Репозиторий Университета

© 2018, The Author(s). Introduction: Trimetazidine (TMZ) has been shown to reduce angina symptoms and to increase exercise capacity in randomized clinical trials, but more extensive data would be useful to assess its effects in real-world clinical practice and in patients with different durations of disease. Methods: CHOICE-2 was a Russian, multicenter, 6-month, open-label, prospective observational study that assessed the effect of adding TMZ modified release 35 mg bid to antianginal treatment in a real-world setting. The present analysis of CHOICE-2 results explored the effects of adding TMZ to background antianginal therapies with regard to the duration of stable angina. Results: A total of 741 patients with known durations of disease were divided into four groups according to stable angina pectoris (AP) duration, ranging from less than 1 year to more than 9 years. Addition of TMZ led to a significant decrease in the frequency of angina attacks and in the use of short-acting nitrates in all groups. In patients with recently diagnosed angina (AP duration < 1 year), the average number of angina attacks per week decreased significantly from 3.75 ± 4.63 to 0.67 ± 1.51 and in those with advanced disease (AP duration > 9 years) from 5.63 ± 5.24 to 1.32 ± 2.07. Angina-free walking distance also improved significantly. Addition of TMZ also improved patient well-being. Results were achieved rapidly (within 2 weeks), were maintained over 6 months, and were obtained in all patient groups regardless of angina duration. Conclusion: TMZ added to other antianginal therapies proved to be effective for reducing angina attacks and short-acting nitrate use, increasing angina-free walking distance, and improving patient well-being in a real-life setting, irrespective of angina duration, including patients with recently diagnosed angina. This provides an opportunity for intensification of treatment early on in the disease process, with the aim of decreasing angina burden and improving patient quality of life. Funding: Servier. Trial Registration: ISRCTN identifier ISRCTN65209863. Plain Language Summary: Plain language summary available for this article.

© 2018, The Author(s). Efficacy and safety of tocilizumab (TCZ), an interleukin-6 receptor inhibitor, were demonstrated in juvenile idiopathic arthritis (JIA) with polyarticular course (pJIA) in the CHERISH trial. This observational, III phase study evaluated long-term treatment of TCZ in pJIA patients was conducted by members of the Pediatric Rheumatology International Trials Organization (PRINTO) from Poland and Russia. Forty-one patients, who had completed the CHERISH core study (104 weeks), were extensionally treated with TCZ (8 mg/kg, intravenous infusion every 4 weeks). Total treatment time was from 131 to 193 weeks. The long-term safety (the primary endpoint) and efficacy were evaluated. All patients achieved ACR70 response in the core study and continued to achieve at least ACR50 response up to week 24 of this study. The safety population comprised 46.41 patient-years (PY). Rates per 100 PY of adverse (AEs) and serious events (SAEs) were 181.0 and 6.46, respectively. Pharyngitis and respiratory tract infections were the most common AEs. Except one AE (severe neutropenia), all others were classified as mild (24.4%) or moderate (29.3%). The incidence of SAEs was low (7.3%). No new safety findings were observed. The safety profile of over 2.5-year treatment with TCZ is consistent with the pre-marketing CHERISH clinical trial. Presented data and continued efficacy response support the use of TCZ in pJIA. EUDRACT No: 2011-001607-12. https://clinicaltrials.gov/ct2/show/study/NCT01575769?term=ML27783.

© 2017, Springer Science+Business Media, LLC. The overview demonstrates how the use of only one physico-chemical approach, viz., the electron paramagnetic resonance method, allowed detection and identification of dinitrosyl iron complexes with thiol-containing ligands in various animal and bacterial cells. These complexes are formed in biological objects in the paramagnetic (electron paramagnetic resonance-active) mononuclear and diamagnetic (electron paramagnetic resonance-silent) binuclear forms and control the activity of nitrogen monoxide, one of the most universal regulators of metabolic processes in the organism. The analysis of electronic and spatial structures of dinitrosyl iron complex sheds additional light on the mechanism whereby dinitrosyl iron complex with thiol-containing ligands function in human and animal cells as donors of nitrogen monoxide and its ionized form, viz., nitrosonium ions (NO+).

