Polycystic ovarian syndrome (PCOS) is one of the most common gynecological disorders, which affects 5-20 % of young women all over the world in different ethnic groups and races, and is a frequent cause of infertility, a miscarriage, complicated pregnancy and childbirth. PCOS is a polysymptomatic disease characterized by hyperandrogenism, menstrual dysfunction and multifollicular structure of the ovaries with ultrasound examination. The main manifestations of PCOS lie in the basis of N1H and Rotterdam diagnostic criteria. There are several different phenotypes of polycystic ovary syndrome in accordance with these criteria. At the same time, PCOS is a metabolic disorder, and the role of insulin resistance has been proven in development of this condition. 1n consequence of which pathogenesis, diagnosis and treatment are of interest not only for gynecologists, but also for endocrinologists, cardiologists, and others clinicians, as PCOS is a serious problem associated with obesity, increased risks of endometrial adenocarcinoma, hypertension and cardiovascular complications, type 2 diabetes and etc. Moreover, economic costs are billions of dollars ayear around the world for the treatment of complications of PCOS. To date, many researchers have been studying the formation of PCOS, and our article discusses the theories explaining pathogenesis and etiology of this disease, clinical manifestations and current approaches to diagnosis of PCOS.

The article presents literature data on the lipid peroxidation and antioxidant defense system (LPO-AOD) under normal conditions. Lipid peroxidation is a physiological process which is constantly occurring in cell membranes and has a chain, free-radical mechanism. Free-radical reactions are involved in the repair of cell membranes, in the processes of phagocytosis and destruction of microorganisms, in conducting nerve impulses, in metabolism of various xenobiotics by liver and in biosynthesis of certain biologically active substances such as prostaglandins. Antioxidant defense neutralizes all kinds of radicals before they cause damage effect in a body. The imbalance in the LPO-AOD system causes oxidative stress. Nowadays research of this process in children of different age is very topical. Thus, reduction of the AOD intensity was proved in case of diseases such as arterial hypertension, chronic gastroduodenitis, influenza, cholelithiasis, pyelonephritis, metabolic syndrome, diabetes mellitus type 1. The conclusion on the necessity of inclusion of drugs with antioxidant action in the complex therapy of various pathological conditions along with the medical methods of treatment is made. Thus, the efficiency of the treatment of various diseases largely depends on the protection of the structure and function of cell membranes, and as a result the inclusion of drugs with antioxidant action in the treatment of almost any pathology in childhood is justified.

A gas-chromatographic study was conducted of the content of essential polyunsaturated fatty acids of the ω-3 family: eicosapentaenoic and docosahexaenoic, an enzyme-linked immunosorbent assay of leptinin the homogenate of placental tissue in women who during the third trimester of gestation (32 weeks) underwent reactivation of chronic cytomegalovirus infection with an antibody titer Immunoglobulin class G to cytomegalovirus 1:1600. The main group of studies was 42 placentas taken from women with cytomegalovirus infection during the period of labor. The obtained data were compared with similar parameters of the control group, which included 35 placental tissues of practically healthy women in childbirth. Based on the analysis of the data obtained, it was found that the reactivation of chronic cytomegalovirus infection in the third trimester of pregnancy (32 weeks) is associated with decrease in the concentration of ω-3 essential polyunsaturated fatty acids: eicosapentaenoic by 23 % (р < 0.01) and docosahexaenoic by 42 % (р < 0.001) with a simultaneous increase in the concentration of leptin in the placental tissue by 61 % (р < 0.001). In these conditions, the mechanisms of regulation of the transmission of fatty acids from the peripheral blood of the mother to the blood of the developing fetus through the placenta are disrupted. The contents of leptin during pregnancy is an important indicator that carries information not only about the energy reserves of the maternal organism, but also about the state of the fe^lacental complex.

