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The purpose of the study was to describe the types of non-beverage alcohol consumed, to evaluate socio-demographic factors associated with its use and to establish effectiveness of the alcohol policy measures taken since 2005 and targeted on reducing non-beverage alcohol consumption. From December 2015 to April 2017, 302 patients of the narcological dispensary were interviewed. The prevalence of non-beverage alcohol drinking among those who reported on their non-beverage alcohol consumption status amounted to 75.8% among males and 57.7% among females. The highest prevalence of non-beverage alcohol consumption (86.9%) was identified among males employed in irregular paid work. According to multivariate analysis, the factors positively associated with the use of non-beverage alcohol were male gender (OR 2.48, 95% CI 1.14-5.43), employment on irregular paid work (or 5.0, 95% CI 2.16-11.56), unemployment in case of seeking work (or 3.55, 95% CI 1.45-8.71), unemployment in case of non-seeking work (OR 3.90, 95% CI 1.09-13.95). The types of non-beverage alcohol used for drinking included medicinal tinctures in 25, 40 and 100 ml vials, spirit cosmetic lotions, colognes, technical/medical ethanol, hygienic spirit solutions, alcohol-containing food flavor enhancers. The lower price as compared with conventional alcoholic beverages was indicated as main reason of non-beverage alcohol consumption (61.7%). The enhancement of previously introduced restrictive measures as well as the implementation of new legislative initiatives are required for more effective control of non-beverage alcohol consumption.

The article presents the analysis of organization of chemical-toxicological service and in the Khanty-Mansi Autonomous Okrug-Yugra. The introduction of three-level system for provision of addiction medical care of population and implementation of the principle of zoning made it possible to organize three-level system of chemical-toxicological service that permitted to achieve equal access to chemical-toxicological and addiction care services in all territories of the region. The investments in chemical-toxicological laboratories, supply of modern equipment, advanced training of laboratory specialists, cooperation with leading research centers and professional communities outside of the region allowed timely and accurately identify psychoactive substances, prompt response in cases of mass poisoning with novel psychoactive substances, and quick introduction of advanced methods of chemical-toxicological examination to the medical organizations of the large industrial northern region of Russia.

The article presents the analysis of drug abuse situation in municipalities and districts of the Khanty-Mansi Autonomous Okrug - Yugra (KHMAO-Yugra) in 2017-2018, as well as the dynamics of changes of the drug abuse situation in KHMAO-Yugra as a whole in 2015-2018. By 2018, the drug abuse situation in the KHMAO-Yugra improved as compared with previous years of the study period and corresponded to the "tense" level, which indicates the need to continue systematic and targeted intersectoral work aimed at reducing morbidity and mortality associated with the use of drugs and psychoactive substances in this northern region of Russia.

The efficient and rational support of quality om medical care rendering is an important aspect of the system of organization of health care functioning. The study considers the development of concept of patient-oriented model of medical care rendering and also system analysis of main parameters of the model. The study was based on the analysis of publications and normative legislative documents of Minzdrav of Russia and the Federal Foundation of mandatory medical insurance, control boards of health care and territorial Foundations of mandatory medical insurance, subjects of the Russian Federation. The comprehensive analysis resulted in formulation of main parameters and propositions of the patient-oriented model. The concept of related model of organization of medical care rendering to population was presented too. The implementation of the proposed concept in case of its appropriate implementation will favor amelioration of clinical outcomes, increasing of satisfaction and compliance of patients, that will permit to optimize organization of medical care rendering.

Objective: To determine the role of serum Klotho (s-Klotho) protein levels changes in patients with different stages of chronic kidney disease (CKD)., Methods: The study involved 130 patients with CKD stages 1–5D (mean age ― 41±6.7 years). Serum levels of parathyroid hormone (PTH), calcium, phosphorus and s-Klotho protein (ELISA method) at baseline and after 1 year of follow-up were examined in all the patients so as the blood pressure (BP), including central (aortic), pulse wave velocity ― with the help of «Sphygmоcor» (Australia), echocardiography, radiography of the abdominal aorta in a lateral projection were also performed., Results: Ehen comparing the s-Klotho levels in patients with different CKD stages, it was found that the level change associated with the reduction of glomerular filtration rate (GFR) ahead of phosphorus and PTH increase in serum, stared at 3A CKD, whereas hyperphosphatemia and PTH increase started at 4–5 CKD stages. According to ROC analysis, decreasing of s-Klotho levels below 387 pg/ml was indicated a calcification risk of abdominal aorta increased with an 80% sensitivity and 75% specificity. In addition, a strong negative relationship of low s-Klotho levels and heart remodeling was found. When comparing the patients with hypertension who were receiving antihypertensive monotherapy, the highest serum levels of Klotho protein were observed in those of them whose target blood pressure level was achieved primarily through Angiotensin II Receptors Blockers (ARB), compared to those who was administered another drug group (p<0.01) or has not reached the target blood pressure level (p=0,008)., Conclusion: The change of serum Klotho levels (decrease) in CKD progression is associated with the degree (increase) of cardiovascular calcification and remodeling (the development of left ventricular hypertrophy, and cardiomyopathy) and it can be seen as an early independent marker of the cardiovascular system lesions in CKD. Our preliminary data of the effect of blood pressure correction on s-Klotho levels may indicate the possibility of drug maintaining serum Klotho levels and it requires further research.