© 2018. ASERS Publishing. All rights reserved. The paper understands cross-border natural resources as a totality of characteristics of local ecological systems, which can act as regulators of human’s life space. Authors state that uniqueness of this phenomenon is defined by the fact that all natural resources act as a single system of planet scale. The problem distinguished in the paper is based on the fact that in the period of ecological systems and natural resources development a little attention is paid to cross-border management on the part of nations they belong to. The research subject is an indicator of stability and quality of management of cross-border natural resources in the aspect of their even existing and carrying out of their functions. Scientific novelty of the research is that it’s proved for the first time that each ecological system has s number of parameters, one of which shows how much it resistant to human impact. The system of providing biodiversity is one of such parameters. In the paper the legal characteristics of the issue are identified with the actual state of interstate cooperation and the opportunity of its expansion within the already existing interstate formation is determined. The example of such formation is European Union. The areas of further research can be defined as an expansion of specified cooperation of Asian and South American continent.

© 2018, Pediatria Ltd.. All rights reserved. Therapy with genetically engineered biological preparations (GEBP) significantly improved the prognosis and quality of life of patients with juvenile idiopathic arthritis (JIA). However, primary or secondary in efficiency, the development of undesirable phenomena require switching to another GEBP. Objective of the research – to determine optimal GEBP preparations when selecting and switching therapy based on the analysis of prescribed GEBP in real practice, depending on the clinical version of the JIA and the presence of uveitis. Materials and methods: the study included 322 patients with JIA on GEBP therapy, observed in the Pediatric Rheumatology Department of Children's Clinical Hospital of the I.M. Sechenov First Moscow State Medical University from Jan. 1, 2015 to Dec. 31, 2017. Retrospective, continuous observational clinical study. Of 322 patients, 70 (21,74%) had systemic JIA, 155 patients (48,14%) had polyarterial seronegative for rheumatoid factor (RF–) variant of JIA, 9 patients (2,8%) – polyarticular seropositive for rheumatoid factor RF+) variant of JIA, 55 patients (17,08%) – oligoarticular (persistent and spreading) variant of JIA, 26 patients (8,07%) – enthesitis (juvenile spondylitis), 7 patients (2,17%) – psoriatic variant of JIA. Results: as the first biological preparation were prescribed: etanercept to 177 (54,97%) patients; adalimumab to 51 (15,84%); tocilizumab to 44 (13,66%); abatacept to 39 (12,11%); infliximab to 11 (3,42%) patients. Transition to the second line of biological therapy was performed in 51 patients (in 15,8% of cases), on the third line of therapy in 13 patients (in 4,04% of cases), on the fourth line in 3 patients (in 0,93% of cases). As the second-line GEBP adelimumab was prescribed in 22 cases (43,14%), tocilizumab in 13 (25,49%), etanercept in 11 (21,57%), abatacept in 5 (9,8%). GEBP inefficiency was the reason for switching to the second line in 32 cases (9,9%). Of these, secondary inefficiency in 22 cases (6,8%); primary inefficiency – in 4 (1,3%), low efficiency – in 6 (1,9%), development/exacerbation of uveitis – in 7 patients (2,2%), in 6 cases (1,9%) due to insufficient compliance, drug shortage in the community, etc. Adverse effects caused switching in 5 patients (1,6%), incl. in 4 children – infusion reactions, in one – tuberculosis. Analysis of GEBP choice depending on the disease form and the presence of uveitis, was performed in 3 groups. Group 1 (n=70) consisted of patients with systemic JIA. Group 2 (n=53) included patients with articular form of JIA and concomitant uveitis. Group 3 (n=199) included patients with articular form of JIA without concomitant uveitis. Patients with systemic JIA as the first-line GEBP tocilizumab was prescribed significantly more often – to 38 patients out of 70 (54,29±5,96%) than etanercept – to 19 patients (27,14±10,19%) (t=2, 3, p<0,05), and other drugs in total (infliximab, abatacept, adalimumab) – to 13 (18,57±10,88%) (t=2,9, p<0,05). Switching to GEBP second line in this group was performed in 20 patients (28,57%). Tocilizumab was the final choice drug (after 3 years of follow-up) at the time of samples collection in 50 patients (71,43%) with systemic JIA. In patients with articular forms of JIA and concomitant uveitis as the first-line GEBP, adalimumab was prescribed significantly more often – in 34 of 53 cases (64,15±8,23%) than other drugs (abatacept, etanercept, infliximab) in total – 19 of 53 cases (35,85±11,01%) (t=2,06, p<0,05). Adalimumab was the drug final choice at the time of sample collection for 43 (81,13%) patients with JIA and uveitis. Most patients with articular form without uveitis received etanercept as first-line GEBP, 150 of 199 (75,38±3,54%), and etanercept prescription frequency was significantly higher than that of other drugs (abatacept, adalimumab, tocilizumab, infliximab) in total – 49 of 199 (24,62±6,19%) (t=7,1, p<0,01). In this group, the switching frequency was the smallest and amounted only 8,54%. The number of patients who received etanercept at the end of the study actually remained unchanged – 148 patients (74,37%).