The article presents the analysis of inspection results of the military personnel who passed a medical examination at the initial military registration, with the call to military service and recognized as health fit for military service. The aim of the research was to study the dynamics of changes in the components of lipid peroxidation and antioxidant defense system of the soldiers during the primary adaptation to military service. Materials and methods: 34 young men (recruits), called up for military service, and 18 military personnel who have served 6 months. As material for biochemical research we used blood plasma and hemolysate. Modern spectrophotometric, fluorometric and statistical methods have been used. Results. In recruits, we noted increased activity of lipids oxidation, low level of blood antioxidant activity and reduced glutathione. In 6 months of the military service we found decreased contents of TBA-active products and improving of the overall antioxidant activity of the blood. Conclusions. Analysis of the data shows significant changes in the indices of lipid peroxidation and antioxidant defense system. The ratio of the activity of oxidation and antioxidant components not only reflects, but also largely determines the rate of metabolism and adaptive capabilities of the organism. The study found that young people, who were recognized as fit for military service due to health criteria for military medical commissions by military commissioners and were called up for military service, have low adaptive capacity and reach the stage of “satisfactory adaptation” only after 6 months of service.

In cosmetology, there is a wide range of methods and means to correct aesthetic deficiencies and symptoms of involutional changes, in particular, dry skin. It is not sufficient to assess the patient visually while deciding which tactics of dry skin complex correction and prevention to choose. Skin dryness has a cyclical character with a tendency to age deterioration, so it is very important to have rational beauty care, adapted to the physiology and skin structure. Operating principles of instruments to assess hydration, hydrolipidic skin mantle, elasticity, flexibility and transepidermal water loss are reviewed. The authors discuss the key goals and practical value of the described biophysical study methods as well as possible impact of age, environment and conducted treatment on the dynamics of the indices. The article presents an overview of the main methods for studying the morphofunctional condition of the skin: determination of skin moisture, elasticity, greasiness, trans-epidermal water loss, as well as skin ultrasound examination. We discuss the main objectives and practical significance of the described methods of non-invasive skin studying, as well as possible influence of age on the dynamics of dry skin of women of different age groups. This paper deals with the clinical aspects of non-invasive methods for diagnostics of various abnormalities and pathological changes in the skin. The necessity of their application in cosmetology is substantiated.

Ph-negative myeloproliferative neoplasm are the group of hematologic disorders which includes primary myelofibrosis, polycythemia vera, essential trombocytemia and several rare diseases. After the discovery of V617 Fgain-of-function mutation the new period of diagnostics, treatment and evaluating of MPN prognosis began. At the current moment several molecules inhibiting JAK2 function are developed. Advanced therapy in patients with primary and post-polycythemic myelofibrosis included molecules inhibiting JAK2 function resulted in rapid and durable improvements in splenomegaly and disease-related symptoms in the phase 3 trials COMFORT-I and COMFORT-II. The effectiveness of the advanced therapy included molecule inhibiting JAK2 was evaluated in three patients with primary myelofibrosis and post-polycitemic myelofibrosis. All represented clinical cases demonstrated positive dynamics of the disease manifested in spleen size reduction, improvement of the symptoms and in one case in reduction of blood transfusions. None of three patients met serious adverse events leading to dose reduction or discontinuation of the molecule inhibiting JAK2. Target agents therapy demonstrated high treatment rates in patients with primary and post-polycythemic myelofibrosis. Thus, it is clearly necessary to perform molecular diagnosis, screening tests at early stages of the chronic myeloproliferative disease for the selection of patients in need for specific treatment.

Bacteria Klebsiella pneumoniae is one of the most common and dangerous pathogens of human infectious diseases. The research of K. pneumoniae resistance to ß-lactam antibiotics (cephalosporins), which are widely used in anti-infective therapy, is very relevant. The aims of the work is to study K. pneumoniae resistance to cephalosporins. Fifty strains of K. pneumoniae isolated from patients (sputum, lavage liquid, blood) of Irkutsk Regional Clinical Hospital and sectional material in 2015 were examined. Resistance to four antibiotics (cefotaxime, ceftriaxone, ceftazidime, cefepime) was determined by disco-diffusion method. 56.0-62.0 % of K. pneumoniae strains were resistant to drugs of 111 generation cephalosporins; 58.0 % - to drug of 1Vgeneration (cefepime). Klebsiella strains showed the highest resistance to ceftazidime (resistance - 62.0 %; intermediate - 20.0 %). The spectrum of resistance to all four antibiotics was revealed in 52.0 % of strains, cross-resistance - in 64.0 %. The resistance of K. pneumoniae from the sectional material was higher than resistance of Klebsiella isolated from the organs and tissues of the patients. Klebsiella isolated from the lavage fluid more often (p < 0.05) showed resistance to cephalosporins compared to strains isolated from sputum. The research brought us to the conclusion that Klebsiella pneumoniae strains were characterized by a significant level of resistance to ß-lactam antibiotics (cephalosporins).

