This literature review shows the importance of including probiotic drugs in the treatment of patients with cardiovascular diseases. Current literature sources were analyzed using the PubMed, Science direct, Elibrary, and Google scholar databases. There are a lot of potential mechanisms of the probiotics effect on the cardiovascular system: synthesis of SCFAs, reduction of endotoxinemia in the blood, regulation of the blood coagulation system, reduction of TMAO synthesis, etc. There are many studies experimental (with laboratory animals) and clinical, that prove pathogenetically and clinically the effectiveness of the probiotic drugs using in patients with cardiac pathology. An important task for a cardiologist is the choice of a probiotic drug, its clinically effective dosage, duration of treatment, and the possibility of combination with conventional cardiac therapy

When a person works in conditions of harmful production, the influence of additional adverse environmental influences on his body is noted. Therefore, it is important to develop and implement methods for assessing the formation and progression of risk factors for the development of chronic diseases, as well as pathological conditions of the body and environmental conditions that negatively affect the work of employees. Objective: to study the signs of endogenous intoxication in workers with liver pathology in large gas processing plants associated with the extraction and processing of gas with an increased content of hydrogen sulfide. Materials and methods of research: the values of the hematological index of intoxication (based on the results of a general blood test) and average weight molecules were studied based on the use of hematological and biochemical research methods in this group of employees (the main group, 972 people) compared with similar indicators for people who do not work in production with exposure to harmful factors, but observed in the same medical and preventive institution (control group, 225 people). Results. The presence of significant (p < 0.001) signs of endogenous intoxication in workers of harmful industries was revealed, their significant deterioration depending on the length of service in harmful working conditions, the predominance of increased values of medium-weight molecules and hematological index of intoxication compared with the control group. Conclusion. The results obtained confirm the presence of an additional toxic load on the body of workers in harmful industries.

The medical staff of multidisciplinary medical and preventive organizations represents a special category of the population that is involved in the epidemic process of circulation of hospital strains. Their microbiota acquires special biological properties due to constant contact with disinfectants and antibacterial agents, therefore it is relevant to assess the lytic activity of commercial bacteriophage preparations in relation to the microbiota of medical workers. The aim of the study determination of the frequency and spectrum of resistance to commercial bacteriophages of representatives of the genus Staphylococcus isolated from the oropharynx and intestines of medical staff of a multidisciplinary hospital. Materials and methods. The assessment of the lytic activity of commercial bacteriophages “Staphylococcal bacteriophage”, “Pyobacteriophage polyvalent purified”, “Sextaphage pyobacteriophage polyvalent”, “Intesti-bacteriophage” to 130 cultures of staphylococcus isolated from the intestines and throat of the medical staff of a multidisciplinary hospital: S. epidermidis (n = 54), S. haemolyticus (n = 44), S. aureus (n = 32). The lytic activity of bacteriophages was studied using the Appelman method, and the sensitivity of cultures to bacteriophages was studied using the drop method on the Mueller-Hinton medium. Results. Among Staphylococcus epidermidis coproisolytes, strains resistant to 4 bacteriophages were 2 times more common (p = 0.01). Coproisolates showed resistance to “polyvalent Pyobacteriophage purified” and to “Staphylococcal bacteriophage” 1.8 times (p = 0.041) and 1.5 times (p = 0.05) more often than oral cultures. Staphylococcus haemolyticys strains from intestinal contents were 2.4 times more likely to be resistant to “Staphylococcal bacteriophage” (p = 0.032), 3 times more likely to “Intestinal bacteriophage” (p = 0.026), and pharyngeal isolates 1.6 times more likely to show resistance to “polyvalent Pyobacteriophage” (p = 0.042) compared to intestinal strains. Staphylococcus aureus isolated from various biomaterials had no differences in the frequency and spectrum of bacteriophage resistance (p > 0.05). Conclusion. Staphylococci isolated from the microbiota of medical staff are characterized by a high frequency of resistance to commercial bacteriophages. The spectrum of resistance to bacteriophages in strains isolated from the oropharynx and intestines differs.

