[The application of information technologies in system of support of decision making in osteopathy].

The implementation of information technologies into treatment practice of modern health care significantly increases efficiency of diagnosis and treatment of dorsopathies. The purpose of the study is to develop software module to evaluate post-urological status of patients with spine dorsopathy to optimize diagnostic process and treatment planning. The article describes application of original software module to assess the post-urological status of patients with spine dorsopathy. The proposed software module is designed for objective assessment of post-urological status of patients with spine dorsopathy based on photographic images of examined patient. The most important advantage of software module is built-in forecasting function that is implemented by calculation of severity of pain perceptions and movement disorders using generated regression equations. The possibility to record data obtained during measurements permits to store information in single system. The implementation of software module into clinical practice will contribute to qualitative improvement of diagnostic processes, simplify work of osteopath and reduce the time spent on examination.

[Statistical modeling of the fact and requests frequency for emergency medical care by primary care different age groups patients.]

The frequency of seeking emergency medical care (EC) can be mediated by the characteristics of the patient's social status, his health literacy (HL) but not only by the clinical signs of the disease, health status. The goal of the cross-sectional survey was to identify factors determining the frequency of applying for EC by the young-aged, middle-aged (18-59 years) and elderly (60-74 years) patients of the primary health organizations in the Arkhangelsk Region and the Komi Republic (North-West Russia). Logistic regression (LR) was used to identify factors mediating the fact of applying for EC; zero-inflated negative binomial regression (ZINB) - to identify factors mediating the frequency of appeals. The majority of elderly respondents in the Arkhangelsk Region (72,5%) and the Komi Republic (74,1%) applied for EC at least once during the calendar year; among the young-aged and middle-aged respondents - 45,3% and 52,1% respectively. In the group of young-aged and middle-aged respondents, a higher frequency of appeals for EC is mediated by the age, low self-esteem of the well-being and health status, a chronic disease(s) affecting daily well-being in anamnesis, a low level of HL; in the group of the elderly respondents - by the fact of absence of a spouse, low self-esteem of the well-being, a chronic disease(s) affecting daily well-being in anamnesis, low levels of HL respectively. The obtained results obtained can be used to identify the «risk group¼ of patients of the primary health organizations who have a higher probability of applying for EC, and to organize additional preventive work with the min primary health organizations.

[Laparoscopic right-side partial nephrectomy with fluorescence imaging in the near infrared spectrum using indocyanine green].

A clinical case of the use of fluorescence imaging in the near infrared spectrum with indocyanine green during laparoscopic right-side partial nephrectomy is presented in the article.

[The determinants of vaccination against the new coronavirus infection (COVID-19) of residents of the circumpolar region of Russia].

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 dynamics of demographic situation and state of reproductive health of population of circumpolar region of the Russian Federation].

The priority of state policy of the Russian Federation is to make conditions for sustainable social economic development of national regions, including the territories of the Arctic Zone. The successful solution of these tasks is possible only if there is sufficient amount of labor resources and at achieving positive dynamics of main demographic processes. The purpose of the study is to establish characteristics of both dynamics of main demographic processes and reproductive health of Northerners as exemplified by the Republic of Komi. MATERIALS AND METHODS: The retrospective ecological epidemiological study was carried out using reports of the Federal statistical observation. To evaluate demographic processes the values of main demographic parameters were calculated. To analyze dynamics of demographic processes time series of demographic coefficients were constructed and values of growth rate indicators were calculated. RESULTS: The number of male and female population of the Komi Republic in 1990-2023 decreased by 46.5% and 37.1%. The specific weight of people older than able-bodied age increased in males from 4.9% to 14.7% and in females from 15.7% to 31.6%. The number of females of fertile age (16-49 years) in the Komi Republic decreased by 152.602 people (-47.5%) and their general fertility rate decreased by 33.3%. The birth rate in the group of young women aged 15-19 years decreased in 1990-2021 by 80.1%; and of women aged 20-24 years decreased by 60.4%. The frequency of abortions tends to decrease, but significantly exceeds the national average values. CONCLUSION: The replacement-level fertility is not achieved in the Komi Republic. Taking into account the peculiarities of demographic, social economic processes, it is necessary to develop and to implement regional program of reproductive health improvement.

[Bilateral laparoscopic nephrectomy for polycystic kidney disease].

A clinical case of surgical treatment of a patient with autosomal dominant type of polycystic kidney disease, stage 5 of chronic kidney disease and secondary arterial hypertension is presented in the article. The technique of single-stage bilateral laparoscopic nephrectomy, patented by the authors, is described. The practicability and safety of a simultaneous bilateral procedures was demonstrated, as well as the advantage of laparoscopic access for this type of surgical interventions. The successful and prompt procedure allowed the patient to undergone to allotransplantation of a cadaveric kidney as soon as possible.

