g., hepatologist or infectious diseases) for Medicaid coverage of hepatitis C drugs, thus increasing the number of patients receiving Hepatitis C treatment. A multi-partnered community approach facilitated by the widespread use of a technology-based provider education platform has facilitated the availability of curative therapy for a potentially fatal disease.

Key lessons learned include leveraging existing partnerships and implementing projects based on provider needs. A unique result of WV Project ECHO is WV Medicaid’s decision to accept case presentations made during the Hepatitis C ECHO session as the specialty consultation requirement (e.g., hepatologist or infectious diseases) for Medicaid coverage of hepatitis C drugs, thus increasing the number of patients receiving Hepatitis C treatment. A multi-partnered community approach facilitated by the widespread use of a technology-based provider education platform has facilitated the availability of curative therapy for a potentially fatal disease.

Since many people now live with human immunodeficiency virus (HIV) as a complex, chronic health condition that may require frequent medical and psychosocial services, a potential new role for HIV-positive peers involves support during an inpatient admission that extends past discharge to improve the transition home from hospital. We sought to begin outlining scope of peer support in complex HIV care, by detailing a training curriculum alongside experiences and recommendations by Peer Volunteers.

A community-clinical partnership designed a personalized peer intervention for people living with HIV who were acutely hospitalized and struggling with antiretroviral adherence and substance use. Five Peer Volunteers delivered the program, which involved being matched with a participant for a pre-discharge in-person meeting followed by frequent phone contact in the 7 weeks following discharge. A 4-day peer training focused on active listening, structuring a call, use of self, boundaries, and facilitating program ced maintaining an emotional connection over the phone and were concerned when participants were nonresponsive. This article discusses how the training was piloted and adapted for practice.

Substantial evidence supports community health workers’ (CHWs) contributions to improving health and reducing inequities. Common evaluation indicators can strengthen the evidence base and support the profession.

We describe the development of a 6-year community-academic partnership to identify common CHW process and outcome indicators.

Methods include interviews, focus groups and a survey conducted in Michigan, a Summit in Oregon, consultations at national conferences, and regular conference calls.

Using popular education as a primary strategy, we have honed our original goal, identified a set of 20 recommended constructs, developed a national constituency with international connections, and obtained dedicated funding.

Participatory identification, development, and uptake of a set of common indicators (CI) for CHW practice will allow data to be aggregated at multiple levels, potentially leading to more sustainable financing of CHW programs. Given that measurement drives practice, a set of common CHW indicators can help to preserve the flexibility and integrity of the CHW role.

Participatory identification, development, and uptake of a set of common indicators (CI) for CHW practice will allow data to be aggregated at multiple levels, potentially leading to more sustainable financing of CHW programs. Given that measurement drives practice, a set of common CHW indicators can help to preserve the flexibility and integrity of the CHW role.

Marginalized populations experience health-harming legal needs-barriers to good health that require legal advocacy to overcome. Medical-legal partnerships (MLPs) embed lawyers into the healthcare team to resolve these issues, but identifying patients with health-harming legal needs is complex, and screening practices vary across MLPs.Purpose of Article Academic and community partners who collaborate in an MLP at a school-based health center (SBHC) share their process of co-creating a two-stage legal check-up for adolescents.

Screening adolescents for health-harming legal needs is challenging. It took ongoing collaboration to refine the process to fit the needs of adolescents and meet the partners’ goals.

Social determinants of health play a significant role in health disparities, and there is a need for innovative solutions to screen and address these in vulnerable populations. Other partners can learn from our experiences to co-create their own approach to addressing health-harming legal needs.

Social determinants of health play a significant role in health disparities, and there is a need for innovative solutions to screen and address these in vulnerable populations. Other partners can learn from our experiences to co-create their own approach to addressing health-harming legal needs.

Lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth may have limited exposure to sexuality education programming that is affirming of their identities and unique experiences.

To develop and evaluate the feasibility and acceptability of a theater-based HIV prevention workshop for LGBTQ youth.

The 3-hour-long workshop (piloted 2014-2015; n = 20 LGBTQ youth, 14-22 years old) consisted of instruction in HIV risk and prevention, humorous role plays, and analysis of HIV prevention strategies using a forum theater format. A mixed methods evaluation focused on feasibility and acceptability, with survey assessment data collected for preliminary efficacy (e.g., HIV knowledge, safer sex self-efficacy).

Participants perceived the forum theater format, humor, and reality of the scenes as strengths. The language of workshop scripts and evaluation materials could be further modified to better affirm gender and sexual diversity.

Preliminary evidence of feasibility and acceptability were demonstrated. Future iterations of the intervention require rigorous quantitative evaluation for efficacy.

