Drugs used in the treatment of alcohol intoxication can have a toxic effect on the cardiovascular, central nervous and digestive systems, which can lead to death, most often occurring at night, which is caused by the predominant tone of the parasympathetic division of the autonomic nervous system, and needs experimental study using chronopharmacological methods. The inclusion of antioxidants in the scheme for the relief of alcohol intoxication contributes to a significant reduction in the pathological effects of depressants used in the standards of treatment of alcoholic disease. The study examined the effect of two groups of drugs and their combinations on pain sensitivity and behavioral reactions of aggression in rats with a formed model of chronic alcoholism. The process of selecting the most rational combinations of drugs for the treatment of patients with alcohol dependence has been carried out. Purpose of the study: To reveal the chronopharmacological features of the effects of certain psychotropic drugs and their combinations on the CNS of laboratory animals in a model of chronic alcoholism. Animals, after 10 days of alcoholization, received saturation with two drugs with a psychotropic effect and their combinations (droperidol, ethylmethyldihydrooxypyridine succinate (hereinafter, ethylmethyldihydrooxypyridine succinate), droperidol + ethylmethyldihydrooxypyridine succinate). Animal behavior was studied using the Hot Plate method. When studying the rhythm of sensitivity to electrothermal stimulation, desynchronization was noted against the background of Mexiprim, which has a direct physiological effect on the sensitivity of laboratory animals to changed conditions, bringing it closer to normal (as in intact animals), due to the fact that it refers to stimulants of the central nervous system, the fact of which is confirmed by the literature data. It was noted that droperidol has a depressant effect on the central nervous system, synchronizing pain sensitivity and aggression reactions, aggravating this process against the background of alcoholism. When conducting a histomorphological study of liver tissue, a negative effect on hepatocytes of droperidol was established against the background of chronic alcohol intoxication, in contrast to its use in combination with ethylmethyldihydrooxypyridine succinate, when a decrease in the affected areas of liver tissue can be observed with its gradual recovery and approach to a healthy structure.

The aim of the research is to study emotional-personal and cognitive disorders in patients with alcohol dependence and their psychocorrection, considering gender aspects. The tasks of the research are: to study the personal characteristics of patients with alcohol dependence, to identify specific emotional and personal characteristics for patients, depending on gender; compare cognitive functions in alcohol dependence, considering gender characteristics; to determine the factors influencing the formation and development of alcohol dependence; develop recommendations for psychoprophylactic effects in the complex rehabilitation of patients, depending on gender characteristics. The object of the research were 140 people with alcohol addiction, who were treated at the Republican Special Scientific and Practical Medical Center for Narcology. The scientific novelty of the research:deformation of the psychological characteristics of women under the influence of alcohol occurs according to the masculine type, and the personality of men changes towards an increase of feminine traits; in patients with alcoholism were found gender differences in the form that in women there are a deterioration in the processes of short-term memory, on the other hand in men usually there are a violation of attention; proved the possibility of early psychoprophylaxis of alcohol dependence on the basis of clinical and socio-biological factors; pathocharacterologically substantiated differential approach to psychotherapy in patients with alcohol dependence, taking into account gender characteristics. Implementation of the clinical research results.This аalgorithm for the psychotherapeutic correction of emotional-personal disorders in patients with alcoholismcan increase the effectiveness of the treatment of patients with alcohol dependence by using psychopharmacotherapy. The introduction of research results into clinical practice has made it possible to reduce the level of relapses and increase the effectiveness of the treatment of alcohol dependence in patients.

The previously unknown diseases of chronic fatigue syndrome and professional or emotional burnout syndrome that appeared in many highly developed countries of the world have a lot of similar symptoms: complaints of overwork, weakness, emotional disturbances, depression, sleep disturbances, headache. As a result of various reasons, there is a spasm of cerebral vessels and a violation of blood circulation throughout the body. Tissues and organs are poorly supplied with blood, metabolism is greatly impaired, and the patient feels lethargic and gets tired quickly. After the overwork of the body, intellectual fatigue begins to set in – the patient becomes distracted, memory and concentration deteriorate. Therefore, the term «myalgic encephalomyelitis» has become synonymous with the syndrome, which means an inflammatory process in the brain, which is manifested, among other things, by muscle pain. According to the «depressive» theory, CFS is simply a variant of this mental disorder. With chronic fatigue syndrome, the nervous system and the general muscle tone of the body are primarily affected. The most common chronic fatigue syndrome among adults, the peak incidence occurs at the active age of 40-59, but adolescents also get sick. Approximately 80% of all cases remain undiagnosed. A thorough clinical examination often fails to reveal any objective abnormalities. We propose to diagnose and objectify these conditions, in addition to special tests, to use in practice standard psychodiagnostic tests, combined in three areas of research – 3D testing. This allows you to optimize the diagnosis, treatment tactics and assessment of the dynamics of diseases. 1 direction – self-assessment of physical, behavioral, social symptoms; 2 direction – standard tests to identify problems in the cognitive-mnestic sphere; 3 direction – assessment of emotional sphere using standard tests-feeling of loneliness, anxiety. It is important to provide an opportunity to study the dynamics of the state through further research using more sensitive tests.