© 2018 Elsevier Inc. Sport-related injury patterns among Para athletes have been described with increasing frequency. This review summarizes musculoskeletal injuries in Para athletes. Seated Para athletes sustain upper extremity injuries more commonly; ambulant Para athletes frequently sustain lower extremity injuries. The upper extremity is the most commonly injured anatomic area in all Para athletes, unlike able-bodied athletes. Advanced age and spinal cord injury may increase the risk of upper extremity injury. Injury data for recreational and youth Para athletes are sparse. Summarizing current injury epidemiology data may help to accelerate the development of injury prevention strategies and lifetime injury models for Para athletes.

BACKGROUND: total hip replacement has long ago become the «golden standard» for the treatment of dysplastic coxarthrosis in thousands of the patients receiving it every year. In the meantime, the analysis of the specialized literature gives evidence of the lack of a systematic and personified approach to the rehabilitation treatment. AIM: The objective of the present study was to improve medical rehabilitation of the patients following the total hip replacement and to develop the personalized programs for walking modality reconstruction taking into consideration the age and the body weight of the patients. PATIENTS AND METHODS: A total of 240 patients were available for the observation including 184 women and 56 men. They were divided into three study groups and one control group, with the differentiation into the following three subgroups: one comprised of the patients of moderate acerage age and body weight, the other containing the obese patients (BMI>35), and the third one involving the elderly patients (age >70 years); each subgroup consisted of 20 patients. All the patients received the early basic rehabilitation treatment, those in the study groups had to perform in addition the robotic training based on the use of hardware techniques supplemented by passive mechanotherapy and electromyostimulation designed to restore the walking stereotype with three types of devices: body weight unloading, video-reconstruction associated with biological feedback and robototherapy. RESULTS: The comparative analysis of the effectiveness of various methods of gait reconstruction has demonstrated the high effectiveness of the application of the hardware technique in the patients of moderate acerage age and body weight. At the same time, the elderly patients had a significantly higher rate of successful walking reconstruction efficiency under the influence of the video-associated training with biological feedback (3 times that achieved with training using the device for unloading the body weight and 4 times compared with the result of a course of robotic walk. The evaluation of the application of the techniques for the gait stereotype reconstruction in the obese patients gave evidence of the advantage of the Lokomat robotic trainings that produced 6 times better results than unloading of the body weight and 5 times better ones than the video-associated training with biological feedback. DISCUSSION: The results of the present study are on the whole comparable with the data reported by other authors although its design was different from that of the majority of the published studies in that our patients were allocated to different subgroups for the further personalization of the methods applied to restore the gait stereotype. The factors limiting the use of the results of this study include the medium-high level of the patients' welfare most of whom are residents of the city of Moscow and Moscow region characterized by a relatively high quality and accessibility of health care. It means that the results of such studies as the one described in the present article are directly related to the quality and accessibility of health care and can be extrapolated only to the socially safe and well-to-do patients. CONCLUSIONS: All the hardware techniques are equally effective in the patients of moderate average age and body weight. The elderly patients showed the best results using the video-reconstruction associated with biological feedback, while the Locomat technique was especially useful for the obese patients.

