This article is devoted to contemporary approaches on statins and non-statin lipid-lowering drugs using according to authoritative Recommendations 2015-2016. Both approaches for cardiovascular risk levels estimation with life-style changes intervention, target level of lipid profile’s parameters and characteristics of statins and non-statin hypolipidemic drugs using for dyslipidemia control in different patient’s categories including children, women, oldest, patients with diabetes mellitus, chronic kidney disease, acute coronary syndrome and post- invasive intracoronary procedures, atherosclerosis-associated peripheral arteries disease are presented. The system literature search is performed on Scopus databases, Web of Science, MedLine, elibrary, 
RISC and other.

The main vitamin D (1,25(OH)2D) function lies in maintaining of calcium and phosphates normal concentrations in a blood plasma that is necessary for adequate bone tissue mineralization and skillet formation. Now there’s no doubt that vitamin D immediately participates in the bone tissue metabolism, directly influencing through VDR receptors located on cells: chondrocytes, osteoblasts, osteocytes and osteoclasts. At that, mechanisms of calcium and phosphorus intestinal absorption stimulation and immediate vitamin D influence on bone cells are significant and complementary in the full-fledged bone tissue metabolism regulation process.

The review deals with the description of the mechanisms involved in the formation of kidney fibrosis. Presented molecular factors activation of the pathological process, signaling pathways, competent cells with synthetic provospolitelnyh mediators, the role of epithelial-mesenchymal transition in the development and progression of renal fibrosis. Demonstrated evidence of the importance of the remodeling of the renal arteries of small diameter in the development and progression of renal fibrosis tissue. Sources of information on topics Review article full disclosure, a presentation of the current views on the study of this problem, use the database PubMed citations, RISC, Scopus, Web- Mathematical Sciences, Google Scholar, Copernicus index, Ulrich Periodicals Directory.

Recent years have witnessed the development and clinical implementation of the new approaches to prophylaxis and treatment of different nosological forms of diseases – combination of conventional therapy and immunocorrection. The review analyzes present-day state of nonspecific prophylaxis and treatment of pseudotuberculosis and intestinal yersiniosis. Information is presented on the effectiveness of immunomodulators, products of vital activity of plant cells and sea creatures, prebiotics, immunoglobuline complex (CIP) in prophylaxis and therapy of these diseases.

Distinctive feature of hypertension is the high frequency of a komorbidnost. Patients with hypertension, as a rule, have one or several accompanying pathologies, treat the most often meeting: chronic obstructive pulmonary disease, cerebrovascular disease, diabetes mellitus, hypothyroidism and others. The komorbidnost leads to mutual influence on the course of diseases, character and gravity of complications, quite often complicates diagnostics, defines features of the choice of anti-hypertensive drugs. In references of the European society of cardiologists and the European society on hypertension, the American association of heart and the American Association of strokes, the Russian cardiologic society and the Russian medical society on an arterial hypertonia the approaches to tactics of maintaining patients with hypertension and the accompanying pathology based on data of evidential medicine are designated. Existence of a komorbidnost at patients with hypertension defines not only the choice of antihypertensive drugs, but also target values of arterial pressure. Recently the available representations are added with results of new researches and meta-analyses. Patients with hypertension and a komorbidnost demand individual approach, complex diagnostics and treatment taking into account all available pathologies.

Objective: to ground the choice of ships’ ballast water decontamination methods with disinfection substance under the title 
«Biopag-D».

Materials and Methods: for study of methods of ballast water decontamination in preliminary experiment in vitro with selected concentration «Biopag-D», in which disinfectant has a the strong antibacterial effect against the test microorganisms.

Results: based on the established concentrations the methods of ballast water decontamination are developed (irrigation of empty ballast tanks, adding the working concentration of the disinfectant in complete ballast tanks and the combined method).

Conclusion: the offered methods of ship’s ballast water decontamination with disinfection substance are a new disinfection technology and will assist contribute to the implementation of the international quality standard of ballast water in the Russian Federation.

Objective: to evaluate the prescription of drug treatment of hyperandrogenism according to the diagnostic algorithm by endocrinologists in clinical practice.

Materials and methods: retrospective analysis of 15 case reports of women with established diagnosis of hyperandrogenism. The following parameters were analyzed: clinical manifestations of hyperandrogenism, laboratory studies, prescribed drugs and complications of the treatment.