Diabetes exerts negative effects on different organs and systems including skeletal system. Diabetes features increase of risk of fractures and healing of such fractures is also complicated. However, the effects of fracture consequences of repeated fracture on bone strength is not well known. Aim. To test strength features of the tibia in diabetic rats after repeated fracture and to consider administration of systemic and local calcium sources for treatment purposes. Material and methods. The study involved 168 female rats with hyperglycemia and obesity. Repeated fracture was modeled as formation of consecutive openings in the femur and the tibia. Fracture of the tibia was modeled after healing of the femur fracture healing. After formation of the defect in the tibia, in several animals the defect remained empty and in other animals the defect was filled with biogenic hydroxyapatite implants (OK-015). A group of animals with empty openings received intragastric calcium drug Calcemin Advance in therapeutic dosage. Another group of animals with the implants also received intragastric Calcemin Advance. Results. Diabetic animals with empty defects exhibited deranged strength features without restoration signs up to the end of observation. In animals that received Calcemin Advance, restoration of strength was observed in later terms mostly due to restoration of mineral contents however constructional features began recovering int the beginning of observation. In animals with hydroxyapatite implants constructional features worsened yet tissue strength increased. Application of both Calcemin Advance and OK-015 results in restoration of all strength features due to systemic and local administration of calcium sources. Conclusion. Repeated fracture in animals with type 2 diabetes results in considerable derangement of strength of the tibia. Administration of Calcemin Advance and implantation of hydroxyapatite material result in restoration of strength feature of the bone. Combined action of intragastric Calcemin Advance and hydroxyapatite implants appears to be the most optimal for recovery of the tibia strength.

Patients with pulmonary TB are at the highest risk of developing cardiovascular complications, including developing conditions for electrical instability of the heart. Objective. To optimize the detection of electrical instability of the myocardium in pulmonary TB patients with concomitant diabetes mellitus or hypertension during TB treatment. Materials and methods. We studied 78 pulmonary TB patients, including 31 patients with concomitant diabetes mellitus and 16 patients with concomitant hypertension. We recorded a 12-lead ECG. We performed ECG analysis, T axonometric, and evaluation of the spatial and frontal angles of QRS-Т. The results were processed using statistical software package MS EXCEL 2016 for Windows and STATISTICA 10. Research results. The highest values of the heart rate were in patients with sQRS-Т ≥ 90º, p < 0.05. In pulmonary TB patients with the normal spatial QRS angle the fQRS-T median had a positive value, while in patients with sQRS-Т ≥ 90º it had a negative value, p < 0,05. The sQRS-Т value was higher in pulmonary TB patients over 45 years old or with concomitant diabetes mellitus, p < 0.05. The fQRS-Т value did not depend on TB process spread, diabetes mellitus type, or the stage of hypertension, p > 0.05. The increased sQRS-Т was more frequently detected in men and women with pulmonary TB / diabetes mellitus – 19/31 (61.3 %) cases, and less frequently – in patients with pulmonary TB/hypertension or just TB – 11 / 31 (43.7 %) and 13 / 31 (42 %) cases respectively. Conclusion. Patients with sQRS-T ≥ 90º should be referred to a cardiologist for consultation.

