[Emotional disorders after stroke]. / Emotsional'nye rasstroistva posle insul'ta.

Emotional disorders are common among patients after stroke. They include anger, fear, emotional expression control (uncontrollable crying, laughing), emotional indifference (apathy), disorders of emotion recognition and emotional empathy. They might develop independently or as a presentation of depression, anxiety, catastrophic reaction, posttraumatic stress disorder etc. Treatment of post-stroke emotional disorders include pharmacotherapy, psychotherapy, neuromodulation.

[The systemic approach to analysis of opinions of patients about medical service].

The maintenance of health of residents of the Northern Regions of Russia, including those living in the Arctic zone of the cbountry, is a condition of its advance development in XXI century. The percentage of Russian citizen vaccinated against the new coronavirus infection (COVID-19) does not exceed 50% after beginning of implementation of vaccination program. It can be conditioned by lower level of both of credence of citizen to health care system and health literacy.Purpose of the study is to establish determinants of vaccination of population against COVID-19 in circumpolar region of Russia as exemplified by the Arkhangelsk Oblast.The sociological survey was carried out using the interview technique of patients of medical organizations (n=433) and conditionally healthy residents of the Arkhangelsk Oblast (n=139). To evaluate the level of general health literacy the Russian version of questionnaire HLS19 - Q22-RU was applied. The most of conditionally healthy respondents and consumers of medical services looked for information about methods of prevention and treatment (80.4% and 58.2% correspondingly), had an experience of vaccination against COVID-19 (79% and 56.3% correspondingly). The relative chances of conditionally healthy respondents, women, and respondents having no children and no credence to national health care system to independently look for information related to COVID-19 is higher at 2.94, 2.08, 1.55 and 1.48-1.57 times correspondingly. The relative chances of conditionally healthy respondents having no children in family and assessing one's economic status as "higher than average" to be vaccinated against COVID-19 is higher at 4.02, 1.52, 1.53 times correspondingly. Availability of experience of vaccination against COVID-19 is conditioned by higher level of general health literacy.In the Arkhangelsk Oblast and other circumpolar regions of Russia the programs of increasing loyalty of citizen to measures of population prevention, including vaccine prevention, is to be implemented with consideration of established determinants of of vaccinations against COVID-19.

[The attitude of medical workers to professional self-education and system of post-graduate medical education in Russia].

The article presents analysis of changes in attitudes of medical practitioners toward professional self-education and barriers to increasing level of education in system of continuing medical education from beginning of its implementation in 2013 to 2020. The most important factor for medical workers motivation is internal factor: more than 90% of respondents indicated acquiring new knowledge and personal development as motivation both in 2020 and in 2014. However, in 2020, 63% of respondents are not ready to pay for their own education. So, medical workers are less interested to invest in their own professional development while interest in obtaining new knowledge and personal growth was soundly expressed. The alarming trend is in the fact that proportion of medical practitioners who consider professionally oriented reading necessary for self-education decreased in 2020. The medical workers also noted mistrust and several subjectively perceived barriers for professional development in the system of continuing medical education.

USE OF 15 MIRU-VNTR GENOTYPING FOR DISCRIMINATING M. TUBERCULOSIS CLINICAL ISOLATES FROM KAZAKHSTAN.

Tuberculosis is one of the main problems of medicine in Kazakhstan. Kazakhstan is on the list of 30 countries with high rates of multidrug resistant tuberculosis in the world. Aim of this study is to conduct genotyping by MIRU-VNTR method to get preliminary data on M. tuberculosis genotypes distributed among the clinical isolates in Kazakhstan. 271 M. tuberculosis clinical isolates were gathered from new cases of tuberculosis from different regions of Kazakhstan in this study. Genotyping was done using 15 MIRU-VNTR (12 MIRU+3 ETR) loci. Obtained digital profiles of the clinical isolates were analyzed using the database on miru-vntrplus.org. Phylogenetic tree was built by UPGMA method. 97 genotypes were identified, 70 (25.8%) of them were unique and were determined in one isolate in the sample collection. The rest 201 (74.2%) isolates were grouped into 27 clusters, that contained from 2 to 102 isolates. According to genotyping results M. tuberculosis Beijing family strains were found in 65.3% cases. 121 out of 177 Beijing isolates (68.4%) were drug-resistant. Prevalence of MDR-TB was detected among drug-resistant Beijing (58.7% - 71/121) and LAM family (50% - 10/20) isolates.

Activated carbon-plasticised agarose composite films for the adsorption of thiol as a model of wound malodour.

Conditions such as diabetes, cardiovascular disease and long-term immobilisation can precipitate the development of chronic dermal ulcers. Such wounds are associated with inflammation and bacterial contamination which in turn can lead to the liberation of offensive odours that cause patient embarrassment and, in some instances, social isolation. Activated carbon-containing dressings have been used to manage the odours from such wounds. However, these can be bulky and can become fouled by wound exudate. Agarose is a natural polysaccharide derived from seaweed that forms brittle free-standing films that can be made pliable by addition of a plasticiser. In this study, activated carbon-containing plasticised agarose films were evaluated for their ability to sequester thiol-containing molecules from solution and the gaseous phase. The water vapour transmission rate was also evaluated to determine the potential breathability of these films should they be considered for application to the skin. It was found that the adsorption of thiols was directly proportional to the activated carbon content of the films. Water vapour was found to pass relatively freely through the films indicating that sweat-induced tissue maceration would be unlikely to occur if applied clinically. In conclusion, activated carbon-containing plasticised agarose films have some potential in the sequestration of malodourous molecules such as those liberated from chronic dermal wounds.

