[Efficiency evaluation of the Neuromidin in the treatment of pain of the patients with discogenic lumbosacral radiculopathy: results of a multicenter post-registration prospective open comparative trial]. / Otsenka effektivnosti Neiromidina pri lechenii bolevogo sindroma u patsientov s diskogennoi poyasnichno-kresttsovoi radikulopatiei: rezul'taty mnogotsentrovogo postregistratsionnogo prospektivnogo otkrytogo sravnitel'nogo issledovaniya.

OBJECTIVE: Evaluation of the effect of Neuromidine on the dynamics of pain syndrome in the treatment of patients with discogenic lumbosacral radiculopathy. MATERIAL AND METHODS: Patients with a confirmed diagnosis of discogenic lumbosacral radiculopathy no more than one year old and moderate intensity of pain syndrome on a visual analog scale were included in the main group (OH, n=62, age - 53.1±15.6 yrs) and the comparison group (HS, n=40, age - 53.7±12.9 yrs). OG patients received Neuromidine (15 mg/1 mL 1 once a day IM for 10 days, then 20 mg 3 times a day for 8 weeks) in addition to the standard drug therapy, HS patients received only standard drug therapy. The duration of the study was 8 weeks. The degree of decrease in the intensity and dynamics of pain syndrome, activity and frequency of pain in the lumbar spine, changes in the level of physical activity, and the severity of emotional disorders were evaluated. The level of inflammatory markers in the blood and the dynamics of monosynaptic spinal H-reflex parameters were evaluated. RESULTS: Before the study, there were no statistically significant differences there were no results of clinical and laboratory-instrumental examination between groups. After 8 weeks, the reduction of pain by VAS in the main group was statistically significant in contrast to the comparison group (p=0.0001). In the main group there was a statistically significant increase in the mean cognitive impairment score (p=0.0029), as well as an improvement in psycho-emotional state with a significant decrease in GAD-7 (p=0.0002) and PHQ-9 (p=0.0096). After 8 weeks of therapy, IL-6 level in the main group was statistically significantly lower (p=0.0027) than in the comparison group. The results of H-reflex study revealed an increase in its amplitude and some shortening of latency at the end of Neuromidine therapy. The drug had no undesirable side effects and was well tolerated. CONCLUSION: Administration of Neuromidine 15 mg/1 ml once a day intramuscularly for 10 days followed by 20 mg 3 times a day for 8 weeks has an effective analgesic effect as adjuvant therapy in patients with discogenic lumbosacral radiculopathy. The inclusion of Neuromidine in the complex treatment of patients with pain syndrome in discogenic radiculopathy is superior in efficacy to standard drug therapy.

[A comparative assessment of microbiocenosis of saliva and oropharynx in patients with migraine]. / Sravnitel'naya otsenka mikrobiotsenoza slyuny i rotoglotki u patsientov s migren'yu.

OBJECTIVE: To identify changes in the microbiome of saliva and to compare it with the microbiome of the oropharynx of patients with migraine. MATERIAL AND METHODS: Sixty patients with migraine (21-56 years old), were examined using a headache diary, MIDAS and VAS. A microbiological examination of saliva and smear from the mucosa of the posterior wall of the oropharynx with evaluation by the method of mass spectrometry of microbial markers (MSMM) with the determination of 57 microorganisms was performed. All patients had comorbid chronic diseases of the gastrointestinal tract and upper respiratory tract (URT), according to anamnestic data and examination by specialists. RESULTS: A significant increase in the content of markers of resident (conditionally pathogenic) microorganisms characteristic of chronic diseases of URT (strepto- and staphylococci); markers of transient microorganisms characteristic of intestinal microflora (clostridia, gram-negative rods, anaerobes) that are normally absent; viral markers of cytomegaloviruses and herpes groups; a decrease in the content of fungi were identified in saliva. A comparative analysis of the microbiome of saliva and oropharynx showed: 1) a significant decrease in the concentration of coccal flora Enterococcus spp., Streptococcus mutans, Staphylococcus aureus, anaerobic bacteria Clostridium difficile and Clostridium perfringens in saliva; enterobacteria Helicobacter pylori; gram-negative rods Kingella spp., fungi and Epstein-Barr virus; 2) an increase in salivary concentrations of Staphylococcus epidermidis, anaerobic Clostridium ramosum and Fusobacterium spp./Haemophilus spp. and gram-negative bacilli Porphyromonas spp. CONCLUSION: A comparative assessment of the microbiota of a smear from the posterior wall of the oropharynx and saliva using MMSM showed the presence of dysbiosis both in the oropharynx and in the saliva of patients with migraine. However, there were fewer deviations from the norm in saliva, therefore, for diagnostic purposes, a smear from the posterior wall of the oropharynx is more significant as a biomarker for patients with migraine.