Preliminary evidence of feasibility and acceptability were demonstrated. Future iterations of the intervention require rigorous quantitative evaluation for efficacy.

Responding to concerns about perinatal health risks and adverse outcomes, we established a community-based participatory research (CBPR) partnership between a Nêhiyawi (Cree) community and university-based researchers. We designed and implemented a community-derived Elders Mentoring Program (EMP) to provide additional support for pregnant women and their partners. Our objective was to understand the collective experiences of those involved in the Program.

We conducted a qualitative description with the principles of CBPR as an overarching framework. We carried out 14 qualitative interviews with parents, perinatal clinic staff, and mentor Elders involved in the Program. We also used detailed notes from Community Advisory Committee (CAC) meetings as data. All qualitative data were analyzed with content analysis.

The Program helped pregnant women and their partners by fostering enhanced and multi-generational support networks. It also improved cultural security within the clinical environment and learning among health care staff. A sense of intergenerational fulfillment and enjoyment among those involved was common and was underpinned by genuine, collaborative relationships.

A community-derived prenatal EMP, designed in partnership with those who have intimate knowledge of the community, is a major step toward ensuring multi-generational and culturally secure care in pregnancy for women and families.

A community-derived prenatal EMP, designed in partnership with those who have intimate knowledge of the community, is a major step toward ensuring multi-generational and culturally secure care in pregnancy for women and families.

Community-based participatory research (CBPR) can effectively address health disparities among groups that are historically difficult to reach, disadvantaged, of a minority status, or are otherwise underrepresented in research. Recent research has focused on the science of CBPR partnership constructs and on developing and testing tools for self-evaluation. Because CBPR requires substantial investment in human and material resources, specific factors that support successful and sustainable research partnerships must be identified. We sought to describe the evolution, implementation, and results of a self-evaluation of a CBPR partnership.

Academic and community members of the Rochester Healthy Community Partnership (RHCP) and researchers from the University of New Mexico-Center for Participatory Research collaborated to evaluate RHCP with qualitative and quantitative research methods and group analysis.

The self-evaluation was used to provide an overall picture of the „health” of the partnership, in termsers to reflect on the mission and values of the partnership, explore the history and context for its existence, identify factors that have contributed to outcomes, and plan strategically for the future.

High staff turnover rates are a burden for behavioral health providers because they may negatively impact staff morale, quality of care, and clinical outcomes as well as increase costs. The Staff Assessment and Retention (STAR) Project is a partnership between a behavioral health managed care organization and community-based providers designed to 1) share information on research-based approaches, 2) identify strategies that providers find successful yet feasible, and 3) develop a learning community around research-based, community-informed strategies to increase staff retention.

Participants from 87 community-based behavioral health providers completed a survey about successful strategies and barriers to staff retention, current retention and turnover rates, and ratings of commonly used strategies supported by research. Results were shared and discussed across the partnership through a learning community including a webinar co-facilitated by two participating providers.

Successfully demonstrated but lesknown to improve retention would not be realized across the community without the collaboration of the payer-provider partnership.Aging is associated with functional and structural declines in organisms over time. Organisms as diverse as the nematode Caenorhabditis elegans and mammals share signaling pathways that regulate aging and lifespan. In this review, we discuss recent combinatorial approach to aging research employing C. elegans and mammalian systems that have contributed to our understanding of evolutionarily conserved aging-regulating pathways. The topics covered here include insulin/IGF-1, mechanistic target of rapamycin (mTOR), and sirtuin signaling pathways; dietary restriction; autophagy; mitochondria; and the nervous system. A combinatorial approach employing high-throughput, rapid C. elegans systems, and human model mammalian systems is likely to continue providing mechanistic insights into aging biology and will help develop therapeutics against age-associated disorders.Non-traumatic, simultaneous pseudoaneurysms of the bilateral superficial femoral arteries (SFAs) are extremely rare. Spontaneous transection of the SFA is another unique pathology. Here, we present a patient with end stage kidney disease who was diagnosed with bilateral, simultaneous SFA pseudoaneurysms. He had a recent history of methicillin-sensitive Staphylococcus aureus septicemia; therefore, infection was suspected to be the main cause. Complete transection of the SFA was noted during the operative exploration of the symptomatic left side. Wide debridement and autologous vein bypass were performed via a clean route. Unfortunately, two months later, recurrent surgical site infection caused distal anastomotic rupture and fatal sepsis.

Determination of oxygen concentration in tissues affected by chronic venous insufficiency (CVI) has shown inconsistent results over the years and has confounded the pathophysiology of venous diseases. This study measured transcutaneous partial oxygen pressure (TcPO

) levels in patients with CVI to assess oxygenation and variation in oxygenation according to CVI stage. Materials and.