This review discusses the data of new researches on the functional purpose of sleep and its stages, and its role in the development of pathological conditions. The main modern hypotheses and concepts about a role of slow sleep and REM-sleep (rapid eye movement) are interpreted. The visceral theory of slow sleep as an activator of restorative processes in the brain and manager of internal organs functions is described. A brain "drainage" function of slow sleep is known. Recent studies suggest sleep-wake disturbances, for example, obstructive apnea syndrome, may influence Alzheimer's disease (AD) onset and progression. Possible mechanisms such asfunctional disorders of brain lymphatic system during slow sleep and the extracellular accumulation of the amyloid-ß (Aß) peptide underlying the relationship between the sleep-wake disturbances and AD are described. The role of REM-sleep in the formation of the central nervous system in the early postnatal period and the performance of the function of mental adaptation are discussed. In this article, we presented data about the role both of neurotransmitters and neuropeptides in the regulation of sleep-wake cycle and the maintenance of wakefulness and REM-sleep. The possible new approach to the forecasting of cognitive and emotional-affective disorders in sleep disturbances is substantiated from the perspective of modern neuroscience and sleep neurophysiology still in childhood is justified.

Background. It is known that obstructive sleep apnea (OSA) has been closely linked to essential hypertension (EH) and is considered as an important stressor. The hypothalamic-pituitary-adrenal axis (HPA) is a major component involved in stress response. However, the response of HPA axis to OSA effects may be variable. Aim: to estimate hormonal status in OSA and non-OSA adolescents with EH. Methods. We examined 38 male adolescents with EH (18 OSA patients - group A, 20 non-OSA patients - group B) aged 14-17 years. OSA was verified by polysomnography applying system GRASS-TeLeFACTOR Twin PSG (Comet, USA). EH was diagnosed with 24-h ambulatory blood pressure monitoring using monitor Oscar 2 for OXFORD Medilog Prima. Hormonal status, including thyroid-stimulating hormone (TSH), prolactin (PRL) and cortisol, were routinely collected using an automatic analyzer «Cobos ELL» (USA) and test-system «Alcor-bio» (Russia). All differences were considered significant at p < 0.05. Results. There were statistically significant differences in morning serum cortisol level of OSA adolescents (745.8 ± 6.4 nmol/L versus 493.2 ± 3.2 nmol/L in non-OSA participants; р < 0.05). Morning serum PRL and TSH levels in the both groups no statistically significant differences, but there is a trend towards its increasing in OSA adolescents with EH (482.8 ± 4.2 mME/L in the group A and 442.2 ± 4.1 mME/L in the group B, and 1.95 ± 0.9 mkME/ml versus 1.5 ± 0.2 mkME/ml, respectively, р < 0.05). Conclusion. The results of this study indicate for chronic stress if OSA in adolescents with EH is present. This is due to the influence of sleep fragmentation and intermittent hypoxia on HPA axis with compensatory stress-related hormones release.

Today, the problem of early diagnosis of hematological changes predisposing to the development of thrombotic complications in patients with essential hypertension (EH) is an urgent problem that requires close attention not only of physicians, but also of pediatricians. The aim of the study was the development of prognostic criteria for risk of prothrombotic changes (PC) in adolescents with EH, timely preventive measures and prevention of thrombotic complications. Sixty adolescents with EH without PC and 37 adolescents with EH and PC were examined. We used the following methods: clinical anamnestic (including genealogy), functional and ultrasound, laboratory, mathematical and statistical. To create a mathematical model of forecasting, discriminant analysis was used, with the help of which from the 59 proposed predictors the algorithm selected 8 most informative features: the C777T polymorphism of the 5,10-methylenetetrahydrofolate reductase gene, the A66G gene of the methionine synthase reductase gene, the daily diastolic blood pressure level, the level of the nocturnal systolic arterial pressure-time index of hypertension, systolic blood pressure during the day, weighed down by thrombotic genealogically history, early onset of thrombosis, burdened thrombotic genealogical history. Our method for predicting the risk of developing PC allows to place adolescents with EH having an increased risk of developing these coagulation shifts in a separate group, to identify thrombogenic risk in adolescence and, if necessary, to initiate preventive measures in time to reduce the incidence of thrombotic complications of EH and mortality of patients.