The problem of iodine deficiency diseases in the country and the world remains quite relevant even now, despite the introduction of iodine enrichment products consumed by the population in some territories. Iodine deficiency is the most common cause of intellectual disabilities worldwide, which can be traced back to the prenatal period. The aim of the study to study the influence of the functional state of the thyroid gland in iodine deficiency diseases on the course of pregnancy. Materials and methods. A cohort cross-sectional comparative study of the reproductive, somatic, and pregnancy course of 152 women with single pregnancy delivered at the Altai Regional Clinical Perinatal Center (Barnaul) was conducted. The main group consisted of 94 women with iodine deficiency diseases, while 53 women had hypothyroidism (n = 53) and 41 women without thyroid dysfunction. The control group included 58 women living in the Altai Territory who were not at risk of natural iodine deficiency and had no thyroid disease detected before or during pregnancy. Results and discussion: the analysis of extragenital pathology revealed that patients of the main group, regardless of the functional state of the thyroid gland, were significantly more likely to be obese compared with women of the control group (57.4 and 13.8 %, respectively, p < 0.001), gestational diabetes mellitus (45.2 and 48.8 %, respectively, p < 0.001), iron deficiency anemia of pregnant women (42.6 and 7.0 %, respectively; p < 0.001). Among the complications of pregnancy, placental dysfunction, lack of water, an underweight fetus or a slowdown in fetal growth prevailed in the main group, regardless of the functional state). Fetal distress was most often observed in childbirth in patients with hypothyroidism. Conclusion. Thus, one of the possible ways to improve obstetric and perinatal outcomes in women with iodine deficiency diseases is pre-gravidar training, which should include not only an assessment of the structure and function of the thyroid gland, but also the identification of latent iron deficiency, metabolic disorders, disorders of carbohydrate metabolism with timely correction, selection of effective drug and non-drug treatment.

In pediatric practice, children from time to time encounter foreign bodies in the respiratory tract. With a typical history of the disease in combination with early childhood, diagnosis and treatment of the disease does not present any particular difficulties. In this clinical case, the diagnosis of the disease was complicated by the absence of the mother during the period of foreign body aspiration, the presence of a family history of a relative with bronchial asthma, concomitant food allergies of the child, manifestations of seborrheic dermatitis and repeated episodes of acute obstructive laryngitis in the history. The administration of bronchodilators and inhaled glucocorticosteroids gave a short-term effect. The foreign body was not radiopaque. Unfortunately, the child could not save the lower lobe of the left lung. During surgery, more than 100 ml of pus was removed along with the foreign body. If there is doubt about the correctness of the diagnosis, multispiral contrast computer diagnostics of the lungs and diagnostic bronchoscopy should be prescribed.

Chronic thromboembolic pulmonary hypertension is a pathology in which obstruction of the branches of the pulmonary arteries occurs as a result of recurrent thromboembolism and secondary vasculopathy in small vessels. Without treatment, this disease can lead to insufficiency of the right ventricle and, as a result, to premature death. Surgical pulmonary artery thrombendarterectomy is the main method of choice for lesions of the main and lobar branches of the pulmonary artery. With distal lesions in the branches of the pulmonary artery, transluminal balloon angioplasty of segmental and subsegmental thromboembolic lesions of the branches of the pulmonary artery is possible. The diagnosis of chronic pulmonary embolism is extremely rare, and this is due to the difficulty of diagnosing this disease, as well as the lack of awareness among doctors about this pathology and the possibilities of its modern treatment. The presented clinical example demonstrates.

Despite the progress in diagnosis and complex treatment, the prognosis for stomach cancer remains unsatisfactory, which is explained by the frequent germination of the tumor of the entire thickness of the stomach wall with the transition to neighboring organs, as well as the presence of distant metastases. Stomach cancer with a transition to the esophagus deserves special attention, which is not allocated to a separate nosological unit, but, due to the peculiarities of the clinical course and surgical treatment, deserves to be allocated to a special group. Adequate nutrition in the perioperative period is an integral part of the management of patients undergoing surgery for malignant neoplasms of the stomach. Nutritional support for patients with stomach cancer, along with dietary recommendations, includes the appointment of additional oral, enteral and parenteral nutrition. A clinical case of the disease was considered, an effective and radical surgical treatment method was demonstrated, and perioperative nutritional support was applied, which made it possible to achieve earlier restoration of peristalsis, as well as improve the immediate results of surgical treatment by eliminating protein-energy deficiency, normalizing the metabolism of intestinal structures, preventing bacterial translocation, dystrophic and atrophic changes in the intestinal mucosa.