© 2017 Taylor  &  Francis. In this study, we tested a hypothesis that a short-term estradiol therapy may reduce blood pressure in preeclampsia by modulating plasma oxidative stress. The intramuscular injections of 10 mg 17-beta-estradiol were prescribed to preeclamptic pregnant women during the 3-day therapy before a labor induction. The analyses of mean arterial pressure (MAP), serum estradiol concentrations, plasma superoxide anion (O2.), hydrogen peroxide (H2O2), nitrites (NO2−), and peroxynitrite (ONOO−) were conducted before and during the therapy. We found that the plasma concentrations of oxidative stress markers, such as O2– and H2O2, are higher in preeclampsia and positively correlated with the MAP value. Moreover, it was shown that the plasma concentration of NO2– as an indicator of NO levels is higher in preeclampsia. A short-term intramuscular application of estradiol decreases the MAP value and the plasma concentration of O.–, H2O2, NO2−, and ONOO– in preeclampsia. A positive correlation between the decrease of MAP values and the decrease of plasma concentrations of O2–, H2O2, and ONOO– was found in preeclampsia during a short-term estradiol therapy. We conclude that the short-term estradiol therapy decreases the MAP value in preeclampsia by modulating the plasma oxidative stress. We speculate that the estradiol metabolism in preeclampsia is an important mechanism that contributes to vascular dysfunction.

© 2018, The Author(s). Introduction: Heart rate (HR) reduction is an integral part of antianginal therapy, but many patients do not reach the guideline-recommended target of less than 60 bpm despite high use of beta-blockers (BB). Failure to uptitrate BB doses may be partly to blame. To explore other options for lowering HR and improving angina control, CONTROL-2 was initiated to compare the efficacy and tolerability of the combination of BBs with ivabradine versus uptitration of BBs to maximal tolerated dose, in patients with stable angina. Methods: This multicenter, open, randomized study included 1104 patients with Canadian Cardiovascular Society (CCS) class II or III stable angina, in sinus rhythm, and on background stable treatment with non-maximal recommended doses of BBs. Consecutive patients were allocated to ivabradine + BB or BB uptitration in a 4:1 ratio. Results: At the end of the study (week 16), addition of ivabradine to BB treatment and BB uptitration resulted in reduction in HR (61 ± 6 vs. 63 ± 8 bpm; p = 0.001). At week 16, significantly more patients on ivabradine + BB were in CCS class I than with BB uptitration (37.1% vs. 28%; p = 0.017) and significantly more patients were angina-free (50.6% vs. 34.2%; p < 0.001). Patient health status based on the visual analogue scale (VAS) was also better in the ivabradine + BB group. Adverse events (AEs) were significantly more common with BB uptitration than with the ivabradine + BB combination (18.4% vs. 9.4%, p < 0.001). Conclusion: In patients with stable angina, combination therapy with ivabradine + BB demonstrated good tolerability, safety, and more pronounced clinical improvement, compared to BB uptitration. Trial Registration: ISRCTN30654443. Funding: Servier.

© 2018 Paediatrician Publishers, LLC. All Rights Reserved. The article provides the characteristic of a tumor from cells of cartilaginous tissue - chondroblastoma. Current data on etiology, key links of pathogenesis, types of tumor, General clinical manifestations, approaches to diagnosis and treatment in children are analyzed.

