Репозиторий Университета

© 2018 Stavropol State Medical University. All Rights Reserved. 57 men and 43 women, aged 22.0±4.2 years were examined to determine the clinical and prognostic value of matrix metalloproteinases in heart remodeling in CTD. Serum concentrations of MMP-1, MMP-9, TIMP-1 were determined by ELI-SA («Cloud-Clone Corp.», China). Imbalance of MMP-1, MMP-9 and their inhibitor - TIMP-1 was revealed in patients with CTD. Significant increase in MMP-1 level was registered in cases of MVP with myxomatous degeneration and mitral regurgitation of II degree. Risk of cardiac remodeling progression at three-year follow-up increases in cases of elevated of MMP-1/TIMP-1 coefficient. Identified changes in the MMPs system in patients with CTD may be used as additional criteria of severity and determination of probability of progression of heart connective tissue structures remodeling.

© 2018 Russian Electronic Journal of Radiology.All Rights Reserved. Purpose. Modern methods of diagnostics and visualization allow timely identifying and sometimes even preventing the development of complications. Our clinical case demonstrates the possibilities and diagnostic algorithm of such serious complication of catheter ablation as pulmonary vein (PV) stenosis. Materials and methods. 61-year old patient after repeated catheter ablations is presented. Results. The use of echocardiography and MSCT allowed determining the stage and characteristics of PVs stenosis. Catheter ablation is one of the most common and effective methods in atrial fibrillation treatment. However, significant increase in number of operations and specialists who perform catheter ablation, leads to appearance of specific complications. Modern methods of visualization and diagnostics allow to timely recognize and sometimes even prevent the development of complications. Conclusion. An echocardiography and MSCT are the main instruments in diagnostics of PVs stenosis.

© 2018 Universiteit Gent. All Rights Reserved. Due to the recent introduction of golimumab into paediatric rheumatology practice, an overview of the clinical studies of this tumour necrosis factor alpha inhibitor, most of which were conducted with adult patients with rheumatic diseases, has been presented. Clinical laboratory effects and tolerability of golimumab in the form of subcutaneous injections have been analysed for rheumatoid arthritis, psoriatic arthritis, and spondylitis. Evaluation of the efficacy and tolerability of golimumab in long-term observational studies (up to 5 years) has been discussed.

© 2018 Izdatel'stvo Meditsina.All rights reserved. Studied the diagnostic and prognostic significance of N-terminal precursor of natriuretic peptide C-type (NT-proCNP) and brain natriuretic peptide (NT-proBNP) in patients with COPD with pulmonary hypertension (PH). The study included 47 patients with COPD (II-IV degrees of severity, 2016 GOLD, men-44, women-3, mean age 59, 3±9.12 years, disease dura-tion of 13.7±5.93 years, the index of Smoking at 23.1±10, 93 pack-years, BAH of 27.2±12, 06 m!kg2.). Criteria of pulmonary hypertension on the basis of the doppler-echocardiography was an increase ofpulmonary artery systolic pressure (PASP) > 40 mmHg alone. Depending on the presence and degree of enhancement PASP patients were divided into three groups: I-without pulmonary hypertension (PASP < 40 mmHg, n=168), 2-moderate pulmonary hypertension (PASP 40-55 mmHg, n=101), 3-group with severe pulmonary hypertension (PASP > 55 mmHg, n=19). There was a statistically significant intergroup differ-ences (p. 2 0, 001, p J} 0, 001, pl3< 0, 001) values of NT-proCNP and NT-proBNP. There was a significant correlation relation-ship SDLA with the concentration of NT-proCNP (r=0, 53, p<0, 05) and NT-proBNP (r=0, 67; p=0, 05). A high diagnostic value of determination of NT-proCNP and NT-proBNP to predict the development and severity of PH in patients with COPD. Cox regression analysis showed that elevated levels of NT-proCNP and NT-proBNP in COPD patients ofPH c are the predictors of hospital mortality.Grant: The study had no sponsor support.

© 2019 American Psychiatric Association. All rights reserved. Abnormal mobility of the posterior membranous wall of the trachea and large bronchi is seen in many bronchopulmonary chronic inflammatory diseases. Currently, clear explanation of a mechanism of the expiratory tracheal stenosis (ETS) is absent. The advanced ETS is associated with severe ventilation abnormalities including asphyxia and syncope. The latter conditions are considered as indications for surgical treatment. Results of the surgical treatment are controversial and are not fully acceptable. For this reason, the surgical treatment for ETS is not routinely used and any successive case of such treatment is of great interest. Strict indications, such as life-threatening conditions or failure of optimal medical treatment, are required for surgical treatment of patients with tracheomalacia and ETS. Surgical treatment for tracheomalacia and ETS is contraindicated in the case of lobar bronchial lesion impeding stabilization the membranous part of the tracheobronchial tree.

