank is an integral part of a riparian biocenosis, experiencing the characteristics of environmental factors which influence its structure. Our study of the vegetation cover was carried out by the method of route survey of ecotopes in the estuaries of the Korozhechna and Ild rivers, tributaries of the Rybinsk Reservoir. Species composition of the flora is given in accordance with APG IV. The cenotic structure is characterized in terms of the Brown-Blanke school. To assess the species composition of the seed bank, a transect was placed along the width of the TFZ, on which cores were selected. Flora of the Korozhechny river is represented by 59 species from 24 families and 45 genera. Most numerous families: Poaceae (12%), Cyperaceae (10%), Polygonaceae (10%), Asteraceae, Ranunculaceae and Brassicaceae (by 7%). Flora of the Ild river is represented by 42 species from 18 families and 29 genera. Most numerous families: Cyperaceae (21%), Ranunculaceae (14%), Poaceae (12%), Plantaginaceae (7%). We found two rare species: Carex bohemica – on the Ild river and Ranunculus reptans – on both rivers. The difference in the species composition is explained by the greater riparian area of the TFZ on the Korozhechna river, characterized by a wide low floodplain. Phytocenosis form multicomponent complexes and are represented by associations Scirpetum lacustris, Phalaroidetum arundinaceae, Caricetum gracilis, Phragmitetum communis – on both rivers, Hippuridetum vulgaris и Batrachietum circinati – in terrestrial form on the Korozhechna river, and Eleocharitetum palustris and Oenantho-Rorippetum on the Ild river. In the seed bank composition of the TFZ of the transition zone of the Korozhechna river receiver 25 species were found, Ild river – 30 species. The ecological structure of the flora of both rivers and the seed bank is dominated by species of waterlogged and humid habitats. Their share (hygrophyte and hygromeso-and mesophyte) accounts for about 50%. With prolonged drying, they can normally develop in the TFZ. In the biomorphological structure, the main part of the flora and seed bank species are perennial grasses, characterized by great environmental plasticity, adapted to extreme conditions of habitat, having wide ecological amplitude with respect to the ground and which can withstand considerable fluctuations in the water level. As a result, our work has confirmed that the seed bank is a hidden component of plant communities and reflects the floristic potential of ecologically unstable territories.

Case report of reversible high pulmonary hypertension (PH) in patient with successful kidney transplantation (KT) is presented. The distinction of the case was the functioning arteriovenous fistula (AVF) with excessive blood flow during 15 years in the absence of indications for hemodialysis. Consequently, PH was complicated by serious congestive heart failure (CHF) with high cardiac output. Surgical closure of AVF resulted in complete regression of clinical, instrumental and laboratory signs and symptoms of PH and CHF within 2 weeks. The pathogenic role of excessive AVF blood flow in PH and CHF formation is a point of discussion. Surgical closure of AVF with excessive blood flow is recommended in cases of presence of symptomatic PH and CHF in patients after successful KT.

Aim: to analyze the relationship between circulating anti-HLA antibodies (class-I and class-II), renal pathology and C4d deposition in cases of late acute and chronic antibody-mediated renal allograft rejection according to the method of antibodies detection (ELISA and LUMINEX). Materials and methods. Th e study included 192 patients with indicative graft biopsies (with C4d-staining) and screening detection of anti-HLA antibodies (109 patients by ELISA, 58 patients by LUMINEX, 25 patients – both methods). Patients were divided into 3 groups based on pathology fi ndings: 85 patients with chronic graft rejection, 39 patients with acute antibodymediated rejection (AMR), 68 patients of control group had no signs of AMR. Results. Anti-HLA antibodies (predominantly class-II anti-HLA) were identifi ed in 84.7% of patients with chronic graft rejection, in 84.6% of patients with acute AMR and 33.8% of control group (р < 0.001). Close correlation between the levels of antiHLA antibodies detected by different methods was revealed for both classes of antibodies (r² class-I anti-HLA = 0.773, r² class-II anti-HLA = 0.379, р < 0.01). LUMINEX proved to be more sensitive in anti-HLA antibodies detection in all groups. It was especially signifi cant for the diagnosis of C4d-negative acute AMR whose frequencies were 22.2% and 4.8% in detection by LUMINEX and ELISA, respectively (р < 0.01). On the other hand, anti-HLA antibodies being detected by LUMINEX in 55% of patients of the control group more often required determination of donor specifi city. Conclusion. Screening of anti-HLA antibodies (by ELISA and LUMINEX) along with specifi c renal pathology and C4d deposition is suffi cient for the diagnosis of acute and chronic AMR in most cases. Being more sensitive LUMINEX method is preferable for the revealing of C4d-negative AMR, but it requires specifi c DSA detection in many cases.