© 2018 Russian Electronic Journal of Radiology.All Rights Reserved. Thiscreatic Featuresarticlehead, ofpresentsthisthat clinicalwas theoperated clinicalcase arecasetwice, difficultiesofbut patientfirst in pre-withoperation andneuroendocrineintraoperativedid not lead tumortopicalto recovery. ofdiag-pan-nosis of small size insulinoma. The authors came to the conclusion that topical diagnostics should be complex.

© 2018, Dynasty Publishing House. All rights reserved. The objective. To specify the frequency and species composition of vaginal bacterial carriage in pregnant women at the term of gestation 35–37 wks. Patients and methods. We examined 800 pregnant women, who were followed-up on an outpatient basis at terms of gestation 35–37 wks. Cultural examination of the content of the posterior vaginal fornix was performed. Species identification of microorganisms was performed by the method of direct protein profiling with the help of MALDI-TOF mass spectrometry, FLEX series, Bruker Daltonic GmbH, Germany. Results. The growth of flora was obtained in 761 patients (95%). Bacterial vaginosis (n = 71), Candida vulvovaginitis (n = 83) were diagnosed in 154 patients (19%). Lactobacillus spp. were found in 80% (n = 637) of examined women, of them in 161 (20%) in monoculture. Bacterial carriage was diagnosed in 55.8% of cases. The prevalence of Enterococcus faecalis, Escherichia coli, Streptococcus agalactiae, Staphylococcus epidermidis and Staphylococcus haemoliticus was noted. They were much more rarely detected in monoculture: E. faecalis (1%), S. agalactiae (0.1%), S. epidermidis (0.1%), Candida albicans (0.1%). In 39 (5%) patients, no growth of flora was found. In 17 patients we found extended-spectrum B-lactamase-producing bacteria: E. coli (n = 15), Klebsiella pneumoniae (n = 2). Conclusion. Taking into account a high prevalence of vaginal bacterial carriage in pregnant women in the 3rd trimester, it might be expedient to consider inclusion of microbiological examination of vaginal discharge in the basic spectrum of antenatal observation and screening examination of pregnant in the Russian Federation.

BACKGROUND: The relevance of this ensues from the fact that despite the numerous currently available health promotion training programs for the reduction of body weight, there is still the need for the development of the new forms of the efficacious physical training programs and the methods of motivation for compliance with them among the people of different age, sex and social status. AIM: The objective of the present study was to determine the role of motivational factors, including the assessment of the biological age, in the improvement of the effectiveness of the health promotion training programs for the reduction of the excess body weight. MATERIAL AND METHODS: A total of 82 students with overweight and first-degree obesity at the age from 17 to 21 years (average age 18.5±1.4 years) were examined. 42 girls included in the first (main) group spent 9 months performing health promotion training programs on an individual basis developed taking into consideration the motivational factors. The physical training programs included the aerobic exercise in the form of dance classes. 40 students in the control group were engaged in physical training envisaged by the academic curriculum of the university. The third group (the group of comparison) was comprised of 36 practically healthy girls having the normal body weight. We studied the components of the body composition with the use of bioimpedanceometry, evaluated the physical working capacity (the PWC-170 test) and the adaptive reserves of the body (heart rate variability test as proposed by R.M. Baevskyi, Garkavi test). In addition, the psycho-emotional status of the participants was estimated making use of the Lusher test and SAN. The biological age was determined by the original method based on the combination of the morphological and functional indices. RESULTS: The excess body weight in the students comprising group 1 was reduced by 10% on the average; simultaneously the physical working capacity among these students increased by an average of 24.5% while the level of emotional stability and self-esteem increased by 20% and 24%, respectively. We also documented a decrease in the initially increased biological age by 5 years on the average. The students included in group II did not experience any significant changes in the parameters of interest. CONCLUSION: The consideration of the motivational factors for the development of the training programs designed to promote the reduction of the excessive body weight significantly increases their effectiveness, as evidenced by the improvement of the morpho-functional and psychological characteristics in the students of the first group and its absence in their counterparts included in group II.