[The development of first medical care support to victims of road traffic accidents: The publications review].

The medical and demographic losses because of road traffic accidents continue to be significant in most of economically developed and developing countries. The national strategies of reducing medical and demographic losses include two groups of measures, depending on object of exposure: (1) targeted to decreasing risk of road traffic accidents and (2) targeted to timely and adequate medical care support of victims. Beyond this classification are activities targeted to developing and improving in participants of road traffic skills of first self-care and mutual assistance. The availability of mentioned skills is important for saving lives and preventing permanent disability of victims of road traffic accidents.

The medical demographic characteristic of group of citizen injured in road accidents on the Federal Highway.

The role of citizen of elderly age in road accidents on the Federal Highway was principally passive since passengers of vehicles predominated (p<0,0001). The most of victims of elderly age (66,7%) suffered of combined lesions. Considering gender of victim, presence of ethanol in blood at the moment of hospitalization, the role of victim of road accident and degree of severity of lesions in citizen of elderly age was in overall higher than in citizen of able-bodied age up to 2.3-2.9 points according ISS scale. The established medical demographic characteristics of victims of elderly age condition necessity of development of differentiated approaches to their medical care support, planning of measures of population prevention of medical sanitary aftermaths of road traumatism.

[The competence in health issues of population of circumpolar region of the Russian Federation].

The health literacy of citizen is determined by a set of demographic and social factors. The deficiency of health literacy of population in the Russian Arctic Zone conditions delay in indicators characterizing population health from their all-Russian values and menaces ability to achieve the targets of the National Strategy of Development of Russian Arctic Zone and Ensuring National Security up to 2035.The purpose of the study is to assess level of health literacy of patients and healthy population residing in circumpolar territories of Russia (Arkhangelsk Oblast).The level of general health literacy in the subgroups of respondents varied in narrow range of 26.9-36.3 points. The most significant difference was established between scores of interactive health literacy (Δ = 4.1 points) and critical health literacy (Δ = 3.4 points), which were higher in group of healthy respondents. The predictors of level of general health literacy are clinical status (value of dependent variables in healthy respondents was on average higher on 0.75-1.73 points), self-assessment of one's positioning in society (every additional point increases average level of general health literacy by 0.47-0.79 points) and age (every additional year of life reduces level of general health literacy by 0.08 - 0.09 points). The results of the study indicate on dependency between clinical status and the level of health literacy, determine social characteristics of risk group with low health literacy as object of additional preventive measures directed at citizen residing in in circumpolar terrotories of The Russian Federation.

[SATISFACTION OF THE RESIDENTS OF THE CIRCUMPOLAR REGION WITH THE STATE HEALTHCARE SYSTEM, DEPENDING ON THE LEVEL OF THEIR HEALTH LITERACY].

Regions of Arctic Zone and Far North of Russia have a weak social infrastructure, including regional segments of the state healthcare system. The study of citizens satisfaction with the healthcare system is one of the leading methods for assessing its effectiveness. Citizens satisfaction may be distorted by their health literacy (HL). Half of the 'healthy' citizens (51.1%) had an excellent or sufficient level of general GVH; 2/3 of the patients of medical organizations (70.4%) had an insufficient or problematic level of general HL. The level of citizens` satisfaction with domestic healthcare is determined by their clinical status - it is higher in the group of patients (60.1%) than in the group of 'healthy' people (31.0%). Patients evaluate it more loyally in comparison with health people. Respondents with an insufficient HL evaluate the health care system less loyally. The high level of HL allows patients to assess the results of the work of the domestic health care system more objectively in comparison with healthy citizens. The aim of this study is to assess the satisfaction of the residents of the circumpolar region of Russia (the Arkhangelsk Oblast) with the regional segment of the State Healthcare System, depending on the level of their HL.

[The means of optimization of medical care support of victims of road traffic accidents at the hospital stage: The publications review].

The road traffic traumatism remains among the most actual medical social problems in Russia. The injured because of road traffic accidents suffer of predominant severe multiple and combined injuries (polytrauma) very often resulting in permanent disablement and lethal outcomes. The existing three-level system of traumatologic centers to supply specialized medical care of the injured in road traffic accidents demonstrates efficiency only on condition of observation of routing of patients. The new organizational approaches to specialized medical care to the injured at the hospital stage is needed for further decreasing of lethality and disability in group of victims of road traffic accidents.

[The regional characteristics of road traumatism in the Arkhangelsk oblast].