Aim. To assess the effects of the multiple-set resistance exercise on the functional status of patients with Stage II essential arterial hypertension (EAH). Material and methods. In total, 40 patients with Stage II EAH, aged 45-55 years, took part in the physical rehabilitation programme, including exercise training on the resistance exercise machine. In the control group, weight lifting was followed by the complete relaxation of involved muscle groups and, therefore, a fast weight lowering. In the main group, the muscle relaxation after weight lifting was only partial, with a slower weight lowering, which resulted in increased lactate production and muscle ache. Ergospirometry, volumetric compression oscillometry, and resistance tests were used. Results. Blood pressure normalization, myocardial contractility increase, and exercise capacity improvement were more pronounced in the main group (p

Целью явилось разработать программу физической реабилитации (ФР) с использованием циклических и силовых тренажеров для больных ГБ 2 стадии. Материалы и методы: обследовано 2 группы пациентов (возраст 45-55 лет). Больные основной группы (ОГ), n=20, занимались на циклических и силовых тренажерах по системе «Изотон», а контрольной группы (КГ), n=20, ФР осуществлялась по классической программе занятий. Тренировочный режим состоял из комбинации циклических (занятия на велотренажере и беговой дорожке) и силовых тренировок. Нагрузка на циклических тренажерах в обеих группах была одинаковой. Отличие между программами ФР заключалось в методике применения нагрузок на силовых тренажерах. Пациенты ОГ тренировались по системе «Изотон», которая состояла в применении стато-динамических упражнений. В КГ занятия проходили по традиционной программе ФР, во время которой не предусматривалось значительного утомления мышц и интенсивных болевых ощущений в них. Результаты: к концу курса ФР у больных исследуемых групп наблюдалось снижение уровня артериального давления (АД). Однако большие сдвиги были отмечены у больных ОГ - снижение на 23,2% систолического АД (САД) и уменьшение на 28,8% диастолического АД (ДАД), в отличие от КГ - 17,6% - САД и 20,5%-ДАД. (р< 0,05). Причем, значимые различия появились лишь, когда в программу ОГ была внедрена методика занятий на силовых тренажерах по системе «Изотон». Сила мышц у пациентов в КГ возросла и достигла статистической достоверности незначительно (в среднем, на 27,1%), по сравнению с ОГ, где прирост силы мышц был более выраженным - на 36,6%. Также после прохождения ФР у больных по данным СЭМ повысилась мощность выполненной нагрузки на 54,7% в КГ и на 27,5% в ОГ. Следует также отметить, что именно после включения в программу силовых тренажеров наблюдался существенный прирост всех показателей (р< 0,05). Причем в ОГ этот прирост выражен наиболее отчетливо (р< 0,05), что доказывает наибольшую эффективность разработанной программы по сравнению с программой, по которой занимались пациенты КГ. Заключение: проведенные исследования показали, что применение в комплексе циклических и силовых тренажеров оказывает существенный гипотензивный эффект у больных АГ, причем более значимые сдвиги были получены у ОГ, занимающихся по системе «Изотон». Тренирующие упражнения на циклических и силовых тренажерах у больных ГБ достоверно приводят к росту силовых показателей мышц и толерантности к физической нагрузке. Применение исследованных ФР с мониторингом состояния кардиореспираторной системы помимо эффективности показало их безопасность у исследованных больных.

Цель: изучить эффективность современных диагностических методов и технологий коррекции функционального состояния организма у больных кардиологического и пульмонологического профиля. Материал и методы: в данной работе были использованы следующие диагностические методы: объемная компрессионная осциллометрия (ОКО), дисперсионное картирование сердца (ДКС), исследование вариабельности ритма сердца (ИВРС) с последующей оценкой вегетативного статуса, спироэргометрия (СЭМ) в качестве пробы с физической нагрузкой, спирография (СГ), исследование газов крови транскутанным методом (ГКТК), биорезонансная технология - МОРА-диагностика. В исследование включено 488 больных кардиологического профиля, 243 из которых страдали ИБС: ПИКС (152 мужчины и 91 женщина, средний возраст 62±4,3 года) и 245 больных АГ (127 мужчин и 118 женщин, средний возраст - 48±5,6 лет), а также 63 больных с респиароторной патологией - бронхиальной астмой (БА) легкой и средней тяжести течения, дыхательной недостаточностью 0 - I степени (29 мужчин, 34 женщины, средний возраст 49±2,6 лет). Больным ПИКС и АГ основной группы проводился комплекс корригирующих технологий: внутривенное лазерное облучение крови (ВЛОК), внутривенная озонотерапия (ВОТ), интервальные ги-поксические тренировки (ИГТ), больные группы сравнения получали низкоинтенсивную накожную лазеротерапию, низкочастотную магнитотерапию, лекарственный электрофорез, больные контрольной группы получали медикаментозную терапию (МТ), сравнимую с основной и группой сравнения. У больных БА применялись методы биоэнер-гомагнитной резонансной терапии - БЕМЕР или ПЕРТ-терапия (основная группа), группа контроля получала МТ, сравнимую с основной группой. Результаты: полученные результаты показали различные аспекты саногенетического воздействия методов ФТ на патофизиологические механизмы у больных ПИКС и АГ - более высокую эффективность ВОТ у больных ПИКС и большее влияние на показатели гемодинамики и регуляции ИГТ у больных АГ. Использование методов биоэнерго-магнитной резонансной терапии у больных БА выявило достоверно значимые положительные изменения по показателям спирограммы, парциального напряжения кислорода крови и толерантности к физической нагрузке по сравнению с контрольной группой. Наблюдалась положительная динамика клинической картины заболевания, что в совокупности с гемодинамическими и другими изменениями у больных ПИКС, АГ и БА нарушениями позволяло уменьшить дозы МТ, снижая тем самым риск развития побочных эффектов и толерантности к лекарственным препаратам. Заключение: современные технологии диагностического мониторинга являются методами точной оценки эффективности программ ВЛ и МР у больных кардиологического и пульмонологического профиля и могут быть рекомендованы для широкого применения в медицинской реабилитации.