Results: despite of absence of any clinical indications laboratory examination was performed, the diagnosis of hyperandrogenism was established in all cases and glucocorticoid treatment was prescribed to all patients. Because of long-term drug intake signs of drug overdose were assessed: iatrogenic hypercortisolism was observed in 4 women. The abolition of glucocorticoid treatment was performed in all patients because of absence of any indications. Nevertheless, chronic adrenal insufficiency developed in 2 women, which required lifelong replacement glucocorticoid treatment.

Conclusions: noncompliance of the diagnostic algorithm of hyperandrogenism has led to iatrogenic hypercortisolism.

Objective. Evaluate the change of etiological structure and clinical outcomes of bacteremia in surgical patients after the implementation the system of monitoring and control antibiotic resistance in a multidisciplinary hospital.

Materials and methods. Interventional study with historical controls. The intervention: antibiotic stewardship program, including a group of experts on antimicrobial therapy, antimicrobial therapy and prophylaxis protocols, infection control, improving hospital bacteriological laboratory, educational programs, internal audit. Study onset: June 2013. Analysis of pre-intervention (Jan. 2011-June 2013) and intervention (July 2013-Dec. 2015) periods was carried out. We assessed incidence of bacteremia caused by methicillin-resistant S. aureus (MRSA), vancomycin-resistant Enterococci (VRE), ESBL-producing Enterobacteriaceae, MDR Gram-negative nonfermenting bacteria (MDR-NFGB), incidence of candidemia, hospital length of stay (LOS) and mortality of surgical patients with bacteremia.

Results. In the intervention period a significant decrease in the incidence of bacteremia caused by MDR-NFGB from 50 (14,8%) to 16 (4,7%), р<0,0001, VRE from 10 (3,0%) to 0, р=0,0008 and incidence of candidemia from 29 (8,6%) to 13 (2,8%), р=0,011, was detected. The frequency of bacteremia caused by ESBL-producing Enterobacteriae did not significantly change [103 (30,6%) vs. 86 (25,1%), р=0,124]. Number of MRSA bacteremias remained low [5 (1,5%) vs. 1 (0,3%), р=0,121]. There was a significant reduction of mortality from 36,8% до 22,3%, р<0,007 in the group of surgical patients with bacteremia. The LOS did not change significantly [34 (IQI 21-64) days и 34 (IQI 17,25-60,75) days, р=0,415].

Conclusion. Implementation of system monitoring and control antimicrobial resistance in multidisciplinary hospital allows to significantly reduce mortality in surgical patients with bloodstream infections due to changes in etiological structure of bacteremia, reduction of the incidence of candidemia and bacteremia caused by MDR-NFGNB and VRE, which may be the result of improving the quality of antimicrobial therapy of severe infections.

Objective: to compare different versions of the development movements of the knee joint replacement.

Materials and methods: in the study involved 130 patients who arthroplasty of the knee was performed. Patients were divided into four groups depending on postoperative rehabilitation program. The first group included 25 patients who started the first day of the main complex of the rehabilitation program, and on the third day was carried out active and passive exercises to flex the knee. In the second group there were 25 patients who exercises on the knee flexion was performed 3 days and with the use of passive movement therapy. In the third group there were 40 patients who had been working out of movements applied immediately after surgery, and in the fourth - 40 patients, and the movements development was applied immediately after surgery, and the use of passive movement therapy.

Results: the amount of discharge for drainage and pain on the VAS scale at 1 and 5 hours were longer in patients of Group IV. On a scale of KSS 6 months after surgery was statistically significant difference between I and II, II and III, II and IV groups, and on the WOMAC scale of 12 months after the arthroplasty - between groups I and II. However, 12 months after the arthroplasty statistically significant difference in the groups on a scale we have not found KSS.

Conclusions: subject to adequate balance ligamentous apparatus in knee arthroplasty it is advisable to conduct an early standard rehabilitation program without using hardware techniques. The use of passive movement therapy significantly increases the amount of discharge for the drainage and increases the pain.

Objective: to assess the impact rizendronate acid on clinical and laboratory flow pattern of osteoarthritis in patients with the metabolic syndrome.

Material and methods: the study included 50 patients with osteoarthritis and metabolic syndrome, which on the background of pathogenetic therapy received rizendronate acid at 35 mg per week during the year. Patients were evaluated indicators of inflammatory activity (ESR, CRP, TNF-α). The severity of articular syndrome was interpreted on a scale in rest and during movement, Lequesne index and WOMAC initially and after 3, 6 and 12 months. Mineral bone density (BMD) was assessed at lumbar spine by carrying out dual energy x-ray absorptiometry.

