The aim of the study was to examine frequency and risk factors of fractures among adolescents and young adults of Irkutsk aged 14 to 24. The results of the study showed that the frequency of fractures was 23.8 %; and boys have fractures significantly more often than girls (p = 0.01). Risk factors for fractures are: male gender (OR = 1.25); body height (> 174 cm for girls (OR = 3.9), > 177 cm for males (OR = 3.5)); body weight (> 60 kg for girls (OR = 2.5), > 66 kg for boys (OR = 2.1)); tenderness to palpation of spinous processes of vertebra (OR = 3.1 for girls, and OR = 2.4 for boys); dietary calcium intake < 500 mg/day (OR = 1.5 for girls, and OR = 2.3 for boys). In addition, back pain (OR = 1.9) and joint hypermobility syndrome (Or = 1.4) were significantly more often found in girls with fractures. There was no statistically significant connection between fractures in adolescents and young adults and hypodynamia, bone mineral density, social factors (single-parent or multi-child family), and parental history of fractures.

Bleeding in pregnancy, childbirth and the postpartum period is one of the leading causes of maternal morbidity and mortality worldwide. There is no doubt that obstetric bleeding demands the development of improved methods for its diagnostics and treatment. We assessed the effectiveness of the treatment strategy for massive postpartum hemorrhage (PPH) with preservation of reproductive function, applied in the Perinatal Center of Irkutsk. We performed a retrospective analysis of 24 delivery cases, complicated by massive bleeding and successfully treated with preservation of reproductive organs. The massive nature of bleeding (> 30 % of blood volume) was registered in 15 (62.5 %) cases, mild (> 20 % but <30 % of blood volume) - in 9 (37.5 %). Emergency operative delivery (cesarean section) was performed in 40 % of massive PPH cases and in 66.7 % of mild PPH cases. Uterotonic drugs were used in all PPH cases. When analyzing complex mechanical methods of PPH arrest, we noticed that in 20 % of cases balloon tamponade was used. In 33.3 % of mild PPH cases, balloon tamponade with great vessels ligation was performed. Thus, the most effective method was balloon tamponade coupled with Baksheev forceps and early surgical hemostasis. All in all, prevention of hemorrhage in risk groups and early fluid and surgical therapy, and also administration of uterotonic drugs in PPH treatment not only provide a hemostatic effect but also preserve reproductive function.

The male factor is the cause of infertility in 40 % of cases. This study is dedicated to the efficiency assessment of ICSI and PICSI techniques and the determination of indications of these methods. There are some relative indicationsfor ICSI in clinical practice: advanced reproductive age of patients, a small number of obtained oocytes, prolonged infertility, repeated attempts of in vitro fertilization. However, normal sperm values are registered in 71.3 % of cases. PICSI method is more preferable at high level of DNA fragmentation and associated changes in sperm indicators. Nevertheless, the pregnancy rate after these methods was comparable - 19.3 % and 19.7 % respectively. The results indicate that the ICSI and PICSI methods do not have a negative impact on the quality of the embryos and do not increase the pregnancy rate.

370 apparently healthy men aged 27 to 35 with considerable mental and physical burden were examined at the sanatorium. They were divided into two groups depending on the duration of rehabilitation. Group 1 consisted of 226 men with rehabilitation period from 18 to 21 days. Group 2 comprised 144 men with rehabilitation period from 10 to 14 days. Each group was subdivided into three subgroups: A, B and C. Patients of Group 1 subgroup A visited cryochamber, patients of Group 1 subgroup B visited infrared sauna, and patients of Group 1 subgroup C visited vibration sauna every second day. Patients of Group 2 subgroups A, B and C had the same procedures every day. Dynamic indicators of nonspecific adaptive response, hemodynamics, vascular adrenergic reactivity of skin, blood coagulation system, lipid and carbohydrate metabolism of all patients were studied. The results allowed us to conclude that all therapeutic complexes could be used in the restoration of adaptive capacity of hard-working people. Cryotherapy performed every second day was the most effective.

The article presents retrospective assessment of chemical factors in aluminum production over a long follow-up period. The main pollutants of the workplace air are fluorine compounds, resinous substances, and disintegration aerosol. The comparative assessment of the workplace air composition during the operation of electrolytic cells with self-baking anodes and when using a new technology with pre-baked anodes was carried out. The results of the research were processed using standard parametric methods of calculation of mean value and error in mean. It is shown that the introduction of a new technology of pre-baked anodes contributes to the optimization of working environment, reduction of harmful chemicals in the workplace air.

