The course of atrial fibrillation (AF) with associated arterial hypertension (AH) and non-coronarogenic pathology for various clinical groups is considered. Comorbid states include diabetes mellitus, chronic obstructive pulmonary disease, Basedow’s desease, hypothyroidism, and abdominal obesity. In addition, approaches to cardiac rhythm disorder treatment are presented, as well as frequency and time duration of sinus rhythm restoration for various clinical groups of patients. Despite the higher significance of AH as an AF predictor, as a result of morphofunctional myocardial changes and neurohumoral activation, presence of a comorbid pathology of non-coronarogenic origin affects the course of the disease, intensity of biochemical, hemodynamic, and functional shifts, as well as possibility of instrumental sinus rhythm restoration. Keywords: atrial fibrillation, arterial hypertension, non-coronarogenic pathology, cardiac rhythm disorder.

It was carried out objective of the morphological study performed was to carry out comparative assessment of peculiarities of acute focal cardiomycyte lesions and molecular protein (desmin) expression in myocardium under acute myocardial ischemia within the experiment. Morphological study of myocardium performed under acute ischemia showed correlation between occurrence of acute focal cardiomyocyte lesions and reduction of desmin expression. Comprehensive approach to myocardium state evaluation using polarization microscopy of hematoxylin- and eosin-stained sections, as well as an immunohistochemical assessment of sections, which makes it possible to detect desmin using confocal laser microscopy, should be considered of value in terms of morphological diagnostics of sudden cardiac death, as well as post-mortem and forensic examination.

The paper presents a study of vascular micromorphology along the enteric anastomosis suture and determination of the degree of the anastomosis deformation at different intersection angles with intestinal wall under diffuse purulent peritonitis. Anatomical analysis was carried out using autopsied specimens. Submucosal and muscular layers of intestinal wall intersected at an angle of 60° demonstrate significantly larger number of arterial and venous vessels, as opposed to intersection at an angle of 90° to the colon axis. This is because at intersection angle of 60° blood is supplied to the section line from at least two adjacent straight arteries. In contrast, when the section is made at an angle of 90°, blood is only supplied to the section line through branches of a single straight artery. It is found that, when intestinal wall is intersected at an angle of 60°, there is no critical anastomosis deformation, while blood supply along the suture line improves significantly. When end-to-end enteric anastomosis is formed, afferent and efferent intestinal loops intersecting at an angle of 60° facilitate better blood supply to suture lines without forcing excessive deformation, which enhances reparative processes in the anastomosis area and reduces probability of a leak.

Timely diagnostics of chronic obstructive pulmonary disease (COPD) has a significant effect on its course as each subsequent COPD exacerbation inexorably leads to disease progression. The goal of the research was to determine the efficacy of digital radiography in terms of COPD diagnostics. The investigated sample included 316 patients (179 males and 137 females aged 31 to 84 with the average age of 57.5 ± 8.2 years) with COPD of various severity subjected to the comprehensive radiological examination of digital radiography and conventional film-screen chest radiology. Radiographic images were assessed using six main attributes by three expert radiologists. The sensitivity, specificity, and accuracy of the methods compared were determined. At the final stage, receiver operating characteristic (ROC) curves were plotted. The sensitivity of digital radiography turned out to be higher by 14 % ( p < 0.05). The significant diagnostic efficacy of digital radiography was also confirmed by higher position of the respective ROC-curve. Digital radiography may act as a standalone tool for early detection of COPD of various severity with reduced radiation burden on a patient.

Specific features of mineral metabolism during pregnancy, whose change under the influence of destabilizing factors can have a negative impact on the homeostasis of the mother - fetus system and lead to disruption of the functioning of the entire system, are defined. An experimental study was conducted over a sample of 70 adult animals, and 420 living fetuses at their 20th day of embryogenesis were obtained and analyzed. In the first series of experiments, females were subjected to a general vertical vibration of 60 minutes per day. In the second series of experimental treatment, cadmium sulfate was administered intraperitoneally to females. The study of mineral metabolism in the mother’s liver during vibration revealed a significant decrease in the amount of Ca by 25 %, Mg by 15 %, Fe by 17 %, but accumulation of Cd by 10 times, Pb by 2 times and Cu by 8 % compared to control, which indicates the pronounced change in the processes of homeostasis in the mother - fetus system and causes an increase in the rates of embryonic mortality. The study of mineral metabolism in both series of experiments testifies to the development of hyperelementosis of a group of toxic trace elements with the simultaneous development, for the most part, of hypoelementosis of vital chemical elements.