[The implementation of new nursing technologies in the Republic of Kazakhstan].

The study was carried out in Astana and Semeii of the Republic of Kazakhstan to investigate preparedness of paramedical personnel of service of primary medical sanitary care of Kazakhstan for implementation of new technologies for medical nurses. The sampling of survey consisted of 168 of paramedical workers. In the group of paramedical workers involved into independent appointment, 70.2% are ready to implement patronage of healthy children aged before one year and in the group of respondents involved into traditional appointment - 51.4%. To implement screening independently in the group with traditional appointment were ready 45.9% of respondents and in the group with independent appointment - 75.4%. To train patients in schools of health in case of traditional appointment were ready only 27.9% of respondents and in case of independent appointment - 73.7%. The paramedical workers involved into independent appointment are more ready for implementation of innovative technologies whereas respondents involved into traditional appointment were more cautious about innovative technologies and less ready for independent decision making.

Mutations in the pncA and rpsA genes among 77 Mycobacterium tuberculosis isolates in Kazakhstan.

SETTING: Pyrazinamide (PZA), an important first-line drug for anti-tuberculosis treatment, demonstrates potent activity against semi-dormant bacilli in acidic environments. However, the diagnosis of PZA resistance is often impeded by technical difficulties. OBJECTIVE: To characterise mutations in the pncA and rpsA genes among PZA-resistant and PZA-susceptible clinical Mycobacterium tuberculosis isolates circulating in Kazakhstan. The potential use of genotyping to identify PZA resistance was also investigated. DESIGN: PZA drug susceptibility testing and pncA and rpsA gene sequencing were performed on 77 clinical M. tuberculosis isolates; mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) typing was performed on 74 clinical M. tuberculosis isolates. RESULTS: Of the 77 clinical M. tuberculosis isolates, 41 (53.2%) were phenotypically resistant to PZA, whereas 36 (46.7%) were susceptible; 48 (62.3%) of these isolates were also multidrug-resistant (MDR). Furthermore, 38 (49.3%) clinical isolates showed mutations in the pncA gene and its flanking region; the majority of these isolates (n = 36, 94.7%) were also MDR. Gene sequencing showed that only synonymous substitutions affecting rpsA occurred. MIRU-VNTR typing revealed that 78.4% of isolates were of the Beijing genotype. CONCLUSIONS: Sequencing revealed that mutations in pncA, but not in rpsA, occurred in PZA-resistant M. tuberculosis isolates circulating in the territory of Kazakhstan.

[Isolation and characterisation of a new bacillar phytase].

Bacillus ginsengihumi phytase has been firstly isolated and studied from the recombinant Escherichia coli strain cellular lysates. The enzyme was obtained from the cellular lysate, purified till homogeneous condition, primary structure was determined. It's concluded that phytase relates to beta-propeller class of phosphatases. The molecular weight of the protein was 41 kDa, pI was 4.8. Some physical and chemical properties of the enzyme were studied.

[Medical rehabilitation efficiency in chronic dust bronchitis patients].

Medical examination covered 41 workers with long length of service in coal and mining industry, diagnosed as having "Chronic obstructive dust bronchitis", who received a complex of therapeutic and prophylactic measures including traditional broncholytic therapy, physical therapy and exercise therapy. 20 patients of main group received additional complex "Vobenzyme + Vitrum + herbal tea + aeration". Efficiency of medical rehabilitation was assessed through external respiration parameters--maximal effect was seen among the main group members (reliable increase of forced vital capacity, peak flow and maximal flow at 25% forced vital capacity).

[Chrono-pharmacodynamics of capoten in patients with ischemic heart disease, postinfarction cardiosclerosis with cardiac failure]. / Khronofarmakodinamika kapotena u bol'nykh IBS, postinfarktnym kardiosklerozom s serdechnoi nedostatochnost'iu.

Hemodynamic parameters were measured before and 30 min, 1, 2 and 3 hours after intake of 12.5 mg capoten in acute pharmacological test at 7.00, 10.00, 13.00, 16.00, 19.00 and 22.00 in 70 patients with ischemic heart disease, postinfarction cardiosclerosis with heart failure stage I-II. The patients were randomized into 6 groups according to the time of the pharmacological test. As shown by tetrapolar chest rheography, the lowest peripheral vascular resistance and the highest cardiac ejection occurred if capoten was used at 10.00. In contrast, vascular resistance rose and cardiac ejection fell in capoten intake at 13.00. At the other hours circulation responded more favourably than at 13.00 but not so strongly as at 10.00. Different hemodynamic reaction to capoten within 24 hours demands further studies.