The article deals with the important problem in the field of consultative psychiatry - comorbid depressive disorders in patients with cardiovascular diseases. Depression is highly prevalent in cardiac patients. Between 31-45 % of patients with coronary artery disease suffer from clinically significant depressive symptoms. Furthermore, 20 % of patients with coronary heart disease meet criteria for the major depressive disorder. Patients with heartfailure, atrial fibrillation and ones undergoing implantable cardioverter-defibrillator placement are similarly at increased risk for elevated depressive symptoms and for major depressive disorder. In patients with heart diseases, depression is chronic, persistent, and associated with worse health-related quality of life, recurrent cardiac events, and mortality. At present, pharmacologic and psychotherapeutic interventions appear to be safe and effective at reducing depressive symptoms in patients with cardiovascular diseases and may impact cardiac outcomes. Despite this, depression remains under-recognized and undertreated in patients at risk for or living with cardiovascular diseases. In this review, we summarize the evidence linking depression to increased risk of cardiovascular diseases and worse patient outcomes. The paper presents a review of the literature on epidemiology, comorbid conditions, and risk factors for depression in heart diseases. Future studies in this direction with involvement of cardiologists and psychiatrists should be held.

The spread of tuberculosis in the penitentiary system institutions has a significant impact on the epidemic situation in the country. The aim of the research is to study the clinical and social characteristics of newly diagnosed patients with pulmonary tuberculosis among the special contingent prisons. Analyzed data include 107 cases of pulmonary tuberculosis newly diagnosed in 2014 among inmates of penitentiary institutions. We studied the age structure of the patients, their educational level, number of previous convictions, family status, addictions and comorbidity, ways of revealing pulmonary tuberculosis, the structure of its clinical forms and characteristics of the specific process. It is established that in the conditions of penitentiary system tuberculosis often affects repeatedly convicted persons with low education level; and in most cases, the disease develops in the first two years of imprisonment. Low level of health literacy of patients, along with the lack of family in more than 2/3 of cases, reduces the motivation and commitment to treatment. We concluded that there is a need for sanitary-educational work of two directions among persons in penal institutions. First, healthy individuals should be filled in on clinical symptoms of pulmonary tuberculosis and with a focus on the need to seek medical help immediately after its occurrence. Second, to reduce the refused treatment rate, the continuous and purposeful work must be done to form commitment to therapy.

In recent years, the frequency of application of regional anesthesia methods, and especially in economically developed countries, has progressively increased. This paper presents the experience of high spinal anesthesia during operations on the upper part of the abdominal cavity in 112 patients. We have developed and proposed a method of simultaneous high spinal anesthesia, with the development of high neuromuscular block to the level of the first and second thoracic vertebrae. By its simplicity and technique, as well as by maintenance high spinal anesthesia is close to epidural analgesia, but unlike that it provides adequate, long-lasting and high level of pain relief of the abdominal organs. Compared to "traditional" methods of pain relief high spinal anesthesia reduces the risk of thromboembolic complications, decreases the amount of blood loss, reduces risk of developing complications from respiratory and cardiovascular systems, reduces the duration of postoperative paresis of the intestine. The use of high spinal anesthesia during operations on the upper part of the abdominal cavity is the method of choice. This type of anesthesia has advantages over other types of pain relief, and is better tolerated by patients. The proposed technique of regional anesthesia - high spinal anesthesia - has broad prospects for use in clinical practice.

Among the unsolved problems of domestic health care are the issues of labor standards. The employer has the right to determine the amount of work performed (both in the direction of reduction and increase), taking into account the specific situation. Meanwhile, staff standards of relevant medical organizations and their structural subdivisions can be used to normalize the work of physicians of certain specialties. This method of rationing is applicable only for those medical specialties for which staff standards have been approved. In the article the method of norming of physicians' work, proposed by the authors, based on the use of staff standards, is considered. As an example, we propose the implementation of the proposed methodology for the standardization of the work of pathologists, taking into account the standards of the pathoanatomical bureau (department) approved by the Order of the Ministry of Health of the Russian Federation as of March 24, 2016 No. 178n «On the rules for pathoanatomical research». At the same time, when calculating the load norms, a coefficient is applied, compulsorily taking into account the load standards per rate of the pathologist doctor in accordance with Order No. 178n as of March 24, 2016, the type of load and the category of complexity of the work performed. The proposed approach can also be applied to physicians of other specialties, for which statutory standards have been legislatively approved, expressed in the appropriate units of workload. The article also provides all the necessary standards for the relevant calculations and presents the legislative base (orders of the Ministry of Health of the Russian Federation) for the period 2015-2016, which contains staff standards for physicians of other specialties.