Within the framework of a cross-sectional analytical study, the structure of cognitive function disorders and psychoemotional status in children with delayed psychoverbal development was determined. 132 children aged 5-11 years were examined: 58% boys and 42% girls. Diagnostics was carried out using a computer psychophysiological complex «Psychomat-99». Methods for studying the sensorimotor reaction, dynamic and static coordination, correction test, Mnemotest and Luscher's test were used to assess the psycho-emotional state. Structural analysis of children with delayed psychoverbal development verified that the most pronounced insufficiency is noted in the speech function – in 98%, a deficit in auditory speech memory is detected in 73%, voluntary attention – in 63%, a lack of visual-spatial memory in 67%, visual-spatial perception – in 59%, thought disorders – in 50%. Less common are violations of executive functions (38%) and emotional sphere (14%). A detailed assessment, taking into account the etiopathogenetic factor of delay in psychoverbal development, revealed that patients with genetic pathology often have problems in the amount of voluntary attention, visuospatial memory, visuospatial perception and thinking. In children with organic lesions of the central nervous system, more often than in other groups, the ability to formulate a speech statement is preserved. Speech delay in these cases is characterized mainly by disturbances in sound pronunciation, in particular dysarthria and dyslalia. In patients with developmental delay with an established psychiatric diagnosis, there is a more pronounced cognitive deficit in comparison with other groups in all areas of intelligence. The use of computer test systems helps to objectively assess the intellectual level of children with mental retardation. The form of testing makes it possible to more effectively keep patients' attention on completing tasks than when using paper media in the process of neuropsychological examination on the computer psychophysiological complex «Psychomat-99». The advantages of computer test systems also lie in the uniformity of the provision of material and the minimization of the subjective component in the interpretation of the results of the study. Domestic, highly informative device for testing «Psychomat-99» can be recommended for use in practical children's health care.

Mucocutaneous bleeding and thrombocytopenia are commonly encountered in pediatric patients. It is important for pediatricians to recognize when these signs and symptoms warrant further investigation and subsequently what investigations are most helpful and when referral to pediatric hematology is necessary. The most important part of an evaluation for a platelet disorder in a well-appearing child is the history, including family history, and physical examination. Platelet function test for children is a highly demanded investigation. The cornerstone laboratory test is the complete blood cell count. Individual laboratories may vary in their reference ranges for platelet count, but the normal range of platelet count remains 150 to 450 × 10⁹/л. Platelet dysfunction is often not diagnosed, since of throm bocytopathies in most cases do not have clear symptoms, in some cases clinical manifestations of platelet dysfunction are even absent. Meanwhile complete blood count cannot completely reflect changes in the patient's platelet step of hemostasis. For more comprehensive assessment of platelet function in the initial step of the hemostasis it is necessary to evaluate the function of platelets in the whole blood. Whole Blood Impedance Aggregometry measures the change in electrical impedance between two electrodes when platelet aggregation is induced by an agonist. The method is performed using whole blood and so eliminates the need to generate platelet rich plasma. Platelet function testing may have a role to optimize antiplatelet therapy to reduce bleeding and ischemic events. Platelet aggregation function tests with different inductors make it possible to estimate the effectiveness of antiplatelet therapy, select individual doses of drugs and conduct drug monitoring. Platelet aggregation in patients on the antiplatelet therapy is induced by inductors: arachidonic acid (ASPI test), adenosine diphosphate (ADP test) and thrombin (TRAP test). The high prognostic significance of the Impedance Aggregometry results makes it possible to decide on the drug of choice for patients after thrombosis and intravascular interventions, as well as to prevent bleeding during and after surgical procedures.