The article considers the results of continuous retrospective documentary study of regional characteristics of road traffic injuries with medical consequences on the Federal highway M-8 "Kholmogory" in the Arkhangelsk oblast in 2012 - 2018. The analysis was applied to 906 medical records of patients older than 18years hospitalized with urgent indications after road traffic accident and received in-patient treatment in medical organizations of the Arkhangelsk Oblast located in area of the Federal highway M-8 "Kholmogory". The significant decreasing of number of accidents with medical consequences recorded in the covered area as well as significant decreasing number of victims and perished with minimal rate ​​in 2018 was established. It is revealed that the largest number of victims of road traffic accidents was recorded in summer - 300 (31.1%) and autumn - 270 (29.8%) of this year. The Saturday and Sunday occurred to be the most dangerous days of the week in this respect. In day periodicity, maximal number of victims was recorded in the evening time (18-24 PM, 35.1%) and the smallest number in the night time (1-6 AM, 14.6%). Among injured individuals, significantly dominated males (p<0,001) and in total sampling young people under the age of 40.

[The combined use of kinesio- and laser therapy in the regional hemodynamic disorders correction in dilated cardiomyopathy]. / Sochetannoe primenenie kinezo- i lazeroterapii v korrektsii narushenii regionarnoi gemodinamiki pri dilatatsionnoi kardiomiopatii.

The search for new methods of symptomatic therapy of dilated cardiomyopathy (DCM) remains a relevant objective of modern cardiology. This is due to the low and short-term existing methods effectiveness of conservative and surgical treatment, including drug therapy. PURPOSE OF THE STUDY: Efficacy evaluation of the combined use of kinesio- and laser therapy for the correction of regional hemodynamics in patients with DCM against the background of maintenance drug therapy. MATERIAL AND METHODS: 100 patients with DCM were examined. All patients received differential maintenance drug therapy (beta-blockers, ACE inhibitors, with intolerance to the latter - angiotensin II receptor blockers, aldosterone receptor antagonists, diuretics, cardiac glycosides, antiarrhythmic drugs). Patients were divided into 2 groups at least 3 months after the selection of drug therapy. Intravenous laser blood irradiation (ILBI) and the selection of unloading therapeutic exercises were performed for patients of the main group during therapy. Patients in the control group received only drug therapy. The main research method was venous occlusion plethysmography. It was used to assess regional hemodynamics with the determination of recirculating blood flow (Qr) and regional vascular resistance (Rr) at rest, venous tone (Vt), reserve blood flow (QH) and regional vascular resistance (RH) against a functional stress test. RESULTS: Data obtained in the dynamic observation process (after 1, 3, 6, 9 and 12 months) in the main group indicate a significant increase in Qr and QH, a decrease in Rr and RH, Vt. Significant positive dynamics in the control group was not observed. The regional hemodynamics indices after 9 and 12 months of observation significantly worsened. CONCLUSION: Thus, according to venous-occlusal plethysmography, the use of unloading therapeutic exercises in combination with ILBI against the background of rationally selected differentiated drug therapy in patients with DCM significantly improves the regional hemodynamics. The developed symptomatic therapy methods can be applied in the practice of cardiologists, general practitioners, therapeutists, rehabilitation physicians to optimize the treatment of patients with DCM.

[The role of CO2-laser in scarring management]. / Otsenka vozmozhnostei uglekislotnogo lazera v lechenii rubtsovykh deformatsii.

AIM: To assess the role of CO2-laser in treatment of various scars and to determine the indications for its application. PATIENTS AND METHODS: It has been carried out a prospective analysis of treatment of 218 patients with scars of different duration, locations and anatomic areas with the use of CO2-laser for the period 2011-2017. POSAS scale and sonography were used for analysis. RESULTS: 1. Laser therapy is not effective for scarring-related functional defects (contractures, ectropion, microstomia), when surgery is indicated. 2. The outcomes of treatment (both surgical and laser) depend on the time of existence of the scars rather their cause and anatomical region. 3. Laser therapy is not effective enough for formed scars existing over 12 months. 4. Laser therapy is effective for immature scars, especially indicated for cicatricial deformation when the aesthetics cannot be repaired with traditional surgery. CONCLUSION: Application of CO2-laser in scars treatment with regard to its real efficiency determines the effectiveness of therapy.

[The Evaluation of Quality of Medical Care Support of Victims of Road Traffic Accidents at Pre-Admission Stage in Conditions of the Russian Arctic].