[Role and place of ipidacrine in the therapy of diseases of the peripheral nervous system. The resolution of the expert council]. / Rol' i mesto ipidakrina v terapii zabolevanii perifericheskoi nervnoi sistemy. Rezolyutsiya Soveta ekspertov.

The resolution of the expert council is devoted to discussing aspects of the use of ipidacrine for the treatment of mononeuropathies, polyneuropathies and radiculopathies of various etiologies. Specialists prepared recommendations for ipidacrine's application in treating peripheral nervous system disorders.

Light antiproton one-electron quasi-molecular ions within the relativistic A-DKB method.

In the present work, two quasi-molecular compounds each involving one antiproton and one electron (p̄), He+-p̄ and H-p̄, are investigated. Using completely relativistic calculations within the finite-basis method adapted to systems with axial symmetry, the adiabatic potential curves are constructed by numerically solving the two-center Dirac equation. The binding energies of electron are obtained as a function of the inter-nuclear distance and compared with the corresponding nonrelativistic values and relativistic leading-order corrections calculated in the framework of other approaches. A semantic analysis of antiproton quasi-molecular ions with compounds containing a proton (p) instead of an antiproton is given. The advantages of the A-DKB method are demonstrated.

[A modified technique for expanding the attached keratinized gingiva zone using a free gingival graft "Danilov`s medallions"]. / Modifitsirovannaya metodika rasshireniya zony prikreplennoi keratinizirovannoi desny s pomoshch'yu svobodnogo desnevogo transplantata «medal'ony po Danilovu¼.

On a clinical example a modified technique for increasing the width of the attached keratinized gingiva zone is presented by taking medallions of a free gingival graft 1.5-2 mm thick from the hard palate using 5 mm mucotomes and transplanting them into the gum defect zones with a simultaneous vestibular deepening in the lateral regions of the jaws. This technology has been tested over a 5-year period with long-term clinical results.

[The role of food allergy as a provoking factor of migraine]. / Rol' pishchevoi allergii kak provotsiruyushchego faktora migreni.

OBJECTIVE: To assess the effect of food allergies on the course of migraine. MATERIAL AND METHODS: Seventy patients with migraine, aged 21-56 years old, were examined using headache diary, MIDAS and VAS, studies of specific antibodies of the IgG4 class (delayed type food allergy) by immuno-enzyme analysis (ELISA), microbiological examination of a smear from the mucous membrane of the posterior wall of the oropharynx with mass spectrometry of microbial markers (MSMM) with the identification of 57 microorganisms. RESULTS: We found an increase in specific IgG4 for a number of food allergens in most patients with migraine, of which 48.5% had a pronounced increase in IgG4 (>150 kEd/l) for at least one allergen (cow's milk - 13% patients, wheat flour - 5%, egg white - 47% or yolk - 26%, quail egg - 15%, sweet pepper - 6%), in 29% of people to several food allergens at once (all of them had chicken egg protein as one of the allergens). There was the association of IgG4 titers to wheat allergen with the severity of headache according to VAS (r-S=0.7; p=0.0046) in patients with the most severe, chronic migraine (17 people) and with an imbalance of the oropharyngeal microbiota, namely, concentration of pathological viruses Herpes spp. (rs=0.29; p=0.02), Epstein-Barr (rs=0.46; p=0.0002) and microscopic fungi (rs=0.39; p=0.0016), detected in these patients. CONCLUSION: We show for the first time the relationship between delayed-type food allergy and redistribution in the microbiome of the oropharynx of patients with migraine and once again confirm the role of delayed-type food allergy as a clinically significant factor influencing the course of migraine (its intensity and chronicity).

Quantum bath suppression in a superconducting circuit by immersion cooling.