Results: among patients receiving rizendronate acid was recorded a significant decline in CRP, ESR, TNF-α, positive changes in the indicators of the articular status – a significant reduction in the severity of pain at rest and in motion, decrease in Lequesne and WOMAC indexes, the trend of increase in BMD, while reducing the need for non-steroidal anti-inflammatory drugs.

Conclusions: the use of risendronate acid in the complex therapy of patients with osteoarthritis with metabolic syndrome allows to achieve the reduction of the intensity of inflammation, the severity of pain while reducing the need for non-steroidal anti-inflammatory drugs.

Objective: to study the reaction of the cardiovascular system on physical activity in school pupils aged 11-14 years with vision pathology.

Materials and methods: the study was conducted with the participation of 113 school pupils aged 11-14 years. The main group consisted of 58 blind and poor-sighted children, the control group consisted of 55 healthy. To assess the level of the exchange-energy processes occurring in the body using the index Robinson.Status activityof the autonomic nervous system was evaluated on the index Kerdo.

Results: the myocardial oxygen demand is lower in boys withvision pathology of the load at height PWC150 and higher in girls of the same group at the 5th minute of rest than inthe children of the same age in terms of healthy. Kerdo index in children of the main group was higher than in healthy and pointed to the significant prevalence of the activity of the sympathetic nervous system (SNS). Endurance factor in children with vision pathology,regardless of gender, to the load and on the 1st, 5th min rest did not significantly differ from the healthy group.Robinson index during exercise in boys with vision pathologywasof lower and girls in the same group is higher than the children of the same age in terms of healthy.The minute volume of blood (MVB), mean arterial pressure (MAP) at rest was substantially higher and lower load in children with vision pathology.

Conclusions: school pupils with vision pathology of predominant activity of the sympathetic nervous system, reduced Robinson index, minute volume of blood and mean arterial pressure, minor violations of the activity of the cardiovascular system.

Objective: this article presents the analysis of treatment’s results, life’s quality and long-term postoperative period’s complications at using intestine segments for replacement plastic of bladder and ureter.

Material and methods: this study included 122 patients with plactic by intestine segments at urology department of Pirogov National Medical & Surgical Center. At bladder’s reconstructive plastic we used Hautmann’s method (59 operations) and Reddy’s method (36 operations). At ureter’s reconstructive plastic we used method of ileoureteroplastic (all 27 operations). After operation, patients underwent urography with intravenous contrast, cystography for impermeability, anastomotic integrity and the lack of reflux. Evaluation of oncological and functional outcomes included clinical, laboratory and radiological diagnostic methods.

Results: long-term results of intestinal grafts showed the highest level of life’s quality after ileoureteroplastic, the lowest level – after Reddy’s method of bladder’s plastic.

Conclusion: postoperative results of intestinal segments at reconstructive plastic operations on the urinary tract analyzed and assessed.

Purpose: the assessment of buspirone hydrochloride effect on clinical and functional state in patients with chronic heart failure (CHF) and mixed anxiety-depressive disorder (MADD).

Materials and method: the study included 49 patients with heart failure of ischemic etiology and MADD. Patients in Group 1 (n=25) received buspirone hydrochloride (in the starting dose of 15 mg/day with a gradual (within 2 weeks) increasing to the effective (30 mg/day)) in addition to standard CHF and coronary heart disease (CHD) therapy. Patients in group 2 (n=24) received standard therapy of CHF and CHD. After 6 months, we evaluated clinical and functional state in patients from both groups.

Result: a statistically significant improvement in clinical and functional status (functional class of heart failure, physical exercise tolerance) were observed in patients with CHF and MADD in group of patients, who received buspirone hydrochloride in addition to standard therapy.

Conclusion: buspirone hydrochloride admission in addition to standard therapy is associated with clinical and functional state improvement in patients with CHF and MADD.

The Rostov-on-Don Anti-Plague Research Institute interacts with a number of health and scientific institutions of the Federal Service on Consumer Rights Protection and Human Welfare Supervision. The basis of this interaction is formed by the activity on execution of existing and development of new regulatory guidance documents; the work of the Reference Center for cholera monitoring; monitoring of the state of natural focal infections in the Rostov Region; the assessment of anti-epidemic preparedness of health care centres; professional training; guidance and practical assistance to comply with biological safety requirements; as well as the fulfillment of relevant scientific research themes.