© 2018 The Author(s). Background: Cornea protects the eye against natural and anthropogenic ultraviolet (UV) damage and mechanical injury. Corneal incisions produced by UV lasers in ophthalmic surgeries are often complicated by oxidative stress and inflammation, which delay wound healing and result in vision deterioration. This study trialed a novel approach to prevention and treatment of iatrogenic corneal injuries using SkQ1, a mitochondria-targeted antioxidant approved for therapy of polyethiological dry eye disease. Methods: Rabbit models of UV-induced and mechanical corneal damage were employed. The animals were premedicated or treated with conjunctival instillations of 7.5 μ M SkQ1. Corneal damage was assessed by fluorescein staining and histological analysis. Oxidative stress in cornea was monitored by measuring malondialdehyde (MDA) using thiobarbituric acid assay. Total antioxidant activity (AOA) was determined using hemoglobin/H2O2/luminol assay. Glutathione peroxidase (GPx) and superoxide dismutase (SOD) activities were measured using colorimetric assays. Results: In both models corneas exhibited fluorescein-stained lesions, histologically manifesting as basal membrane denudation, apoptosis of keratocytes, and stromal edema, which were accompanied by oxidative stress as indicated by increase in lipid peroxidation and decline in AOA. The UV-induced lesions were more severe and long healing as corneal endothelium was involved and GPx and SOD were downregulated. The treatment inhibited loss of keratocytes and other cells, facilitated re-epithelialization and stromal remodeling, and reduced inflammatory infiltrations and edema thereby accelerating corneal healing approximately 2-fold. Meanwhile the premedication almost completely prevented development of UV-induced lesions. Both therapies reduced oxidative stress, but only premedication inhibited downregulation of the innate antioxidant activity of the cornea. Conclusions: SkQ1 efficiently prevents UV-induced corneal damage and enhances corneal wound healing after UV and mechanical impacts common to ocular surgery. Its therapeutic action can be attributed to suppression of mitochondrial oxidative stress, which in the first case embraces all corneal cells including epitheliocytes, while in the second case affects residual endothelial cells and stromal keratocytes actively working in wound healing. We suggest SkQ1 premedication to be used in ocular surgery for preventing iatrogenic complications in the cornea.

© The authors team, 2018.All Rights Reserved. Due to its cardinal differences from the adult oncology the children's oncology takes a special place in the national cancer control program. The article analyzes up-to-date problems and suggests their solutions. It contains statistical indicators and a three-level model of medical care for children with cancer. The tasks of the national program stated in the article reflect the author's point of view and are to be further discussed.

© 2018 Paediatrician Publishers, LLC. All rights reserved. Background. Planning the management for medical care delivery for children with cancer, as well as analysis of the effectiveness of medical care delivery is based on the statistical indicators analysis. Objective. Our aim was to analyze the main indicators characterizing medical care delivery for children with cancer in the Central Federal District. Methods. The operative reports for 2017 provided by the executive health protection authorities of 18 subjects of the Russian Federation that are part of the Central Federal District have been analyzed. Results. The study enrolled the following data: number of children was 6 824 049 (0–17 years), pediatric oncological departments — 9, pediatric oncological beds — 464, days of berth employment per year — 319.3. The number of practitioners providing medical care to children with cancer was 91, 64 (70.3%) of them had a certificate of training as a pediatric oncologist. In 11 subjects, the department of pediatric oncology was not available; one of the districts did not provide any pediatric oncological beds. The number of primary patients with malignant neoplasms was 821. The number of deceased patients was 156 including 66 identified in 2017. The incidence of malignant tumors was 12 (per 100 000 for the 0–17 age group), the mortality rate was 2.3 (per 100 thousand for the age group 0–17 years), one-year mortality rate — 8%. We failed to reveal the average time from diagnosis establishing till its validation before the treatment onset since the reports did not provide precise information on the point. 12 (1.5%) primary patients left for treatment abroad. Conclusion. Most reports included indicators which lack congruity with one another. The incidence rates were significantly lower than those in countries with high statistical reliability. The percentage of patients identified actively remained extremely low. To improve the revealed defects a single database of children with oncological diseases should be implemented in the Russian Federation.