For the purpose of studying the immunopathogenesis and the search for novel biomarkers for the assessment of syphilitic infection activity, we analyzed B1 cells, that are responsible for basal protection and primary immune reactivity and for generating broad specificity antibodies, and estimated the frequency of occurrence of different autoantibodies. B1 cells are an innate subpopulation of B cells in the fetal hematopoiesis responsible for natural antibody production in the absence of exogenous stimulation. The protective function of B1 cells is to provide protection during the lag phase, the latent period necessary for the deployment of adaptive/acquired immunity mechanisms upon encountering an infectious agent, and in the regulation of subsequent immune responses. B1 cells produce antibodies that bind with low affinity to microbial structures common to various pathogens. Subsequent contact with the antigen leads to an increase in affinity, an increase in antibody titer and the formation of their stable level. Peripheral blood levels of B1(CD19⁺CD5⁺) cells were evaluated using flow cytometry in 96 patients with syphilis. Elevated proportions of B1 cells relative to all B lymphocytes have been documented in 44% (95% CI 34-55%) patients. No significant difference was seen regarding clinical form of the disease, gender, age, HIV coinfection, Jarisch – Herxheimer reaction, and antibody titres of non-treponemal tests. There was no statistical correlation between B1 cells and other B- and T-cell subsets. Antibodies against oxidized low-density lipoprotein and cardiolipin were detected more frequently than antibodies against mitochondrial antigen M2, modified citrullinated vimentin, cyclic citrullinated peptide, nuclear antigens, myeloperoxidase, proteinase 3, Fc portion of immunoglobulin G. Overall, the results indicate that B1 cells and phospholipidspecific antibodies are involved in the immune response in syphilis. Improving understanding of the immune response to Treponema pallidum may help develop new diagnostic approaches.

The urgency of the problem of pressure ulcers does not decrease, despite the achievements of modern medicine. Pressure ulcers occur both in hospital patients and in patients receiving treatment at home or in long-stay institutions. The main reason for the high prevalence of pressure ulcers is the aging of the population and an increase in patients with comorbid pathology. A pressure sore is a localized injury to the skin and/or underlying tissue that typically occurs over a bony prominence, usually as a result of long-term pressure or pressure combined with shear or friction. The most common sites for pressure ulcers are the skin covering the sacrum, coccyx, heels, and thighs, although other areas may be affected: knees, ankles, back of the shoulders, or back of the skull. From a clinical point of view, a bedsore can be described as an ulcer resulting from pressure. It is believed that the most important factors contributing to the formation of pressure ulcers are continuous pressure, displacement forces, friction and moisture. A large role in the development of ulcers is also played by the limited motor activity of patients, inadequate nutrition and care. In this article, pressure ulcers are considered as a multidisciplinary problem that doctors of various specialties must face. The most effective method of dealing with pressure sores is preventive measures. Modern prevention of bedsores includes a number of areas and should take into account the patient's condition, as well as the capabilities and qualifications of medical personnel. The main goal of the treatment of bedsores is to restore the integrity of the skin, while the tactics of management are largely determined by the staging of the pathological process. Complex treatment of pressure ulcers depends on their stage and includes both pharmacological effects and surgical intervention. One of the components of the treatment of pressure ulcers is to provide nutritional support with integral mixtures enriched with arginine, vitamins, antioxidants, and the micronutrient zinc.

Influenza is one of the most significant medical and economic health problems worldwide due to the high level of morbidity and contagiousness, which leads to large economic losses. Influenza is widespread everywhere, affects all groups of the population, causing the development of epidemics and pandemics. Influenza viruses, especially type A virus, have many subtypes with different combinations of the main surface antigens – hemagglutinin and neuraminidase. Various epidemic subtypes of influenza caused by type A virus are the reason for the annual rise in morbidity. Influenza is a serious danger for people at risk, which can include people suffering from a number of chronic diseases for a long time, such as diseases of the cardiovascular system, respiratory tract (including bronchial asthma), various metabolic disorders, primary and secondary immunodeficiency conditions, malignant neoplasms, as well as the same pregnancy, especially in the third trimester. So, for example, high susceptibility to influenza in people suffering from bronchial asthma is due to specific pathogenetic processes associated with the defeat of the epithelium of the respiratory tract by an infectious agent, suppression of the activity and functional ability of macrophages and T-lymphocytes, which in turn can significantly increase the risk of secondary bacterial flora joining, and as a consequence a more severe course of the infectious process with the development of various complications. The analysis presented in this article of a clinical case of severe influenza A in a pregnant woman suffering from bronchial asthma for a long time is a good example of how the immunocompromised and comorbid background of patients affects the severity and form of the flu course. In the article, the authors noted that early detection of influenza and the appointment of adequate complex therapy helps to reduce the frequency of occurrence and manifestation of complications. The authors also emphasized the special importance and leading role of timely and mass vaccination of the population, and first of all those at risk, which leads to a decrease in the growth of morbidity and the spread of the epidemic process. However, despite the existence of specific prevention, the incidence of influenza remains high, which once again indicates the importance of the problem and the need to update the measures necessary to reduce the intensity of the epidemic process.