The article presents the results of pathophysiological and pathomorphological evaluation of effectiveness of pharmacotherapy in experimental dyslipidemia. Dyslipidemia was induced in rats by prescribing the atherogenic diet for 12 weeks. Pharmacotherapeutic effectiveness of the complex plant remedy based on Tibetan medicine was studied. The tested remedy in the form of decoction was introduced intragastrically in the dose of 1 mL per 100 g of weight once a day during the whole period of the experiment. The control group received the distilled water according to the same scheme. It is established that atherogenic dyslipidemia was accompanied by structural changes in all membranes of aorta in the form of edema, leukocyte infiltration and desquamation of endothelial cells. Morphometric parameters of aorta were characterized by increasing thickness of t. adventitia, the total width of t. intima and t. media, as well as the total thickness of aortic wall. In the blood of animals the level of circulating endothelial cells increased by 2,17 times, platelet aggregation increased by 17,6 % on average. The prescription of phytoremedy reduced the severity of pathomorphological and morphometrical changes in aorta, decreased the content of circulating endothelial cells in blood by 38 %, inhibited platelet aggregation by 30 % on average.

HIV infection poses a threat to the existence of humankind as a whole. Currently, lamivudine is widely used in antiretroviral therapy regimens. Modern methods of assessing quality, both in substance and in tablets, are characterized by a number of shortcomings: high cost of equipment, expensive GSO production of the United States. The development of new methods for the analysis of lamivudine, as well as the improvement of existing methods, is an urgent problem. The purpose of this study is to develop a new technique for the quantitative determination of lamivudine by UV spectrophotometric method using a standard sample. The absorption spectrum of lamivudine solutions was studied at different pH values (1.1-14.1) in the wavelength range 200-400 nm. The optimal solvent for the spectrophotometric determination of the test substance was 0.1M HCl (pH 1.1). At pH 1.1, two absorption bands with absorption maxima at wavelengths of 212 ± 1 nm and 279 ± 1 nm are observed in the absorption spectrum of the lamivudine solution. A substance of organic nature, 4,4'-dihydroxyphthalophenone, was chosen as the standard sample for the determination of lamivudine. The maximum absorption of lamivudine (279 nm) is included in the optimal range for 4,4'-dihydroxy-phthalophenone (268-282 nm). The conversion ratio of lamivudine for 4,4'-dihydroxyphthalophenone is 0.1985. The error in determining lamivudine in the substance does not exceed 0.85 %, in tablets -1.6 %. The validation assessment confirmed the compliance of the developed methodology with normative documents and its suitability for analysis.

This article considers the wound-healing effect of a hydrogel based on polyhexamethyleneguanidine hydrochloride under conditions of thermal shock modeling. The presence of gelling properties in combination with the high biocidal activity of polyguanidins opens the prospect of obtaining an effective single-component external agent, which is very important for antimicrobial chemotherapy of wounds and burns, as in their treatment there is a high probability of infecting the wound with microorganisms causing various infectious diseases. Previously, we developed a method for the preparation of a hydrogel based on polyhexamethyleneguanidine hydrochloride, which involves the cross-linking of the amino-end groups of the branched polymer with formaldehyde, resulting in a cross-linked polymer, which is a lump-like mass. The mechanical treatment of the hydrogel makes it possible to give the material an ointment form that is convenient for application to the skin. An experiment on the evaluation of the wound healing action of hydrogel was carried out under the conditions of modeling a thermal burn. The comparative preparation was multicomponent gel "Levomekol", in which polyethylene oxide was used as the basis. It was established that the hydrogel activates the growth of antioxidants and leukocytes in the blood of animals in dynamics on the 10th, 17th and 24th day of the experiment, amounting to 56.4 %, 33.8 % and 20.9 %, and of leukocytes - 27.7 %, 19.6 %; 6,2 % in relation to the norm. The method of contrast radiography of penetrating wounds showed that the daily reduction in the wound area is most pronounced in the hydrogel group, which indicates a pronounced reparative effect.