The 95 cases of adverse drug reactions in children were registered in the Centre of Drug Safety Monitoring of Irkutsk Region from 2009 to 2015. In 21.4 % of cases, the coexistent affections developed. Children were allergic three times more often than adults. In 14.7 % of cases severe allergic reactions were registered. Most often allergies occurred after taking immunotropic (62.2 %), antimicrobial (16.2 %) and nonsteroidal anti-inflammatory drugs (10.8 %). 10.5 % of cases concerned inefficient drug use in children under 3 years; and 36.8 % of cases concerned children aged 3 to 18 years. The following risk factors of inefficient antibiotic therapy in children with urinary system infections were determined: the duration of the disease up to 5 years, isolation of two or more infectious agents and concomitant infections of upper and lower urinary tract. Adverse drug reaction occurred more often when more than three drugs were prescribed at the same time. Such cases were generally registered in patients with infectious diseases and epilepsy. Risk of adverse reaction increased with the off-label drug use. Introduction of monitoring methods and prediction algorithms allowing to reveal with high probability and to prevent adverse drug reactions in children improved efficiency and quality of pharmacotherapy

The article presents the pathophysiological assessment of the results of atherogenic dyslipidemia simulation in Wistar rats. Dyslipidemia was followed by 24 % increase of triglyceride and 19 % raise of total cholesterol in blood, while the atherogenic cholesterol of low density lipoproteins increased by 39 %, and the content of anti-atherogenic cholesterol of high density lipoproteins decreased by 21 %. Furthermore, the level of modified low density lipoproteins in the blood increased by 1.8 times. On the background of lipid storage disorder the rats of the experimental group showed the signs of endothelial dysfunction: circulating endothelial cell number increased by 1.9 times, proinflammatory cytokines interleukin-1beta (IL-1ß), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-a) increased by 21, 18 and 16 % respectively, high-sensitivity C-reactive protein (hsCRP) concentration - by 2.2 times, and fibrinogen concentration - by 17 %.

Tissue samples from 228 small mammals captured from 2013 to 2015 in four districts of Irkutsk region and in one district of Novosibirsk region were examined for the presence of Anaplasmataceae bacteria and Babesia parasites by nested PCR method with subsequent sequencing of positive samples. In Ekhirit-Bulagatskiy District of Irkutsk region, Babesia microti DNA was found in 10.9 % of small mammals, Anaplasma phagocytophilum DNA - in 7.3 %, and Ehrlichia muris DNA - in 1.8 %. Infected mammals were not found in the other three examined districts of Irkutsk region. In Novosibirsk region, B. microti DNA was found in 8.9 % of small rodents, A. phagocytophilum DNA - in 8.9 % of small mammals, and Candidatus Neoehrlichia mikurensis DNA - in 8.9 % of small mammals. The identified infection agents corresponded to microorganism species and genetic variants previously found in Ixodes persulcatus ticks but not in ticks of other species.

The influence of the plant composition on the functional state of rat hepatic mitochondria and biochemical indices of energy metabolism was studied. Experiments were carried out on 42 white Wistar rats. The application of the plant composition increases contingency between oxidation and phosphorylation, as well as coefficients of respiratory stimulation and respiratory control by 17 % (р < 0.05) and 15 % (р < 0.05) respectively as compared to the control group. The tested herbal medicine increases the ATP content by 29 % (р < 0.05) and improves the activity of pyruvate kinase and H+-ATPase by 1.9 and 1.2 times respectively which indicates a partial restoration of energy metabolism in hepatocytes. The results of the research allow us to recommend the plant compositionfor its further study as a potential prospective hypolipidemic remedy for non-alcoholic fatty liver disease.

Present study was performed in Krasnokamensk city. We conducted retrospective study of 34 incident cases of tuberculosis (TB) among employees of the Priargunsky Industrial Mining and Chemical Union exposed to radiation (uranium production and processing). The comparison group included 47 TB patients, permanent residents of Krasnokamensk. The study found out that long-term dynamics of TB morbidity in the main group exceeded the one of the comparison group. Among the employees, most cases were registered in the 20-35 age group (47.0 %), and among the Krasnokamensk residents - in the 35-50 age group (51.0 %). In the main group, the most common cases were gross and extrapulmonary forms of tuberculosis (53.0 % and 14.7 % respectively). In the comparison group, minor TB forms dominated (59.5 %) and only one case of extrapulmonary tuberculosis was registered (p < 0.05). The effectiveness of the treatment in compared groups did not differ.

There is no uniform method to conduct the epidemiological monitoring of BCG complications in the Russian Federation, Current indicators of BCG complications include the number of complication cases (cases registered within two years after vaccination) and the total number of the vaccinated children. Our aim is to discover a new indicator of BCG complications and to compare it with the indicators of the existing methods, The comparative analysis of new and existing methods of all complication cases (continuous sampling, n = 110) was conducted in the Irkutsk Region (Eastern Siberia) from 2005 to 2014, The calculating formula included the ratio of the number of children with complications vaccinated in the analyzed year to 100,000 children vaccinated in the same year, The new method shows the advantages over the existing methodological approaches, It demonstrates more adequate assessment, expressed in the highest approximation coefficient of trend model compared to the other methods, and stability of indicator over the years, The incidence of complications in the Irkutsk Region has a steady decreasing linear trend and a significant negative growth rate of the indicator (-17,9 %), The new method offers an adequate assessment and can be used as an epidemiological control system not only in the Russian Federation but in other high TB-burden countries with massive BCG vaccination of children,

The article presents the results of the study of resistance of Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Aspergillus fungi to disinfectants. The microorganisms were isolated from the surgical ward environment of Central District Hospital of Neryungri. All strains were sensitive to Lysoformin 3000. Most of the microorganisms were sensitive to Ecocide and Septodor (85,7 % and 71,4 % respectively). Only E. coli was resistant to these disinfectants. The microorganisms showed the highest resistance to Javelion. S. aureus and E. coli were resistant to Javelion. The most effective disinfectants against Aspergillus were 1% solution of Septabic, 0,2% solution of Vegasept, 0,4% solution of Septodor, 0,5% solution of Lysoformin 3000. The other disinfectants (Chlor-sept, Hypocloride and Alfadez forte) had lower fungicidal activity against Aspergillus.