Quantum circuits interact with the environment via several temperature-dependent degrees of freedom. Multiple experiments to-date have shown that most properties of superconducting devices appear to plateau out at T ≈ 50 mK - far above the refrigerator base temperature. This is for example reflected in the thermal state population of qubits, in excess numbers of quasiparticles, and polarisation of surface spins - factors contributing to reduced coherence. We demonstrate how to remove this thermal constraint by operating a circuit immersed in liquid 3He. This allows to efficiently cool the decohering environment of a superconducting resonator, and we see a continuous change in measured physical quantities down to previously unexplored sub-mK temperatures. The 3He acts as a heat sink which increases the energy relaxation rate of the quantum bath coupled to the circuit a thousand times, yet the suppressed bath does not introduce additional circuit losses or noise. Such quantum bath suppression can reduce decoherence in quantum circuits and opens a route for both thermal and coherence management in quantum processors.

[The state of the oropharyngeal microbiome in patients with migraine]. / Sostoyanie mikrobioma rotoglotki u patsientov s migren'yu.

OBJECTIVE: To determine a role of changes in the oropharyngeal microbiome in the development and clinical manifestations of migraine. MATERIAL AND METHODS: Seventy patients with migraine, aged 21-56 years, and 15 healthy subjects matched for age and sex were examined using headache diary, MIDAS and VAS, the Gastrointestinal Symptom Rating Scale (GSRS), microbiological smear examination from the mucous membrane of the posterior wall of the oropharynx with evaluation by the method of mass spectrometry of microbial markers (MSMM) with determination of 57 microorganisms. RESULTS: The following changes in the oropharynx of individuals with migraine compared with the group of healthy individuals (control group) were found: a) a significant increase in the content of markers of resident (conditionally pathogenic) microorganisms characteristic of chronic diseases of the upper respiratory tract (strepto- and staphylococci); b) the appearance of markers of transient microorganisms normally absent, characteristic of the intestinal microflora (clostridia, gram-negative rods, enterobacteria, anaerobes); c) the appearance of viral markers of cytomegaloviruses, Herpes group, Epstein-Barr; d) a significant decrease in the content of bifidobacteria and lactobacilli). All people with migraine had a history or were found on examination to have chronic diseases of the upper respiratory tract (sinusitis in 48%, pharyngitis in 43%, tonsillitis in 25% of people), and gastrointestinal diseases. Dyspepsia was the most frequent and pronounced of the gastrointestinal syndromes on the GSRS in people with migraine (87%). This corresponds to the data on the extremely frequent occurrence of IBS (70% of patients) and other gastrointestinal pathology obtained from the patient history. CONCLUSION: In our work, the microbiota of the oropharynx in patients with migraine was studied for the first time using a new MSMM method. Disturbance of the oropharyngeal microbiome compared to the norm was detected in 100% of people with migraine. The changes characteristic of most patients included a significant decrease in the content of normal flora, an increase in the concentration of conditionally pathogenic microorganisms and the appearance of pathogenic microflora characteristic of chronic diseases of the upper respiratory tract and gastrointestinal tract, which may indicate their role in the pathogenesis of migraine.

[Comparative analysis of the use of symptomatic slow acting drugs for osteoarthritis containing chondroitin sulfate or affecting its biosynthesis in patients with non-specific low back pain]. / Sravnitel'nyi analiz primeneniya simptomaticheskikh preparatov zamedlennogo deistviya, soderzhashchikh khondroitina sul'fat ili vliyayushchikh na ego biosintez, u patsientov s nespetsificheskoi bol'yu poyasnichno-kresttsovoi lokalizatsii.