© 2018 Vserossiiskoe Obshchestvo Kardiologov. All rights reserved. Aim. To evaluate the changes of endothelial function in arterial hypertension (AH) patients with paroxysmal atrial fibrillation (AF) in treatment with propafenone (Propanorm, PRO.MED.CS Praha a.s.) in comparison with bisoprolol. Material and methods. To the study, 62 AH patients included with paroxysmal AH, age 45-63 y.o. (mean age 54,5±3,7 y.o.). Patients were randomized to 2 groups: 32 of group 1 (main) for rhythm-control were taking propafenone (Propanorm, PRO.MED.CS Praha a. s.) 450 mg daily, and 30 of group 2 (comparison) were taking bisoprolol for rate control. The groups were comparable by gender, age, severity of AH and duration of arrhythmia. Changes in endothelium vascular motion function and biochemical markers of endothelial dysfunction were assessed at inclusion and in 12 months of therapy. Results. Sinus rhythm retention in propafenone group facilitated the improvement of vascular motion function of endothelium - endothelium dependent vasodilatation of brachial artery showed tendency to rise significantly from 5,4±0,3% to 6,9±0,1% (р=0,01). In patients taking bisoprolol for pulse reduction during 12 months, there was negative tendency from 4,8±0,2% to 3,6±0,1% (р=0,003), that points on worsening of endothelial function with persistent AF. Repeat measurement of biochemical markers of endothelial dysfunction revealed that in 12 months there is raise of endothelin concentration in both groups. Value of the collagen-binding activeness of von Willebrand factor in 12 months significantly reduced from 131±12 to 118±6 U/dL (р<0,05) in those retaining sinus rhythm with propafenone, and increased from 135±11 U/dL to 147±12 U/dL in those with rate control by bisoprolol. Conclusion. In AH patients with paroxysmal AF retention of sinus rhythm with propafenone facilitated the improvement of vascular motion function of endothelium and decrease of collagen binding activeness of von Willebrand factor.

© 2018 Stolichnaya Izdatelskaya Kompaniya. В последние годы наблюдается очевидная тенденция увеличения в популяции числа пожилых больных. Эти пациенты в большинстве случаев страдают несколькими коморбидными заболеваниями, что значительно утяжеляет прогноз и усложняет тактику ведения. Представлен клинический случай пожилой пациентки, длительное время страдающей сахарным диабетом 2 типа, получающей инсулинотерапию, нахо- дящейся на программном гемодиализе из-за терминальной хронической почечной недостаточности, а также имеющей постоянную форму фибрилляции предсердий. Пациентка была госпитализирована в ГКБ №1 им Н.И. Пирогова по поводу острого повторного инфаркта миокарда. Проведено экстренное чрескожное коронарное вмешательство, стентирование инфаркт-зависимой артерии стентом с лекарст- венным покрытием. Послеоперационный период осложнился развитием острой кровопотери на фоне кровотечения из верхних отделов желудочно-кишечного тракта, тяжелой анемии сочетанного генеза (постгеморрагической, нефрогенной), что потребовало от врачей принятия нестандартных решений по выбору антитромботической терапии. Данный клинический случай иллюстрирует сложности ведения пожилых полиморбидных пациентов в реальной клинической практике, и спорные вопросы, возникающие при назначении им антитромботической терапии, особенно, после развившегося кровотечения. Рекомендательные документы не могут дать ответ на все вопросы, которые ставит перед врачом повседневная практика. В каждом конкретном случае возобновление антитромботической терапии и ее оптимальный выбор для пожилого полиморбидного пациента с развившимся кровотечением является предметом дискуссии, и представляет для лечащего врача настоящий вызов.