© 2018, Media Sphera Publishing Group. All rights reserved.  Objective. To assess the prognostic significance of biological rhythms in depression on the example of the individual chronotype. Material and methods. One hundred patients (women 68%), aged 18—77 years, mean age 48±16, were examined before and after 8 weeks of treatment. The Morningness-Eveningness Questionnaire (MEQ) was used. Treatment response (a decrease of 50% in total MADRS scores to the 8 th week of treatment) and dynamics of depression severity (dMADRS; R) were assessed. Results and conclusion. Evening chronotype was found to be associated with poor prognosis. TCAs and SSRIs were more effective in eveningness, other antidepressants—in morningness. MEQ changes during and after treatment may reflect the resynchronizing activity of antidepressants.

© 2018 Media Sphera Publishing Group. All rights reserved. Development and use of new anticancer drugs has resulted in the improving of 5-year survival rates in patients with cancer. However, many of the modern chemotherapies are associated with cardiovascular toxicities that increases cardiovascular risk in cancer patients, including hypertension, heart failure, thrombosis and thromboembolism, cardiomyopathy, and arrhythmias. These side effects limitation restrict treatment options and farther perspectives. With increasing use of modern chemotherapies and prolongation of the cancer patients survival, the incidence of cardiovascular disease in this patient population will continue to increase. Accordingly,careful assessment and management of cardiovascular risk factors in cancer patients by oncologists and cardiologists working together is essential for optimal care.

The objective of the research was to elaborate experimental-theoretical and clinic-bacteriological rationale for the application of laser diagnostic for identification of main pathogens of purulent-inflammatory processes in maxillofacial area. For germs identification by giant Raman scattering effect SERS-substrate with nano silver metallic balls, reference strains (Ps. aeruginosa 27853 and S. aureus 25923) and clinical cultures of Staphylococcus, Bacillus and Escherichia coli were used. Using an example of purulent inflammation pathogens we considered that each of bacterial species is characterized by individual spectral lines of Raman scattering, which allows to identify them in short term (1-2 min). Moreover the proposed method is highly sensitive (105-106 CFU/ml). Creation of germs library and device portability makes use of laser diagnostic for express-indication purulent infections possible directly in clinical conditions. Thus, analytical capability, quick result, high sensitivity and peculiarity, economical effectiveness due to lack of necessity to use growth medium and to transport it to microbiological lab gives an opportunity to consider laser diagnostic as a perspective universal express-method of clinical microbiology.

© 2018 Stolichnaya Izdatelskaya Kompaniya. The article presents a clinical observation of the left atrial appendage thrombosis in a 51-year-old female patient with a paroxysmal form of nonvalvular atrial fibrillation which occurred despite long-term anticoagulant therapy with apixaban in a full dose (5 mg b.i.d.), and the patient's management. The patient was admitted with recurrent symptomatic paroxysm for more than 48 hours, because of which, in accordance with the recommendations, transesophageal echocardiography was performed before an emergency rhythm restoration. Thrombus in the left atrial appendage 0.5×1.03 cm in size was detected. It was decided to refrain from the immediate restoration of the rhythm due to the very high risk of thromboembolic complications. In connection with the categorical refusal of the patient from warfarin, it was decided to replace apixaban with another direct oral anticoagulant - dabigatran 150 mg bid for a period of 4 weeks followed by performing a control transesophageal echocardiographic study. As a result, no thrombus was found on control echocardiography. The particularity of this observation is concomitant hypertrophic cardiomyopathy and diabetes mellitus type 1 in this patient..

© Bionika Media Ltd. Objective. To carry out a systems analysis of the data available in the current literature on the impact of vitamin D deficiency on the risk of endometriosis and reproductive cancer, as well as on the possibilities of vitamin D supplementation in order to treat and prevent these diseases. Material and methods. The review includes the data of foreign and Russian articles published in the past 10 years and found in Pubmed on this topic. Results. The paper describes the mechanisms by which vitamin D is involved in the processes of inflammation, immunomodulation, and proliferation, as well as the role of its deficiency in pathogenesis of pathological proliferation and inflammation in endometriosis, breast cancer, and ovarian cancer. It gives the data of clinical trials confirming the role of vitamin D deficiency in the progression and negative effects of endometriosis and carcinogenesis, the possibility of vitamin D supplementation for the prevention and adjunct therapy of reproductive cancer and endometriosis. Conclusion. It is necessary to conduct further studies to experimentally and clinically evaluate vitamin D deficiency in endometriosis and cancer. Currently, vitamin D supplements should be prescribed to patients with this pathology if they have been found to have a low blood level of 25(OH)D3.

