Aim. Determination of clinical and laboratory features of tick-borne rickettsioses, in particular caused by Rickettsia (R.) raoultii and R. sibirica, in adult residents of the Novosibirsk Region.

Materials and Methods. In the period from April to September 2016-2017 a total of 665 patients, who were examined on admission to the Novosibirsk Infectious Clinical Hospital No. 1 and had a history of tick attack, or crawling, or an episode of visiting the forest zone with the subsequent rise of body temperature to 37°С and above. Samples of blood, cerebrospinal fluid and skin scrapings from the tick’s bite site were taken from patients in the first 1-2 days after hospitalization and before the antibacterial therapy start. All patients underwent a comprehensive clinical and laboratory examination at the prehospital and hospital stages. The rickettsial DNA was detected by a nested PCR method followed by sequencing of the PCR fragments.

Results. The rickettsial DNA was found in clinical specimens of 37 patients (5.6% of all examined patients): in 14 patients — the DNA of R. sibirica, in 15 — R. raoultii, in one patient — Candidatus R. tarasevichiae, in 7 patients — the DNA of another rickettsia species and genovariants of the spotted fever group (SFG). The symptoms of R. raoultii disease were different from those of Siberian tick-borne typhus (STT). Only two of 15 patients (13.3%), in whose samples the DNA of R. raoultii was detected, had an eschar with regional lymphadenitis and rash, while in patients with STT — in 11 of 14 (75.8%). All patients with R. raoultii had asthenic syndrome, two-thirds — headache and febrile fever, and one-third — febrile fever up to 39°С. Arthralgia and myalgia characteristics of STT were rarely noted. The meningism phenomena were observed in 7 patients with R. raoultii and in 4 patients with R. sibirica, and in 5 patients the rickettsial DNA was found in cerebrospinal fluid — in 4 patients with the DNA of R. raoultii and in one — with that of R. sibirica. The duration of the febrile period under conditions of antibacterial therapy was 5 days on average.

Conclusion. Rickettsioses caused by R. raoultii do not have specific pathognomonic features, though sometimes such symptoms as fever, rash, lymphadenopathy, and eschar may suggest a presumptive diagnosis.

The aim of the study is to assess the impact of exoskeleton training on the quality of life (QL) of patients with spinal cord injury (SCI) during the recovery and the late period of the disease.

The studies involved 80 patients who received treatment in a hospital setting on a basis of the Novosibirsk Research Institute of Traumatology and Orthopedics n.a. Y.L. Tsivyan. The comprehensive rehabilitation program consisted of 2 sessions of 20 days each and included training using the ExoAtlet powered exoskeleton, therapeutic exercises and physiotherapy. All patients completed a standardized SF-36 Health Survey Questionnaire during visits 1-4 before and after each inpatient rehabilitation interval and a month after the rehabilitation activities. The baseline QL of patients with SCI and possible impact of exoskeleton training on the psychological and physical health components of participants were estimated.

Statistically significant data on the increase in QL associated with the psychological component of health in patients with SCI during the recovery and late disease period under the influence of rehabilitation with the exoskeleton training were obtained. The quality of life parameters associated with the physical component of health also improved in participants during the recovery period of the traumatic disease, whereas in patients in the late period of it these indicators did not change significantly. In all cases the reliable changes of the studied parameters were recorded after 2 sessions of exoskeleton training only.

Thus, the use of the ExoAtlet powered exoskeleton contributes to the improving of the quality of life in patients with SCI and can be recommended for inclusion in the comprehensive rehabilitation and habilitation program of this category of patients.

The results of the study of the conditions for the analysis of active pharmaceutical substance (APS) of bismuth subsalicylate by the method of stripping voltammetry are presented. This method is not pharmacopoeial, but it is widely used for the analysis of bismuth compounds in other objects. The influence of the main parameters of the method, in particular, the beginning and rate of a sweep, the time and potential of accumulation, on the quantitative determination of the bismuth ion in the studied APS was investigated. The dependence of the quantitative indicators of the voltammetric peak on the beginning of the sweep was not revealed. When the sweep rate changes from 60 to 120 s, the peak height changes in proportion to the rate value. The optimal range of the analyte accumulation rate on the electrode was determined, which allows changing this parameter during the test. The accumulation potential is of the greatest interest for research since this parameter has the greatest influence on the quantitative characteristics of the peak.