© 2018 Media Sphera Publishing Group. All rights reserved. Obesity, including morbid obesity, is a growing worldwide problem. The adverse effect of obesity on the kidneys is associated with the development of comorbid conditions, such as insulin resistance (IR), metabolic syndrome (MS), diabetes mellitus (DM), arterial hypertension (AH), which are the recognized risk factors of chronic kidney disease (ÑKD). Obesity also causes direct kidney damage with the development of non-immune focal segmental glomerulosclerosis. The leading pathophysiological mechanisms of kidney damage in obesity are intrarenal hemodynamic disorders with the formation of hyperfiltration and damaging effects of adipokines produced by adipose tissue. Bariatric surgery (BS) has taken a leading position in the treatment of morbid obesity, demonstrating its effectiveness not only in long-term weight loss, but also in the correction of IR, MS, DM, AH. Nephroprotective effect of significant and persistent weight loss is caused by the elimination of hyperfiltration and damaging effect of adipokines. Results of the observational studies of the immediate and long-term effects of BS have demonstrated positive renal outcomes, in particular, the decrease in albuminuria/proteinuria, the improvement or stabilization of glomerular filtration rate, the delay of end-stage renal failure development; surgical correction of body weight in dialysis patients with morbid obesity lets them realize subsequent kidney transplantation. Large, randomized prospective studies with a longer follow- up are needed; analysis of the long-term renal consequences of BS in obesity patients with pre-existing renal impairment, including dialysis patients, is required; stratification of the BS risk of renal complications (acute kidney damage, nephrolithiasis, nephrocalcinosis) and effective strategy for managing these risks need to be developed.

© 2018 Vserossiiskoe Obshchestvo Kardiologov. All rights reserved. A literature review provided, on the usage of various schemes of perioperational anticoagulation therapy (ACT) in atrial fibrillation patients undergoing scheduled surgery. It is noted that clinicians quite often pass through a situation when patients taking ACT require invasive investigations and surgery. Perioperational management of such category of patients is complicated as, on the one hand, the surgery under ACT is associated with intraoperational hemorrhagic complications, and, on the other hand, ACT cessation might increase the risk of thrombotic complications. The variants assessed, of different periprocedural ACT in patients taking vitamin K antagonists. It was found that as an alternative to continuous ACT recently, bridge therapy with low molecular weight heparins applied, aiming the decrease of the risk of bleeding in adequate thromboprophylaxis. The results of clinical trials provided on the assessment of bridge therapy in surgery. Risk stratification approaches presents for thromboembolic and hemorrhagic complications in surgery.

© 2018 Stolichnaya Izdatelskaya Kompaniya. Acute myocardial infarction (AMI) is one of the main causes of morbidity and mortality, both in the Russian Federation and around the world. Approximately, in up to 10% of patients with clinical diagnostic features of AMI, early angiography does not reveal an occluded vessel or possibly any evidence of coronary artery disease. These patients constitute an intriguing subgroup referred to as "Myocardial Infarction with Non-Obstructive Coronary Arteries" (MINOCA). MINOCA is a collective concept that unites many different pathologies, which determines the essential heterogeneity of the etiological factors. Coronary artery embolism is recognized as an important non-atherosclerotic cause of AMI. In turn, the most common underlying disease in those with coronary embolism is the atrial fibrillation. The advantages of reperfusion strategy and cardioprotective therapy in the treatment of obstructive arteriosclerosis are well studied, widely presented in the literature and supported by a strong evidence base, while the issues of diagnosis and treatment of patients with MINOCA are currently widely discussed We present two clinical cases of embolic myocardial infarction in patients with atrial fibrillation, diagnosed in our clinic in 2017..

© 2018 SPIE. In this work, tissue-engineered structures based on a matrix of protein conjugates, chitosan and carbon nanotubes were prepared and studied. Bovine serum albumin (BSA), bovine collagen (BCrossed D sign¡) were used. Two types of single-walled carbon nanotubes (SWCNTs) were used to form a strong internal scaffold in a protein-chitosan matrix under the action of laser radiation. Tissue-engineered structures were created by means of layered deposition and laser evaporation of the initial aqueous dispersion from SWCNT, BSA, BC and chitosan succinate. As sources of laser radiation, a continuous diode laser with a wavelength of 810 nm and a pulsed fiber laser with a wavelength of 1064 nm and frequency of 80 kHz were used. Studies of tissue-engineered structures were carried out using vibrational spectroscopy methods (IR and Raman). The changes in the frequencies and intensities of the corresponding absorption bands and Raman lines of the amide group oscillations were analyzed. IR spectra of tissue-engineered structures demonstrated a high degree of binding of organic (protein, chitosan) and inorganic (SWCNT) components. The structure and defectiveness of the carbon nanotube scaffold were investigated in the Raman spectra.