OBJECTIVE: Retrospective comparative analysis of the use of SYSADOA preparations containing chondroitin sulfate (Chondroguard, 2 ml, 25 amp., glycosaminoglycan-peptide complex, 1 ml 25 amp., bioactive concentrate of small marine fish, 2 ml, 10 amp.) in patients with chronic non-specific low back pain (LBP) of lumbar and sacral localization caused by spondylosis and osteochondrosis of the lumbar spine, at the stage of outpatient care. MATERIAL AND METHODS: Data of medical records of patients (n=120; men - 32, women - 88, age - 54.1±7.6 years, duration of disease exacerbation 4.0±1.7 months) with nonspecific LBP were systematized according to the inclusion/exclusion criteria. All patients were divided into 4 groups: Group 1 (n=30) received Chondroguard im., 2 ml every other day, the course of treatment was 25 injections, 25 days; Group 2 (n=30) received glycosaminoglycan-peptide complex on the 1st day - 0.3 ml, on the 2nd day - 0.5 ml, and then 3 times a week for 1 ml, course of treatment - 25 injections, 25 days; Group 3 (n=30) received bioactive concentrate of small marine fish, 2 ml im., every other day, the course of treatment was 10 injections; repeated courses of treatment - after 6 months; Group 4 (n=30) received Amelotex (meloxicam) at a dose of 15 mg once a day for 15 days. All patients of the first 3 groups received Amelotex at a dose of 15 mg with the possibility of reducing the dose to 7.5 mg or completely discontinuing the drug if necessary. Retrospectively, dynamic monitoring was performed in the medical records of outpatients after 50 days and 6 months from the start of therapy according to the following parameters: intensity of pain according to VAS, short form of the McGill pain questionnaire, vital signs of patients (Oswestry Disability Index, version 2.1a [Oswestry Disability Index], and Roland-Morris questionnaire), propensity to chronic pain syndrome according to the STarT Back Screening Tool questionnaire, the presence and severity of comorbid fibromyalgia according to the Fibromyalgia Rapid Screening Tool questionnaire, the level of pain catastrophization according to the Pain Catastrophizing Scale, the severity of comorbid anxiety and depression according to the Hospital Anxiety and Depression Scale, the severity comorbid insomnia (Insomnia Severity Index), quality of life according to the SF-36 scale, the effectiveness of drugs according to the patient on a 5-point scale, the need to take NSAIDs and analgesics, tolerability on a 4-point system. The safety of therapy was monitored using the WHO and Naranjo scales. RESULTS: In patients with nonspecific LBP, a greater degree of reduction in the intensity of the pain syndrome, a smaller number of exacerbations of the pain syndrome over 6 months of observation, an improvement in the functional status and life activity, a tendency to a decrease in the severity of anxiety and depression, sleep disturbances and comorbid fibromyalgia, limiting the risk of chronicity and catastrophization of pain, the presence of a structure-modifying effect on IVD and degenerative changes in the facet joints, a significant improvement in the physical and mental components of health, high satisfaction and safety of therapy, which included taking Chondroguard with meloxicam, with a decrease in the need to take the latter by the 50th day observation period compared to other regimens. The effects of Chondroguard and meloxicam turned out to be long-term and were recorded by the 6th month in the absence of Chondroguard, which indicated the preservation of the influence of highly purified cholesterol on the pathogenetic mechanisms of the formation of LBP. CONCLUSION: The study allows us to recommend the use of a parenteral form of cholesterol (Chondroguard, CJSC «PharmFirma «Sotex¼, Russia) for the treatment of nonspecific LBP with moderate or severe pain, chronic relapsing or persistent course, in combination with NSAIDs and their subsequent cancellation or administration on demand.

Spin-Echo Silencing Using a Current-Biased Frequency-Tunable Resonator.

The ability to control microwave emission from a spin ensemble is a requirement of several quantum memory protocols. Here, we demonstrate such ability by using a resonator whose frequency can be rapidly tuned with a bias current. We store excitations in an ensemble of rare-earth ions and suppress on demand the echo emission ("echo silencing") by two methods: (1) detuning the resonator during the spin rephasing, and (2) subjecting spins to magnetic field gradients generated by the bias current itself. We also show that spin coherence is preserved during silencing.

[The measurement of degree of satisfaction of patients at evaluation of quality of applied services in hospital on the basis of SERVQUAL technique].

