[The persistent disability of population in the Russian Federation: analysis and assessment of regional characteristics].

The disability is one of the main indices of public health, along with medical and demographic characteristics, morbidity and physical development that characterizes level of social economic development and is a major problem of health and social care authorities. The availability of statistical data and analysis of problem of population disability will allow to properly plan activities of various administrative bodies. The article presents trends of persistent disability in the Russian Federation during the studied period. In recent years, total number of disabled people has been gradually decreasing. In Russia, most of disabled people have disability group II. At the same time, the percentage of persons with group III increases and proportion of disabled persons with the groups I and II gradually decreases. The children disability in Russia tends to increase. In the Russian Federation, the analysis of regional differences in disability is presented. The analysis and assessment of regional characteristics of disability are necessary for planning and forecasting measures of medical and social support of persons with disability. The analysis of available statistical data permitted to established interdepartmental dissociation on this issue. The results of the study permitted to conclude that the need of increasing attention to the problem of disability results in strengthening interdepartmental interactions and developing of unified register of disabled people.

[About Problems of Palliative Care].

The palliative care is determined as "a complex of medical interventions targeted to deliverance from pain and relief of other severe manifestations of disease, for improving quality of life of terminally ill citizens" (Art. 36 of the Federal Law of 21.11.2011 № 323FZ) on the stage of uncontrolled progression of disease. The actual status and accessibility of palliative care was analyzed, including development of this issue in both the Russian Federation and number of foreign countries. According to the WHO, in Russia, 360-460 out of 100,000 population need palliative care. Out of them, 200 individuals with oncologic diseases, 150 individuals with non-malignant diseases and 12 individuals with AIDS/HIV. The health authorities face the task of significant increasing of scope of palliative care to make it more accessible. In recent years, issues of palliative care were intensively considered at the level of patients, of public organizations and legislators, as well as at the level of physicians, the Ministry of Health Care officials and others. Despite the great attention of researchers to issues of palliative care, the majority of physicians confirm its low accessibility to patients, as testify the results of survey of health workers carried out by the Foundation of Independent Monitoring of Medical Services "Zdorovie". The article also considers issues of normative base regulating palliative care provision and application of narcotic analgesics. The analysis of study results permits to conclude that despite considerable attention to palliative care, the issue of its accessibility continoue to be very actual.

[The Problems of Statistical Registration of Mortality Because of External Causes in Russia].

The physical accessibility of pharmaceuticals considering space-time factors and assortment accessibility is minutely considered on the example of the Sakhalin oblast. The conclusions considering universality of factors of accessibility and availability in every subject are made emphasizing necessity of characteristics to be taking into account. The analysis of factors of accessibility in the subject permits to establish risk zones preventing accessibility of pharmaceutical for population.

[The Scientific Analysis of Factors of Physical Accessibility of Medications as Exemplified by the Sakhalin Oblast. Part II].

The Sakhalin oblast is considered as a detailed example of physical accessibility of pharmaceuticals with regards to time-space factors and assortment accessibility. The conclusions are made concerning universality of factors of accessibility and availability of characteristics to be taken into account in every subject. The analysis of factors of accessibility in the subject permits to establish risk zones preventing accessibility of pharmaceuticals to population.

[A case of unusual sphingomyelinosis]. / Sluchai svoeobraznogo sfingomielinoza.

Sphingomyelinosis in a 1.5-year-old girl with unusual clinicomorphological manifestations without hepato- and splenomegaly is described. The diagnosis was established on the basis of postmortem biochemical examination of the brain.

[Experimental model of generalized herpetic infection in newborns]. / Eksperimental'naia model' generalizovannoi gerpeticheskoi infektsii novorozhdennykh.

Generalized herpetic infection (GI) with a predominant involvement of the brain, eye, liver and spleen, in which cell rhexis and hyperchromatosis and large necrotic foci were observed, has been experimentally reproduced in newborn rabbits. Administration of herpes simplex virus at the dose of 5LD50 resulted in the suppression of immune reactions and animal death 4-5 days later. Dose of 2LD50 resulted in the immune response in the lymphoid organs, but the signs of the disease disappeared 5 days after the injection of the virus. The hypothesis on the existence of several clinico-morphological variants of GI is postulated.

Study of brain and vascular plexus gangliosides in meningoencephalitis of various etiology.

The content of brain and vascular plexus gangliosides and their composition have been studied in 15 cases of meningoencephalitis of various etiology and degree of disease. The most pronounced decrease of ganglioside concentration was found in brain of children, who died from herpes virus infection. Decrease of ganglioside content was revealed in brain grey matter of patients with influenza virus or meningococcus infection, but not in cases of mycoplasma infection. These data provide evidence of nerve cell destruction due to meningoencephalitis of various etiology. The biochemical data obtained are in good agreement with the results of the brain of children infection by herpes virus (increase of GD1b content in grey matter). Ganglioside content in vascular plexes of patients with meningoencephalitis was found to be, on the contrary, much higher (ca 4 times) than in the controls. The higher the lesion of choroid plexes in meningoencephalitis is, the higher the ganglioside content in them is.