A special feature of Y. pseudotuberculosis strains is its biochemical uniformity irrespective of the time and location of the causative agent isolation and the existence of 21 serological variants. Y. enterocolitica is a quite a heterogeneous species and is classified into 6 biochemical types associated with 29 serological variants. 221 Y. pseudotuberculosis and 447 Y. enterocolitica strains in total isolated in Siberia and in the Far East were characterized. Y. pseudotuberculosis genotype dominating in the Siberian and Far Eastern regions is presented by 0:1b serotype of the first genogroup (pYV+, ympA+, HPI^-) in two- (47:82 МDa) or single-plasmid (47 МDа) variants. Ribotyping and fingerprinting revealed 8 and 10 Y. pseudotuberculosis genotypes, respectively, that indicated relative heterogeneity of the circulated strains. Regional difference of ribotypes and fingerprints was noted. 401 of447 Y. enterocolitica strains were classified as biotype A1 including 11 serotypes (0:4,32; 0:4,44; 0:5; 0:6,30; 0:6,31; 0;7,8; 0:12,25; 0:13,7; O:19,8; 0:41,43) and 46 strains belonged to biotypes 2-4 of O:3 and O:9 serotypes. Y. enterocolitica strains of biotypes 1A were isolated both from the environments, animals and patient samples as like the representatives of biotypes 2-4. The differentiating tests of fucose and sorbose made it possible to identify two species new for the Russian Federation - Y. mollaretii and Y. bercovierii. Y. enterocolitica biotypes 2-4 carried pYV plasmid and chromosomal ail, ystA virulence genes. These strains were referred to phagotypes X₃ (2/0:9) and VIII (4/0:3) and also to phagotype X_z (3/0:3), unique for Russia. Y. enterocolitica biotype 1A containing ystB thermostable toxin gene was confirmed to be an infectious etiological agent.

The review concerns modern pharmacological methods of Parkinson's disease treatment. The basic drugs used in practice are levodopa, dopamine receptor agonists, MAO-B inhibitors, anticholinergics, COMT inhibitors, and amantadine drugs. The article considers main features, assessment methods and targets of the differentiated therapy, presents benefits and drawbacks of each drug, and describes the problem of generics. According to the study, there is a preferences to use long-acting drugs. The choice of a drug for Parkinson's disease treatment depends on such characteristics as the patient's age, the character of Parkinson's disease, the severity of movement disorder, concomitant diseases, the drug price, the patient's individual sensitivity to different drugs. Finally, the article presents recommendations on initial treatment of Parkinson's disease.

The mismatch repair (MMR) system detects non-Watson - Crick base pairs as well as the defects, appearing in course of DNA replication, and helps to eliminate them by catalyzing the excision of the defect-containing region of daughter DNA and its error-free resynthesis. Thus, MMR remarkably improves the fidelity of replication. After separation, both strands contain non-repairable damages and the mismatches may generate DnA mutation in 50 % of cell progeny after next replication. MMR dysfunction causes surge of mutation rate, abnormal recombination, and cancer in humans and animals. Therefore, the main MMR efficiency parameter is mismatch correction before the next replication cycle. Mismatch detection is made by the MSH2 protein, which forms a heterodimer with either MSH6 or MSH3 (Mut S), depending on the damage (MSH6 is needed for the amendment of single base mispairs, whereas both MSH3 and MSH6 can correct IDLs). A heterodimer of MLH1 and PMS2 (Mut L) controls the interaction between the mismatch-detecting complex of proteins and other proteins essential for MMR, including exonuclease 1, helicase, nuclear antigen of proliferating cells, single-stranded DNA-binding protein and DNA polymerases δ and ε. MLH1 can form a heterodimer with two additional proteins - MLH3 and PMS1. PMS2 is required for the correction of single based mismatches, and PMS2 and MLH3 contribute to the correction of IDLs. The Nobel Prize in Chemistry 2015 was awarded for the studies of DNA repair, i.a. MMR.

The clinical case of a rare pancreatic tumor in a 8-year-old child with hypoglycemia (decrease in blood sugar to 1,5 mmol/l) is presented. A sonographic picture of the solid pseudopapillary tumor of the pancreas is shown. The capability of ultrasound investigation in differential diagnostics of small-size neoplasms at early stages is pointed out. The role of the Doppler's effect with color mapping in visualization of the pancreatic vascular pattern normality and at the verification of pancreatic pathological mass is described. Histological examination which identifies the cellular structure forms solid and pseudopapillary images.