Thus, the method of stripping voltammetry can be used to analyze the active pharmaceutical substance of bismuth subsalicylate.

A study evaluating the use of lithium ascorbate in the treatment of cognitive dysfunction involved 200 patients with cerebrovascular disease (mean age 52 years, 92 men, 108 women). Participants were divided into two groups: main (n = 100) — conventional therapy (vascular, nootropic) + lithium ascorbate (at a dose of 780 mg/day) and control (n = 100) — conventional therapy only. The treatment continued for 2 months. In all patients, the level of Li in the hair, the amount of brain-derived neurotrophic factor (BDNF) in the blood plasma, and the neuropsychological status were assessed before and after treatment.

It was found that the use of lithium ascorbate in combination with conventional therapy contributed to a significant increase in working efficiency, BDNF level, to mood improvement, as well as an increase in the quality of life of patients in the main group.

The study devoted to the clinical and dynamic features of the course of bipolar affective disorder (BPAD) comorbid with cannabinoid dependence syndrome included 104 patients aged 23 to 28 years (mean age 25.19 ± 1.74 years). All study participants were divided into two groups: the first, main group included 54 respondents with a clinically proven BPAD diagnosis (F31 according to ICD-10) comorbid with cannabinoid dependence syndrome (F12.2 according to ICD-10) with the onset of use of cannabinoids after the BPAD diagnosis; the second, control group consisted of 50 patients with clinically proven BPAD diagnosis (F31 according to ICD-10). The duration of the disease in both groups is more than 3 years. All patients included in the study received adequate psychopharmacotherapy.

In the main group, the absence of symptoms of depression was noted in 63% of cases, a low level of anxiety — in 29% of cases, the duration of remission over 2 months — in 39% of cases. A decrease in the intensity of symptoms such as sadness, melancholy, despondency was noted. In addition, 74% of the main group respondents looked to normalization of sleep, more than 60% — stabilization of the emotional background, 81% — appetite enhancement and weight gain. Analyzing the obtained results, it can be assumed that the use of cannabinoids in individuals with BPAD paradoxically alleviates certain symptoms of the disease, which requires further discussion and research.

The study on assessing the quality of life of patients with arterial hypertension (AH) comorbid with chronic cerebrovascular diseases (CVD) involved 70 people of both sexes, aged 20 to 75 years, who underwent a comprehensive examination and treatment at the Clinic of the Federal Research Center of Fundamental and Translational Medicine (Novosibirsk). The study participants were divided into 3 groups: the main group included 23 patients with hypertension combined with chronic cerebrovascular diseases; the comparison group — 23 patients with isolated arterial hypertension (AH), and the control group — 24 patients with dorsopathies without cardiovascular pathology. Health-related quality of life (QOL) was assessed using the validated MOS SF-36 Questionnaire. Patients of the main group and the group of comparison underwent a course of drug therapy, in accordance with modern medical and economic standards.

The comparative analysis showed a significant decrease (by 21.8%) in the level of physical functioning, as well as in the mental component of health (by 20.49%) in patients with AH combined with chronic CVD, compared to patients with isolated AH. In comparison with the control group, there was a significant decrease in the main indices of QOL in patients with AH comorbid with chronic CVD. The course of inpatient therapy led to a significant increase in physical and role functioning, as well as significant increase in an integral indicator of QOL in patients of the main group — by 22.9%.

Aim. To study the toxic effect of a drug product (DP) based on a complex of lithium citrate, aluminum oxide and polymethylsiloxane on the cardiovascular and central nervous systems of experimental animals.

Materials and methods. The drug was administered intragastrically once a day for 90 days in the morning from 10:00 to 11:00. Experimental animals were divided into 4 groups: three experimental (administration of the studied DP at doses of 400, 2000 and 4000 mg/kg respectively) and one control (administration of the medium). The assessment of the drug effect on the central nervous system was carried out by examining the exploratory behavior of rats in the Open Field test. Emotional response was assessed by the Brady and Nauta method (1953). The assessment of the functional state of the rat cardiovascular system was performed using the electrocardiography (ECG).