[Changes in the levels and composition of glycolipids in various sections of the spinal cord of patients with spinal tuberculosis]. / Izmenenie soderzhaniia i sostava glikolipidov v raznykh otdelakh spinnogo mozga u bol'nykh tuberkulezom pozvonochnika.

The post mortem content and composition of cerebrosides, sulfocerebrosides and gangliosides found in different sections of the spinal marrow of the healthy persons and 5 patients with spinal tuberculosis were analysed. It was shown that the changes in the content of gangliosides were varying in the lesion focus of different patients. In all patients with chronic tuberculous spondylitis, a significant drop in the content of cerebrosides (myelin markers) and sulfocerebrosides in the lesion focus, as compared with controls, was detected. There were some changes found in the content of cerebrosides and gangliosides in the spinal marrow lesion focus, which are also typical of the disease associated with demyelination of the nervous system. The findings suggest that identification of blood anti-cerebroside antibodies in patients with spinal tuberculosis allows one to make an early diagnosis of abnormalities in the cellular structures of nervous tissue in this form of the disease and to predict its course.

Biochemical and immunochemical analysis of gangliosides of human small cell lung carcinoma: production of monoclonal antibodies against a unique marker of small cell lung carcinoma, ganglioside Fuc GM1.

Immunization of mice with a pure preparation of the ganglioside adsorbed on Salmonella typhimurium and hybridization of splenocytes with myeloma P3-X63-Ag 8.653 have resulted in hybridomas producing monoclonal antibodies against ganglioside Fuc GM1, a marker of human small cell lung carcinoma. Characterization of four hybridomal clones and data on the antigenic specificity of the monoclonal antibodies are given. All four monoclonal antibodies reacted only with Fuc GM1 in an enzyme-linked immunosorbent assay. In radioimmunodetection of the antigen on thin-layer plates, two of the four monoclonal antibodies gave cross-reactions with Fuc GD1b. The obtained monoclonal antibodies have revealed the presence of Fuc GM1 in all seven cases of small cell lung carcinoma we have studied and the absence of Fuc GM1 in the normal human lung tissue and in lung adenocarcinomas.

Systematic position of fish species and ganglioside composition and content.

The ganglioside content in brain of cartilaginous and bony fishes studied varies from 110 to 581 and from 104 to 595 micrograms sialic acid per g of wet weight respectively. A high degree of alkali lability and the predominance of C18-sphingosine and N-acetylneuraminic acid are typical of fish brain gangliosides. A high content of oligosialogangliosides with four and more residues of sialic acid and the predominance of gangliosides with gangliotetraosyl carbohydrate chain are characteristic for teleost brain. No pronounced difference was revealed in ganglioside composition and content of clupeomorphs and percomorphs. Gangliosides with short (lactosyl and gangliotriaosyl) carbohydrate chain predominate in brain of all cartilaginous fishes studied. A statistically significant difference was found in ganglioside content, relative oligosialoganglioside content and ganglioside fatty acid composition of squalomorphs and rajiformes, on one hand, and dasyatiformes and galeomorphs, on the other hand.

[Pathological anatomy of herpetic brain lesions in infants]. / Patologicheskaia anatomiia gerpeticheskikh porazhenii golovnogo mozga u detei.

Results of morphological examination of brain herpetic lesions in 29 children are presented. There were 5 observations of necrotic meningo-encephalitis, among children with generalized intrauterine herpes, less severe changes were found in other cases. 14 children suffered from acute necrotic meningo-encephalitis developed after birth. Changes typical for herpes are described in neural, glial and ependymal cells; the type of response in different forms of lesions is shown. The correlation between the gangliosides content in the brain tissue and the surviving neural cells and a specific increase of ganglioside GD1b fraction in brain tissue were demonstrated by biochemical and morphological studies.

[Concentration and composition of cerebral gangliosides in Down's disease]. / Soderzhanie i sostav gangliozidov mozga pri bolezni Dauna.

Content and composition of gangliosides were studied in brain white and grey substances of patients with mongolism. Content of gangliosides, which are typical components of plasmatic membranes of nervous cells, was decreased in brain grey substance of the patients as compared with control group, whereas content of the lipids was increased in white substance. Differentiation of neurones appears to be inhibited in mongolism. Content of disialoganglioside GDIa exceeded the content of other gangliosides in brain white and grey substances in normal state; content of GMI, GTI, GDIb was also increased. Composition of gangliosides from brain of the patients with not distinctly altered as compared with that of children of control group.

[Problem of toxoplasmosis]. / K probleme toksoplazmoza.

The paper presents brief characteristics of the causative agent and methods of its detection in tissues. The time course of the development of morphological changes in the central nervous system (CNS) is characterized on the basis of the authors own studies. In particular, the possibility of formation of congenital CNS defect upon intrauterine infection with toxoplasma has been demonstrated. A direct correlation between the results of morphological and biochemical examinations of the CNS has been found. A case of toxoplasmosis developing postnatally as a result of exogenous infection with a description of the primary focus in the lungs is presented.