This article discusses clauses of national standards compatible with international standards of ISO 9000-9001 family,in section of measurement of degree of satisfaction of patients with medical services quality. The main methods applied are sociological survey SERVQUAL focused on measurement of degree of satisfaction of patients, GAP-analysis (identification of discrepancies and gaps) and technique of management decision-making concerning improvement of medical services quality. The SERVQUAL survey with its five qualitative criteria was applied. The primary data was obtained from sampling of 500 well structured questionnaires. In total, 365 respondents participated in the study. The produced correlation matrix confirmed strong relations between criteria estimating expected and interpreted quality of medical services and full average interpreted quality. The analysis of reliability confirmed that questions of questionnaire are reliable and the results of statistical calculations can be used in further analysis. The analysis of descriptive statistics, correlation matrix, patient profile, reliability and qualitative GAP analysis were carried out. The requirements of assuring reliability and adequacy of questionnaire, representativeness of sample size to carry out high quality measurements were kept. The results on every criterion were obtained. The qualitative results of discrepancy of and perceptions of patients are received. The negative values of indices of discrepancy of the interpreted and expected outcomes of medical services are received. The level of satisfaction of patients remains insufficient. The study proposes to improve quality of medical services in hospital, especially by criterion "Materiality" to justify expectations of patients. The results of the study are of practical importance for executives of regional health care administrations, head physicians of medical organizations engaged in improvement of medical care quality and increasing of efficiency of medical services.

[The experience of SERVQUAL technique application in measuring satisfaction of patients with medical services quality].

The implementation of system of quality control conforming to requirements of interstate ISO 9001 standards in in the medical organization, the important role is assigned to indicator of satisfaction of patients with quality of medical care as a feedback channel. The study purpose was to investigate satisfaction of patients with quality of medical services in medical organization rendering hospital medical care on the basis of SERVQUAL technique. The analysis of results of survey of 339 patients treated in the twenty-four-hour department of municipal hospital demonstrated rather high rating of perception of quality of rendered medical services that made up to 4.47 points according five-point scale. The application of GAP analysis technique allowed to reveal gaps between expected and real quality of received medical services by means of SQL index quality. The highest points were received for such criteria as "Sympathy" (0.61 points), "Responsiveness" (0.20 points). The satisfactory results were in case of criteria "Materiality" (-0.38 points), "Reliability (-0.43 points). The lowest points were received for criteria "Persuasiveness, confidence" (-0.69 points) that reflects inadequate orientation of hospital personnel to settle problems of patients. The study demonstrated that applying the SERVQUAL technique in assessment of quality of medical services allows to reveal the most significant factors determining satisfaction of patients. The results of survey based on the SERVQUAL technique and processed by GAP analysis are to be considered in management decision making concerning choice of correcting and preventive actions in quality management of rendering medical services at the regional level.

[Chronic fatigue syndrom: modern aspects of diagnosis and treatment]. / Sindrom khronicheskoi ustalosti: sovremennye aspekty diagnostiki i lecheniya.

The article presents a modern ecological approach to the pathogenesis and treatment of chronic fatigue syndrome (CFS). CFS is views in terms of gene-environment concept. The basic data in patients with CFS, triggers of diseases that implement the mechanisms responsible for the manifestation of symptoms are presented. A systematic approach to the diagnosis and treatment of diseases is given.

[The evaluation of the efficacy of Alflutop in the complex treatment of patients with chronic lower back pain (the observational study ZEITNOT)]. / Otsenka terapevticheskoi effektivnosti Alflutopa v kompleksnom lechenii patsientov s khronicheskoi bol'yu v nizhnei chasti spiny (nablyudatel'noe issledovanie TsEITNOT).

OBJECTIVE: To analyze the effect of Alflutop on neuroinflammation in patients with chronic lower back pain (CBP). MATERIAL AND METHODS: Forty-one patients with a verified CBP diagnosis were enrolled in the study. Alflutop was used for treating CBP, 1 ml once/day, for 20 days. Treatment efficacy was monitored using the Visual Analogue Scale (VAS), DN4 test; the Roland-Morris questionnaire; the index of pain activity in the lumbar spine; and the level of tumor necrosis factor-α (TNF-α) in blood plasma. There were three visits in total: screening (visit 0), treatment start (visit 1, 0-3 days after screening) and visit 2 (3 months later (±7 days) from the start of treatment). RESULTS: Before the start of therapy, in some patients (group 1, n=14 (34.1%) the TNF-α concentration in the blood plasma was below the detectable level (less than 4.0 pg/ml), while in group 2 (n=27 (659%)), the expression of TNF-α in peripheral blood was observed at the level of 6.3 [4.9; 7.4] pg/ml. Patients in group 2 significantly (p<0.05) differed from patients in group 1 by the greater number of CBP exacerbations over the last year as well as by the results of testing on DN4 (higher values) and SBI (greater discomfort). In group 2, a significant relationship was found between the TNF-α level in blood plasma and the number of exacerbations as well as between the TNF-α level and the number of DN4 points. At visit 2, patients in group 2 had a significant (p<0.05) decrease in pain intensity according to VAS, an improvement in the quality of life according to the Roland-Morris questionnaire, a decrease in the severity of the neuropathic component of pain according to DN4 test as well as subjective condition improvement associated with the activity of pain in the lumbar spine. A significant relationship was found between the level of TNF-α and the number of DN4 points after treatment and the period of active observation. CONCLUSIONS: In the majority of CBP patients, the high relapse rate and neuropathic nature of pain may be associated with persistent neuroinflammation due to TNF-α synthesis. Alflutop inhibits the TNF-α expression substantially, which significantly correlates with a decrease in the neuropathic pain syndrome component according to the DN4 questionnaire. The use of Alflutop can be considered as an effective method of treating patients with CBP, which has an impact on the process of neuroinflammation as one of the leading causes of changes in the pain nature and its chronicity.