Results. After a course of the DP based on the complex of lithium citrate, aluminum oxide and polymethylsiloxane, no significant changes in the exploratory behavior in the Open Field test were observed. The Emotional Response test also did not show any differences in the parameters of the experimental groups and the control one. In rats of all experimental groups with repeated intragastric administration of the DP, neither cardiac rate and conduction disturbances, nor changes in the amplitude of the ECG waves and the duration of intervals in comparison with the control group were found. The mean ECG values in animals of all groups did not go beyond the physiological norms for this type of animals.

Conclusion. The absence of toxicity of the drug based on the lithium complex with regards to the central nervous and cardiovascular systems was found after its prolonged administration (90 days). The data obtained represent the necessary fragment of the preclinical study of the DP for the subsequent obtaining permission to conduct clinical trials.

The analysis of the drug provision for the population living in the municipal districts of the Novosibirsk Region (NR) for the period 2012-2020 was carried out. It was established that in the NR the List of drug products (DP), the sale of which can be carried out by medical organizations licensed for pharmaceutical activitiy and their separate divisions, includes 254 drug products under the international non-proprietary names, 620 trade names medicines from 55 pharmacotherapeutic groups. The results of the study of DP prices from the current List show that most of them (82%) are included into the price category up to 300 rubles, that testifies to availability of the pharmaceutical care to rural population of the NR. At the same time, the lack of a unified approach to the formation of the regional List of DP is revealed, which puts residents of NR municipal districts in completely different conditions in terms of drug availability.

Measures are proposed for optimization of the pharmaceutical care provision system for rural population of the NR: monitoring of DP as to having the state registration at least 1 time a quarter and making changes to the current List; control of availability of vital and essential medicines in the assortment of medical and obstetric stations taking into account types of the medical care provided there and the price level.

Aim. Analysis of the use of cephalosporin antibiotics in a multifield hospital (MH) of the Republic of Tajikistan in 2011-2018.

Materials and methods. To assess the dynamics of the use of cephalosporins, the ATC/DDD methodology was used (parameters: index DDDs (Defined Daily Doses) / 100 bed-days, total DDDs per year, percentage of total DDDs).

Results. In the treatment of various infectious diseases, cephalosporins are much more often used in comparison with antimicrobial drugs (AMD) of other classes. The proportion of cephalosporins in the structure of all AMD used in the MH is about 70%. The undisputed leader is ceftriaxone, the use of which has increased by 7.5 times over the indicated period. The decline in the use of first-generation cephalosporins should be considered a positive trend in approaches to antibiotic therapy. There were only isolated cases of the use of 3^rd generation cephalosporins — ceftazidime and cefoperazone, as well as the 4^th generation cephalosporins — cefepime, which were random.

Conclusion. The results of the study can serve as a rationale for planning the procurement of drugs for multifield hospitals, as well as for the analysis of the antimicrobial drugs use rationality, taking into account the risk of antibiotic resistance development.

Biopsy materials from 145 patients were studied. All patients after a comprehensive clinical and instrumental examination, taking into account the grade of intervertebral disk degeneration according to Pfirrmann, underwent decompression and stabilization interventions on the lumbar spine, with a complete or partial facetectomy at the level of the lesion. All examined biopsy materials were divided into 4 groups depending on the grade of intervertebral disk degeneration according to Pfir-rmann: group 1 — grade II (n = 31); group 2 — grade III (n = 36); group 3 — grade IV (n = 46); group 4 — grade V (n = 32).

An increase in volume fraction of chondrocytes in intermediate zone was established. The cellular density growth was associated with an increase in the proportion of 3- and 4-cell lacunae and the emergence of 4-6 cell clusters at the advanced stages of disk degeneration. At the same time, the chondrocyte volume fraction in the superficial zone decreased significantly.

The revealed nature and dynamics of changes in the facet joints can be used in the interpretation of neuroimaging results for more reasonable choice of fixation techniques of a spinal motion segment in degenerative diseases of lumbar spine.

Clinical and anatomical case study of the first death from the novel coronavirus infection in the Novosibirsk Region is presented. The matter of etiology, epidemiology COVID-19 are also briefly taken up, data on pathological anatomy in COVID-19 are generalized, with the emphasis on morphological changes in lungs in pneumonia caused by coronavirus infection.