© 2018 Dynasty Publishing House. All rights reserved. The objective: To study the effectiveness and long-term outcomes of sclerotherapy for ovarian endometriomas and to substantiate the conditions and indications for minimally invasive intervention. Patients and methods: We analysed 124 interventions performed by the technique of aspiration (sclerosing) therapy of endometrioid ovarian cysts. The patients' age varied from 18 to 42 years, averaging 26.4 ± 4.2 years. The mean diameter of ovarian endomeriomas varied from 25 to 65 mm. In 84 (67.7%) of observations, pathological process was unilateral, in 72.3% - bilateral. 43 (34.6%) women had disease recurrence after previously performed cystectomy, in 28 (22.6%) endometrioid cysts were located in the only ovary and in 7 (5.6%) patients ultrasonography found that the ovary contralateral to endometrioid tumour was sharply decreased and its sections lacked the signs of antral follicles after preceding cystectomy. In fact, in 35 (28.2%) patients endometrioma was diagnosed in the only ovary. All patients after aspiration therapy of endometriomas received dienogest (2 mg) + ethinylestradiol (0.03 mg) (Siluette®, «Gedeon Richter»). Results: The recurrence rate of endometriomas during the first 12 months of follow-up was 38.7%, during the first 3 months of follow-up this parameter did not exceed 9.7%. Within 7-12 months after intervention spontaneous pregnancy occurred in 36.3% (46) of women, ending with childbirth in all cases (with the use of contraception 25 patients - 46%). Conclusion: Sclerotherapy of ovarian endometriomas with ultrasound monitoring of intervention is a minimally invasive method of treating women of reproductive age, ensuring preservation of ovarian reserve. It is not a monotherapy, its outcome is in many respects determined by the adequacy of postoperative hormonal treatment.

2019 © Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All Rights Reserved. The goal of study was the epidemiological substantiation of optimization measures of a vaccinal prevention of whooping cough in the Russian Federation. Materials and methods. The retrospective descriptive epidemiological research has been conducted by analysis of the official statistical data on the whooping cough case rate (form No. 2) in 2005-2017 in the Russian Federation, as well as the data about preventive whooping cough inoculations (forms No. 5, No. 6) in 2005-2017 and about epidemic outbreakes in 2017 (form No. 23-17). The assessment of an economic damage from whooping cough in 2005-2017 has been carried out. Results. The following adverse characteristics of a modern epidemiological situation on whooping cough in Russia are shown: long-term recurrence of epidemic process, tendency of rising of a case rate of children of 0-2 years; high percentage of children of preschool and school age among whooping cough cases; prevalence among the patients with whooping cough of the children who have been vaccinated against this infection previously, epidemic outbreakes in children's collectives, the stability of a case rate of teenagers and adults with prevalence of the mild and the erased clinical forms of this infection. The risks due to weaknesses of the whooping cough vaccinal prevention are noted: the insufficient immunization coverage owing to falce contraindications and refusals of parents of vaccinations of children, noncompliance with terms and intervals between inoculations, lack of domestic vaccine for revaccination of children at the age of 5 years and older. Conclusion. It is necessary to introduce in the national vaccination schedule a preschool booster dose for children at the age of 6 and adolescents at 14 years with the combined reduced antigen content tetanus-diphtheria and acellular pertussis vaccines as well as the inoculations of this vaccine according to epidemiological indications to health workers, employees of educational institutions. A revaccination against whooping cough is recommended as “cocoon” for the persons contacting to not vaccinated child under 1 year of age.