Safety assessment of new nanostructured treatments and substances requires special attention from producers during synthesis and technological cycle and from the medical staff examining the persons contacting them. Toxicity studies should be conducted before the beginning of their use, in order not to allow producing of nanopreparations with detrimental effects on human health. In the current economic climate, use of wastes from the production of metal silicon is promising. The article deals with the safety problems resulting from contact with wastes from the production of metal silicon. Concentrate of nanostructures based on silicon dioxide contained separate 1 μm nanoparticles and agglomerates from 1 to 45 ßm has been investigated. This concentrate is a perspective additive to increase sustainability properties of building materials. The objective of the research was to examine biological properties of siliceous dust administered to rats through various routes. Acute toxicity, species and sexual sensitivity after oral administration of the concentrate of nanostructures in mice and rats of both sexes, acute skin irritation from a single exposure were studied. The concentrate of nanostructures based on silicon dioxide can be classified in V category of hazard based on acute oral toxicity by classic toxicological methods (DL50 > 2000 mg/kg, no sexual and specific sensitivity). It produces slight irritating effect in acute dermal toxicity test that will disappear completely within 16 hours of exposure.

At present, development of effective vaccines of new generation is an actual problem, in particular concerning the tularemia causative agent. It determines the need to search antigen determinants with high immunogenic activity. Some authors demonstrate that outer membrane proteins of Francisella tularensis possess immunological activity. This fact gave occasion to isolation and comprehensive study of F tularensis cellular envelopes as a perspective component in vaccine engineering. The influence of cell walls of F. tularensis was studied for morphological changes in immunocompetent organs of experimental animals. Cell walls were obtained from three virulence strains of living cultures: F. tularensis subsp. mediaasiatica А-61, F. tularensis subsp. nearctica В-399 A-Cole, F. tularensis subsp. holarctica 306 and vaccine strain F. tularensis subsp. holarctica 15 (extracted by Research Institute of Epidemiology and Hygiene). Cell walls of different subspecies of F. tularensis stimulate the production of antibody forming cells and cell proliferation more in T-dependent zones of lymph nodes and spleen. It has been determined that these antigen preparations do not cause stress reaction of the experimental animal organisms. Basing on the findings, we made a conclusion that there is a need for further detailed investigation of immunogenic properties of CE F. tularensis subsp. holarctica 306, F. tularensis subsp. mediasiatica А-61 and F. tularensis subsp. tularensis B-399 A-Cole as perspective components in development of tularemia vaccines.

This work is devoted to the assessment of the vulnerability of the Sary-Jaz autonomous focus of plague by using of GIS technologies. This focus of the plague covers a very large and difficult to access territory. The annual survey and disarming of this territory is very expensive. Therefore, it is necessary to select sectors that need more attention. That why, it is necessary to assess the vulnerability of the population in various sectors. Now in the world literature there is a lot of work on the assessment of vulnerability from these or those dangers, but there is no definition of hazard, risk and vulnerability indices for the focus of plague. The paper presents the results of the determination of these indices and calculates indices for each sector of the natural focus of the plague. As a result of the work, the final map of the Index of the epidemiological vulnerability of the Sary-Jaz autonomous focus of the plague was obtained. Detail results of the assessment and the final map for the study area are given. The authors hope that the calculations and results obtained in the course of this work will find their application both for theoretical assessments of the vulnerability of various territories from plague and for practical actions to reduce vulnerability.

More than one-third of the population of Russia annually receives physiotherapy treatment in clinics, hospitals and rehabilitation centers. Physiotherapy range includes more than 250 medical practices and scientific specialty related to basic science. A physical factor used in physiotherapy is a conventional name of the energy or of its carrier, energo-informational impact of which improves microcirculation and restores local homeostasis in damaged tissues. At the base cerebral functions lies activation of neurotransmitters synthesis and improvement of neuro-humoral regulation of organs and systems. Natural therapeutic factors quickly interact with the body, allowing in the course of treatment to control their dosimetric parameters, are well compatible with many therapeutic agents and methods, are widely available, non-toxic and do not cause allergic reactions. The high therapeutic effectiveness of physiotherapy is achieved by appropriately selected dosimetric parameters corresponding to compensatory possibilities of the organism.