The retrospective continuous documented study of volume and quality of emergency medical care of victims of road traffic accidents occurred in the Arctic zone of the Russian Federation in 2012-2016. It is determined that on the examined territory there are enough of forces and means for timely and qualitative emergency medical care support of victims of road traffic accidents. It is established that more than 80% of all victims received medical care at the very site of accident during 20 minutes and no longer from the moment of calling ambulance and more than 90% of all victims were transported to admitting office of duty hospitals during first 40 minutes from the moment of being injured. The medical care, including application of pain killers (77.2%), intra-venous infusion of anti-shock remedies (35.1%), application of transport immobilization (74.9%) and implementation of medical evacuation to multi-field hospitals of Severodvinsk, was provided by specialists of emergency medical care teams to significant majority of victims of road traffic accidents (p < 0.001). It is established that a significant number of victims of road traffic accidents with combined and multiple injuries did not received at the pre-admission stage the anti-shock infusion therapy appropriate to their health condition. The mistakes of diagnostic of injuries due to road traffic accidents were established. The most significant of them in 10.4% was under diagnostic of shock condition in victims that conditioned inadequate infusion therapy and inadequate volume of rendered medical care of victims at the pre-admission stage of medical evacuation.

Enantioselective cytotoxicity of ZnS:Mn quantum dots in A549 cells.

Chirality strongly influences many biological properties of materials, such as cell accumulation, enzymatic activity, and toxicity. In the past decade, it has been shown that quantum dots (QDs), fluorescent semiconductor nanoparticles with unique optical properties, can demonstrate optical activity due to chiral ligands bound on their surface. Optically active QDs could find potential applications in biomedical research, therapy, and diagnostics. Consequently, it is very important to investigate the interaction of QDs capped with chiral ligands with living cells. The aim of our study was to investigate the influence of the induced chirality of Mn-doped ZnS QDs on the viability of A549 cells. These QDs were stabilized with D- and L-cysteine using a ligand exchange technique. The optical properties of QDs were studied using UV-Vis, photoluminescence (PL), and circular dichroism (CD) spectroscopy. The cytotoxicity of QDs was investigated by high content screening analysis. It was found that QDs stabilized by opposite ligand enantiomers, had identical PL and UV-Vis spectra and mirror-imaged CD spectra, but displayed different cytotoxicity: QDs capped with D-cysteine had greater cytotoxicity than L-cysteine capped QDs.

Enantioselective cellular uptake of chiral semiconductor nanocrystals.

The influence of the chirality of semiconductor nanocrystals, CdSe/ZnS quantum dots (QDs) capped with L- and D-cysteine, on the efficiency of their uptake by living Ehrlich Ascite carcinoma cells is studied by spectral- and time-resolved fluorescence microspectroscopy. We report an evident enantioselective process where cellular uptake of the L-Cys QDs is almost twice as effective as that of the D-Cys QDs. This finding paves the way for the creation of novel approaches to control the biological properties and behavior of nanomaterials in living cells.

Chlorin e6-ZnSe/ZnS quantum dots based system as reagent for photodynamic therapy.

Stable water-soluble complexes of Cd-free ZnSe/ZnS quantum dots (QDs) and chlorin e6 complexes have been prepared. These complexes have shown approximately 50% intracomplex fluorescence resonance energy transfer from QDs to chlorin e6. The photodynamic therapy (PDT) test of the complexes against the Erlich acsite carcinoma cell culture demonstrated a two-fold enhancement of the cancer cell photodynamic destruction as compared to that of free chlorin e6 molecules. It was shown that the PDT effect was significantly increased due to two factors: the efficient QD-chlorin e6 photoexcitation energy transfer and the improvement of cellular uptake of the photosensitizer in the presence of ZnSe/ZnS QDs.

Reversible photoluminescence quenching of CdSe/ZnS quantum dots embedded in porous glass by ammonia vapor.

The photoluminescence response of semiconductor CdSe/ZnS quantum dots embedded in a borosilicate porous glass matrix to exposure to ammonia vapor is investigated. The formation of surface complexes on the quantum dots results in quenching of the photoluminescence and a shortening of the luminescence decay time. The process is reversible, desorption of ammonia molecules from the quantum dot surface causes the photoluminescence to recover. The sensitivity of the quantum dot luminescence intensity and decay time to the interaction time and the reversibility of the photoluminescence changes make the CdSe/ZnS quantum dots in porous glass system a candidate for use as an optical sensor of ammonia.

[Laparoscopic transperitoneal and retroperitoneal partial nephrectomy].

The article presents a modern approach to partial nephrectomy, and evaluation of individual results of laparoscopic partial nephrectomies. The study included 38 patients who underwent laparoscopic partial nephrectomy in the period from 2006 to 2011. Kidney cancer was diagnosed in 30 patients, other diseases--in 8. Mean duration of surgery was 225 min. Warm ischemia time was less than 36 minutes. The average postoperative period was 8,7 days. Despite the technical difficulties in the development and implementation of laparoscopic partial nephrectomy, the benefits of minimally invasive techniques are obvious, and the operation can comply with all the principles of oncology and become an alternative to open surgery.