Two-level systems in superconducting quantum devices due to trapped quasiparticles.

A major issue for the implementation of large-scale superconducting quantum circuits is the interaction with interfacial two-level system (TLS) defects that lead to qubit parameter fluctuations and relaxation. Another major challenge comes from nonequilibrium quasiparticles (QPs) that result in qubit relaxation and dephasing. Here, we reveal a previously unexplored decoherence mechanism in the form of a new type of TLS originating from trapped QPs, which can induce qubit relaxation. Using spectral, temporal, thermal, and magnetic field mapping of TLS-induced fluctuations in frequency tunable resonators, we identify a highly coherent subset of the general TLS population with a low reconfiguration temperature ∼300 mK and a nonuniform density of states. These properties can be understood if the TLS are formed by QPs trapped in shallow subgap states formed by spatial fluctutations of the superconducting order parameter. This implies that even very rare QP bursts will affect coherence over exponentially long time scales.

[Clinical and psychological features in patients with incident and recurrent cases of benign paroxysmal positional vertigo]. / Kliniko-psikhologicheskie osobennosti patsientov pri vpervye voznikshikh i retsidiviruyushchikh pristupakh dobrokachestvennogo paroksizmal'nogo pozitsionnogo golovokruzheniya.

OBJECTIVE: To assess the clinical and psychological features in patients with incident and recurrent posterior canal BPPV. PATIENTS AND METHODS: The study included 47 patients (mean age 49.1±10.9 years; 12.8% of men and 87.2% of women) with idiopathic BPPV, posterior canal. According to the anamnesis, the patients were divided into two groups: 27 (57.4%) patients with incident BPPV (iBPPV) and 20 (42.6%) patients with recurrent BPPV (rBPPV). All patients were treated with repositioning Epley and/or Semont maneuvers until resolution of canalolithiasis. After that, clinical and psychological testing was immediately carried out, including short version of Vertigo Symptom Scale (VSS), Dizziness Handicap Inventory (DHI), Visual analogue scale (VAS) for fear of vertigo spells, Depersonalization-Derealization Inventory (DDI), Social Readjustment Rating Scale (SRRS) of Holmes and Rahe, Anxiety Sensitivity Index (ASI), Generalized Anxiety Disorder Scale (GAD-7) and Patient Health Questionnaire (PHQ). RESULTS: Patients with rBPPV compared with iBPPV had more severe symptoms of dizziness according to DHI (p=0.02) due to a functional and emotional subscales, as well as a more pronounced feeling of fear according to VAS (p=0.01). The data obtained on the remaining scales and questionnaires did not show statistically significant differences between the groups. The revealed results may indicate a greater predisposition of patients with rBPPV to the development of a special kind of mental disorders - functional dizziness or persistent postural-perceptual dizziness, which requires additional study and development of preventive measures.

[Multidomain approach in chronic non-specific back pain patient's treatment]. / Mul'tidomennyi podkhod k terapii patsientov s khronicheskoi nespetsificheskoi bol'yu v spine.