© 2018, Indian Journal of Public Health Research and Development. All rights reserved. Study design: randomized controlled before-and-after and in follow-up trial. Forty-six CAD patients volunteered to take part in the study: a group of 27 patients undertook an Intermittent Hypoxia (O2 at 10%) - Hyperoxia (O2 at 30%) Training (IHHT), while a control group (CTRL) of 19 patients was allocated to sham IHHT treatment (breathing via face mask by room air, O2 at 21%). Exercise performance, blood and metabolic profile, quality of life (MOS SF-36, Seattle Angina Questionnaire, SAQ) were measured before and after IHHT/sham IHHT in both groups; the intervention group was also assessed one month after completing the IHHT. The IHHT intervention group showed improved exercise capacity (+1,8 ml O2/min/kg, p=0,02), reduced resting systolic and diastolic blood pressures (151/85 before vs 130/73 after p<0,01), enhanced Left Ventricle Ejection Fraction (62,6±5,5% vs 58±6,2%, p<0,01), glycemia was significantly reduced only at 1-month follow-up (6,18±1,7 after vs 7,10±2,34 mmol/l at baseline, p=0,037). Frequency of angina as reason to stop exercising was significantly reduced after treatment and at 1-month follow-up. In CAD patients an Intermittent Hypoxia-Hyperoxia Training program is associated with improved exercise tolerance, risks factors profile and quality of life (SF-36, SAQ). IHHT has proved to be safe, well tolerable and easily applicable in cardiac patients.

© 2018 Media Sphera Publishing Group.All rights reserved. Purpose: To assess the prevalence of atrial fibrillation (AF) and use of antithrombotic agents in adult patients with acute coronary syndrome (ACS). Materials and Methods. We consecutively enrolled all ACS patients (n=1155) who were hospitalized in two Moscowbased percutaneous coronary intervention centers (each center performs over 500 PCIs a year) between October 2017 and February 2018. AF was diagnosed in 204 patients (17.7%). The risk of thromboembolic complications was assessed using the CHA2DS2-VASc Score. The risk of hemorrhagic complications was assessed using the HAS-BLED Score. The data were processed using StatSoft Statistica 10.0 and IBM SPSS Statistics v.23 software. Results. The prevalence of diagnosed AF was 13.6%, while the prevalence of undiagnosed AF was 4.1%. Of the 179 discharged patients with AF, only 2 had a low risk of ischemic stroke (IS). One hundred and fifty patients (83.8%) eligible for oral anticoagulant therapy received oral anticoagulants. Patients with diagnosed AF were administered oral anticoagulants (OACs) significantly more often than patients with undiagnosed AF [125 (91.9%) vs. 25 (58.1%), р 0.001]. Novel oral anticoagulants (NOACs) were administered four times more often than vitamin K antagonists [120 (80.0%) vs. 29 (19.3%), р0.001]. Rivaroxaban was used in 51.3% of cases. Of the 29 patients treated with warfarin, only 3 (10.3%) achieved the target international normalized ratio (INR) at discharge. Of the 107 patients who underwent percutaneous coronary intervention (PCI), 77 patients (80%) received an OAC and two antiplatelet agents (with 74% receiving this three-agent therapy for one month), 11 patients (10.3%) received an OAC and an antiplatelet agent, and 18 patients (16.8%) received two antiplatelet agents. The only antiplatelet agent used as part of the three-agent therapy was clopidogrel. The three-agent therapy without PCI was administered in 43.1% of cases. Conclusion. We found that the prevalence of AF in patients with ACS was high. The fact that doctors administered NOACs suggests that they are aware of the need to use these agents to prevent thromboembolic complications in AF patients.

© 2018 Media Sphera Publishing Group. All rights reserved. Purpose: To assess effectiveness of algorithms of minimization of right ventricular pacing (MRVP) for prevention of progression of atrial fibrillation (AF), lowering of frequency of hospitalizations due to cardiovascular causes, and mortality in patients with sick sinus syndrome (SSS) and history of paroxysmal AF compared with standard compared with dual-chamber pacing (DDDR). Materials and methods. We included in this single-center prospective study 74 consecutive patients with indications to permanent DDDR pacing because of SSS combined with documented history of paroxysmal AF. Patients were randomized in the groups of DDDR pacing (n=3 6) and with activated algorithms of MRVP (n=38). Pacemaker check up was made after 6 months during I year after device implantation. Primary composite endpoint included development of persistent AF, hospitalization due to cardiovascular causes, and all cause death. Results. During follow-up there was no statistically significant difference in achievement of the primary endpoint (27.8 and 18.4% in groups of DDDR pacing and activated algorithms of MRVP respectively (relative risk 1.29% confidence interval 0.43 to 3.86; p=0.25). Rate of development of persistent AF in both groups was comparable (8.6 and 5.3% in DDDR and MRVP groups, re-spectively; p=0.47). Median AF burden was 6.0 (0;42) and 6.0 (0;42) min/day in DDDR and MRVP groups, respectively (p=0.67). Conclusion. Our study failed to demonstrate advantages of the use of algorithms of decreasing "unmotivated" right ventricular pacing over standard regimen of standard DDDR pacing in patients with SSS and history of paroxysmal AF.