Dynamics of the key epidemic parameters of tuberculosis (TB) and HIV + TB coinfection, as well as tuberculosis with no coinfection, was studied for a 5-year period from 2011 to 2015 in a major industrial city in Siberian Federal District cha-racterized by unfavorable epidemic situation in terms of the both diseases considered. HIV-infection incidence caused a decrease in tuberculosis morbidity rate reduction in Kemerovo in 5 years almost by a factor of two: from 46.7 % owing to patients with no HIV-infection to 25.7 %. Tuberculosis prevalence went down insignificantly in the period of study by 8.6 %. At the same time, the prevalence of the disease with no HIV-infection decreased by 30.3 %. The amount of HIV patients among incident patients increased from 11.0 to 34.8 %, and in patient cohorts with active tuberculosis - from 10.9 to 28.8 %. These forms of tuberculosis in HIV-infected patients were detected usually detected after patients’ complaints. Preventive examinations for tuberculosis were ineffective in terms of detection of the disease in HIV-infected patients. New approaches to tuberculosis detection in HIV-infected patients, as well as intensified set of tuberculosis prevention measures in the form of early assignment of antiretroviral therapy and, if indicated, chemical prophylaxis, are required.

Data on MR-tomographic imaging of abdominal organs and retroperitoneal space performed for 109 patients with acute abdominal pathology within the first day of hospital admission is presented. In addition to ultrasound examination of abdominal cavity, magnetic-resonance imaging (MRI) (Signa, General Electric, 1.5 T) was performed in all the patients. MRI’s high diagnostic efficacy in combination with the method’s non-invasiveness and the absence of ionizing radiation make it the best method in the diagnosis of acute abdominal pathology that makes it possible to optimize the diagnostic algorithm, avoid abdominal surgical intervention, including those for diagnostic purposes, and to implement minimally invasive surgical techniques.

To estimate indoor treatment efficacy in pulmonary multi-drug resistance (MDR) tuberculosis patients, 481 medical histories of patients with pulmonary tuberculosis treated at Novosibirsk Research Institute of Tuberculosis in 2014-2016 were analyzed. The group included 246 incident patients, 95 patients admitted with recurring pulmonary tuberculosis, and 140 due to the chronic course of the disease. Bacterial excretion was observed in at least 96.4 % cases, with drug resistance (DR) of M. tuberculosis was detected in 94.0-100 % patients. The detection rate of multiple DR reached 80.5 % and broad DR 29.3 %. The average time of cessation of bacterial excretion defined using fluorescent microscopy was 3.2 months and for bacterial inoculation method 4.5 months. The average time of cavity closure was 5.5 months. Thus, the amount of incident patients in 2016 was 48.3 %, and chronic course of the disease was recognized in 32.8 %. In 2016, cessation of bacterial excretion in incident patients defined using fluorescent microscopy was 91.7 % and for bacterial inoculation method 88.6 %; the values for the chronic course of the disease were 60 and 47.8 % respectively.

The objective of the presented research was to study psychological peculiarities in post-heart transplantation patients. The sample studied comprised of 29 patients of E. Meshalkin National Medical Research Center. A study group included 15 post-heart transplantation patients with registered diagnosis of dilated cardiomyopathy; and a control group included 14 patients with registered diagnosis of coronary artery disease (CAD). The following techniques were suggested to patients from both groups of the sample: method of self-relation study by S.R. Panteleev, self-actualization test by A.V. Lazukin, assessment scale of need for achievement by Yu.M. Orlov, method of types of attitude to the disease by L.I. Wasserman and A.Ya. Vuks. Selective self-perception and preservation of working efficiency and confidence under familiar circumstances were found typical for recipient patients. It was found that post-heart transplantation patients have tendency to neurotic immersion in past experiences, hypochondria, and self-doubt. Motivation and commitment to success in the majority of patients from the study group were at the medium level. Patients from the post-heart transplantation group demonstrated neurasthenic and dysphoric attitudes to the disease in a statistically significantly higher number of cases, than patients with CAD from the control group.

The analysis of HIV-infection epidemiological data in the world, in Russia, and in Novosibirsk oblast is presented. The analysis performed revealed that, unlike countries with wide antiretroviral therapy (ART) coverage, HIV-infection situation in the Russian Federation with ART coverage of only 32.8 % continues to deteriorate, with epidemic going from vulnerable groups to general population. A decrease in morbidity rate of 16.3 % was observed in Novosibirsk oblast in 2016 compared to long-term annual average from 2011 to 2015. Novosibirsk oblast was ranked 8th in morbidity rate and 10th in prevalence among all Russian territorial entities in 2016. The adopted Government Decree “On State Strategy of HIV Spread Prevention in Russia through 2020 and beyond” is intended to change the situation. With present rate of HIV-infection spread in place accompanied by lack of adequate prevention measures, future situation forecast remains unfavorable.