The concept of chronic nonspecific back pain (CNBP) as a pathology of the spine (osteochondrosis, spondylosis, intervertebral disc herniation, facet syndrome) is extremely outdated and has not justified itself, first of all, from the therapeutic view point. Numerous studies, including meta-analyzes and systematic reviews, have convincingly shown the ineffectiveness of the methods of CNBP treatment, aimed only at solving the problems of the spine itself and / or surrounding tissues. A substantial amount of special imaging studies have proven the dissociation between morphological vertebral changes and the clinical picture of pain. CNBP is the overall result of the interaction of numerous factors in the spine tissues (changes in the discs, joints, ligaments, fascia, muscles) and factors beyond the spine. The latter include, first of all, psychological and social factors, cognitive functions, the quality of night sleep, the level of physical activity, concomitant diseases (comorbidity). In each patient, the interaction of these factors determines the development of specific pathophysiological mechanisms of pain and, as a result, an individual clinical picture of pain (phenotype). Understanding these processes will allow for the reconsideration of the approach of searching for an anatomical pain source as the main pathogenetic factor; recognizing the multifocal generation of chronic pain as the result of a complex interaction of biological, psychological and social factors; the development of new principles and therapy algorithms. The authors propose to introduce into practice a multidomain screening approach for evaluating patients with CNBP, which would take into account the phenotype of pain, factors affecting its perception, and allow personalized treatment for each patient based on the biopsychosocial approach.

[PRACTICE OF MANAGEMENT OF PATIENTS WITH INFECTIOUS ENDOCARDITIS IN CONDITIONS OF LOW FREQUENCY OF ETIOLOGICALLY SIGNIFICANT PATHOGENS IN THE RUSSIAN FEDERATION].

The article presents the results of a multicenter study of the etiology, antibiotic sensitivity and pharmacoepidemiology of infective endocarditis in the Russian Federation. The purpose of this study is to analyze the current practice of management of patients with infective endocarditis in conditions of low frequency of etiologically significant pathogens in the Russian Federation. The study included patients of both sexes of all age groups with definite and probable infective endocarditis. 406 cases of infectious endocarditis (240 in retrospect and 166 in the prospective part) were analyzed. Etiologically significant pathogen was isolated in 144 cases (35.5%). The structure of pathogens was dominated by gram (+) cocci (90.3%), most often - Staphylococcus aureus (46.5% of all isolated pathogens). Aminoglycosides (22.8%), parenteral cephalosporins of the III generation (22.1%) and glycopeptides (14.5%) were most frequently used in the course of starting antimicrobial therapy. When changing the mode of antimicrobial therapy, glycopeptides (18.6%), aminoglycosides (15.3%), fluoroquinolones (11.2%) and parenteral cephalosporins of generation III (9.5%) were most often prescribed.

[The modern characteristics of occupational morbidity of agriculture workers].

On the basis of updated data from 82 subjects of the Russian Federation multivariate analysis of occupational diseases of agricultural workers was implemented. It is established that in unhealthy work conditions are characteristic for 30% of workers in the agricultural sector. In the enterprises of agriculture, the percentage of workplaces not meeting sanitary hygienic standards made up to 35%. The high etiologic pathogenic relationship between nosological form of disease and working conditions in the profession is established. Most often, the occupational pathology was developed in agricultural workers in case of conditions of physical overload (37.2%), effecting of physical factors (26.8%) and contact with infected animals (14.6%). In nosological structure of accumulated occupational diseases the first place took radiculopathy of cervical and lumbar sacral levels (23%), the second - vibration disease (15.3%), followed by brucellosis (14.6%), the fourth - neuro-sensory deafness (11.5%). The regions of the Russian Federation are characterized by pronounced heterogeneity both related to general level of registered occupational diseases and its nosological spectrum. In the whole, in Russia during 2011-2015 persistent trend of decreasing of occupational diseases morbidity of agricultural workers was marked.

Near-Field Scanning Microwave Microscopy in the Single Photon Regime.

The microwave properties of nano-scale structures are important in a wide variety of applications in quantum technology. Here we describe a low-power cryogenic near-field scanning microwave microscope (NSMM) which maintains nano-scale dielectric contrast down to the single microwave photon regime, up to 109 times lower power than in typical NSMMs. We discuss the remaining challenges towards developing nano-scale NSMM for quantum coherent interaction with two-level systems as an enabling tool for the development of quantum technologies in the microwave regime.