Violation of the sense of smell until recently did not belong to the most urgent problems of medicine. However, with the advent of the pandemic caused by the SARS-CoV-2 virus, the interest of researchers and clinicians in olfactory dysfunction has increased many times around the world, which is explained by the highest incidence of dysosmia in COVID-19 – up to 50% of the total number of cases. According to the European consensus documents on rhinosinusitis and nasal polyposis, impaired sense of smell along with difficulty in nasal breathing, abnormal nasal discharge and headache are among the most common subjective signs of acute rhinosinusitis. According to expert estimates, the frequency of olfactory dysfunction in such patients reaches 14-30%. More than 80% of patients with acute sinusitis indicate a concomitant olfactory disorder. It usually recovers on average within two weeks from the onset of the disease. Dysosmia in patients of this group in 60-80% of cases is not accompanied by destruction of the olfactory epithelium, but is associated with edema of the mucous membrane and hypersecretion of mucus, which leads to the closure of the lumen of the narrow olfactory fissure. As part of this work, from June 2020 to December 2021, 32 patients aged 29 to 52 years (21 men and 11 women) without neurological diseases with postviral anosmia were under observation. Complaints about the complete lack of smell, discomfort in the root of the nose, nasality and the results of subjective olfactometry made it possible to establish the diagnosis of conductive anosmia in all patients. The patients received antibacterial therapy with a semi-synthetic third-generation cephalosporin antibiotic. In addition, the course of outpatient treatment included anemization of the upper sections of the nasal mucosa and physiotherapy. All patients tolerated the treatment well, no side effects were recorded. After a week, all patients noted an improvement in nasal breathing, the disappearance of nasality, and an improvement in the sense of smell. In the future, patients were recommended to independently conduct olfactory training for 3-4 months: inhalation of essential oils of rose, eucalyptus, lemon, clove, jasmine, orange and coffee.

The COVID-19 coronavirus pandemic is significant for modern medical science and practice. Patients with concomitant pathology during the COVID-19 pandemic, in particular arterial hypertension, require special attention, as they are among the most vulnerable groups to this infection. This requires optimization of diagnostic and clinical approaches to helping patients with this pathology. In this regard, the study of the course of the infectious process COVID-19 in patients with hypertension is of scientific and practical interest. On the basis of the State Budgetary Healthcare Institution S. P. Botkin City Clinical Hospital of the Moscow Department of Health 145 patients with COVID-19 were under observation, 91 of whom had a coronavirus infection combined with arterial hypertension, 54 patients had no arterial hypertension. All patients underwent a comprehensive clinical and laboratory examination and clinical follow-up in dynamics. The course of COVID-19 coronavirus infection in patients with arterial hypertension is characterized by the development of more severe pneumonia (in 5,5% of patients with hypertension, lung lesions are diagnosed with computed tomography of more than 3 degrees) and more pronounced respiratory failure in a larger number of patients (in 8,8% with hypertension, infection was accompanied by the development of respiratory failure of 2 or more degrees). Patients with hypertension had higher rates of CRP, ferritin and glucose, while changes in the leukocyte formula were comparable between the groups. The dynamics of the level of postinfectious IgG class antibodies was characterized by a gradual decrease in their level during the year, while in patients with COVID-19 occurring against the background of hypertension, higher rates of postinfectious IgG class antibodies were observed on average in the first months after infection. The development of coronavirus infection COVID-19 in patients with particular arterial hypertension requires special attention from the doctor, due to the risk of developing a severe form of infection.

The purpose of this study was to consider the economic aspects of the rehabilitation of patients with maxillofacial defects carried out on the basis of the Clinic of Professor Nikolaenko, the Medical and Production Center Epitetika, Krasnoyarsk and the Krasnoyarsk Regional Clinical Oncological Dispensary named after. A. I. Kryzhanovsky, with the support of the Krasnoyarsk regional science fund. Maxillofacial defects can be caused by trauma or be congenital, but up to 80% of facial defects are the consequences of neoplasms in the head and neck and their surgical removal. For the rehabilitation therapy of forty-two patients suffering from defects in the maxillofacial region, epitheses of various designs were made. Silicone elastomers were used as a material using CAD/CAM technologies. Epithesis was fixed using special adhesive materials and magnetic attachments. The age of the patients ranged from 11 to 77 years, including 27 men (64,3%) and 15 (35,7%) women. The conducted studies have shown good results in the restoration of maxillofacial defects from an aesthetic and functional point of view. Taking into account the individual approach for each manufactured epithesis, as well as due to the high cost of the materials used (titanium implants, mesostructure, medical silicone, etc.), the cost of one patient's rehabilitation can be more than 1,500 thousand rubles. depending on the type of epithesis and method of fixation. Specialists of the Medical and Production Center Epithetika developed and patented a universal system for fixing the epithesis of domestic production with full import substitution of materials and works. This approach allows to reduce the cost of rehabilitation systems for patients with maxillofacial defects using epitheses by more than 30%. At the same time, the cost does not depend on the exchange rate, Western sanctions and the political situation in the world. The best option is to include a full range of rehabilitation in the list of services provided by the Russian Compulsory Medical Insurance Fund.