© 2018 Russian Photodynamic Association. All rights reserved. Currently, reconstructive-plastic surgery is becoming the standard for surgical and combined treatment of breast cancer (BC) patients. With a one-stage reconstruction of the breast, the use of biological implants that can replace muscle autografts and, consequently, reduce trauma, blood loss and operation time, and also to avoid defects in the donor zones is becoming topical. From 2014 to 2017, 151 reconstructive operations on 121 patients with BC (average age 41.5 years) using synthetic and biological materials were carried out in P.Herzen Moscow Oncology Research Institute. 0 stage of BC TisN0M0 was diagnosed in 11 (9.1%) patients, I stage - in 52 (42.9%), IIA - in 41 (33.9%), IIB - in 9 (7.4%), IIIA - in 4 (3.3%), IIIB - in 2 (1.7%), IIIC - in 2 (1.7%). To strengthen the lower slope, a biological implant - Permacol acellular dermal matrix, was used in 34 cases. Cosmetic result was rated as excellent in 20 (58.9%) cases, good in 11 (32.3%), unsatisfactory in 3 (8,8%). Biological materials are an important addition to various options for breast reconstruction. The criterion for selecting the material for strengthening the lower slope of the breast with subcutaneous or cutaneous mastectomy for cancer with a one-stage reconstruction using a silicone endoprosthesis is the pinch-test value.

© 2018 Onkopediatria. All rights reserved. Background. Analysis of statistical data in the federal districts of the Russian Federation provides opportunities to assess the quality of medical care delivery in children with cancer and plan further development with consideration for the point elimination of existing defects. Objective. Our aim was to analyze the main indicators characterizing medical care for children with cancer in the North-West Federal District. Methods. The study analyzed operative reports for 2017 provided by the executive public health authorities of 11 subjects of the Russian Federation affiliated to the North-West Federal District. Results. The pediatric population was 2 537 133 children (0-17 years), the pediatric oncological bed capacity - 174 (0.7 per 10 000 aged 0-17 years), the annual berth average occupancy - 290.7 days. 6 (54.5%) subjects did not provide pediatric population with departments of pediatric oncology, 4 (36.4%) subjects did not have bed capacity. The number of practitioners providing medical care to children with cancer was 38, 27 among them (71%; 0.1 per 10 thousand 0-17 years) had a certificate of pediatric oncologist. 2 (18.2%) subjects did not have pediatric oncologists in the medical stuff. The incidence of malignant tumors in children aged 0-17 was 15.6 (per 100,000), the prevalence was 92.6 (per 100,000), the mortality rate was 2.6 (per 100,000), one-year mortality rate - 4.5% (18/397). The number of patients identified actively was 11 (2.8%). 160 (40.3%) primary patients were sent to Federal medical facilities, 6 (1.5%) - left the territory of the Russian Federation for the further treatment. Conclusion. The incidence and mortality rates are rather low which indicates the defects in patient detection and lack of reliable follow-up data. The percentage of patients referred for treatment to Federal medical facilities is not very high; however, to interpret this indicator according to patient routing, we have to analyze the medical history of all the patients. We can assert that health care delivery service for children with oncological diseases is at an acceptable standard level but needs to be improved.

© 2018, Media Sfera. All rights reserved. Given the prevalence of myopic refraction (from 50 to 84% in Asian countries and 35 to 49% in European countries and the United States in young people), the development of methods for monitoring and preventing myopia continues to be an urgent task. One of the directions of pharmacological intervention on the progression of myopia is associated with the use of a non-selective M-cholinoreceptors antagonist — atropine. The review presents the results of studies on various aspects of the potential for topical application of atropine to control the progression of myopia (experimental and clinical data on the mechanism of action, the effectiveness of clinical use, the possible side effects of various concentrations of the drug).The heterogeneity of the data presented does not yet lead to the conclusion that the long-term instillations of atropine are effective in prevention of progressive myopia. In addition, the wide application of this method, for example, in the territory of the Russian Federation, is limited by approved official instruction for the local application of the atropine solution in ophthalmology.