A prospective study was performed on consecutive patients with unilateral CVI. TcPO

of diseased and unaffected limbs was measured in the supine and dependent positions. A single TcPO

value was measured at the site of greatest skin change or at the edge of the ulcer. The TcPO

values were analyzed and compared according to stage.

A total of 96 patients were included in the study with C4 (24.0%), C5 (19.8%), and C6 (56.3%) disease. The mean age was 44.7 years, and 85 (88.5%) were male. There was a statistically significant (P<0.01) difference in mean TcPO

levels between the unaffected limb (supine, 32.1 mmHg; dependent, 50.7 mmHg), C5 diseased limb (supine, 16.6 mmHg; dependent, 35.5 mmHg), and C6 diseased limb (supine, 24.2 mmHg; dependent, 40.4 mmHg). In the supine and dependent positions, the mean TcPO

in the affected limb was significantly lower (P<0.01) than that in the unaffected limb.

TcPO

in advanced CVI can be used as a marker of oxygenation status. This is the first study in an Indian population looking at the relevance of TcPO

in the prognostication of advanced CVI.

TcPO2 in advanced CVI can be used as a marker of oxygenation status. This is the first study in an Indian population looking at the relevance of TcPO2 in the prognostication of advanced CVI.The purpose of the article is to reveal the essence and specific features of public control as a mean of ensuring the realization of the right to health care, taking into account the existing scientific points of view and reasoning. The research materials were scientific works of Ukrainian scholars, analytical materials, political and legal opinion-based journalism, Internet resources and Ukrainian legislation regulating the activities of public control (supervision) in the health care sector. Generally scientific (systemic, structural and functional, comparative, etc.) and specially legal methods of scientific cognition (formal and legal, comparative and legal, method of studying legal practice, etc.) were used in the course of the study. The author has provided characteristics of public control in the health care sector and has formulated own definition of such a control. The author has studied the powers of the subjects of public control in the health care sector, where control over the observance of legislation in the activities of a certain authority or health institution is the main one. It has been noted that the activities of subjects, exercising public control, have the organizational nature and do not lead to legally significant consequences, although they contribute to the implementation of legal forms of ensuring relations in the health care sector. It has been emphasized that the subjects, exercising public control, do not have authoritative powers, but contribute to the realization of civil right to participate in the healthcare management.The development study was a continuation research of the action mechanism of the developed innovative pharmaceutical substance based on the 3,7-diazabicyclo[3.3.1]nonane derivative, which belongs to the class of AMPA receptor modulators. A significant amount of data has been accumulated on the pharmacology and mechanism of action of glutamate receptors, which are widely represented in the central nervous system of animals and humans. AMPA receptors are ionotropic and, along with receptors of other subtypes, are involved in glutamate-mediated excitatory signaling. Several subunits (GluRAl-GluRA4) are distinguished in the structure of the AMPA receptor, which exhibit different sensitivity to receptor ligands. Modulators of AMPA receptors exhibiting pharmacological activity were studied derivatives of pyrrolidinones, benzothiadiazine dioxides, benzylpiperidines and biarylpropylsulfonamides. The aim of this study was to analyze the therapeutic potential of the mechanism of action of new positive allosteric modula as growth and differentiation, the formation of new synapses makes the development of new drugs based on tricyclic derivatives of 3,7-diazabicyclo[3.3.1]nonane is especially promising for use in the later stages of post-stroke rehabilitation.According to the WHO data, over 35 million people in the world suffer from severe forms of cognitive impairment. Due to the insufficient effectiveness of separate therapy for amyloid or vascular pathologies, an opinion is expressed about the prospects of combined pharmacotherapy of cognitive impairments. The aim of the study was the pharmaceutical development of the combined tablet dosage form formulation with modified release of citicoline and memantine for the treatment of cognitive impairments. Information bases (eLibrary, PubMed) were used, content analysis on State Register of Medicinal Remedies database (grls.rosminzdrav.ru). The compatibility assessment was carried out by stress experiments method in combination with chromatographic analysis. Comparative pharmacokinetic studies were carried out on rabbits. The justification of the pharmacological and clinical feasibility of the proposed fixed dose combination has been carried out, the objective advantage of which is the potentiation of the pharmacotherapeutic action due to the unidirectional effect of memantine and citicoline, and the expected effect is to improve cognition, functioning and behavior and / or slow down their deterioration. The use of the combination will allow achieving ease of treatment, reducing costs, and, accordingly, compliance. The choice of the optimal dosage form for the developed combination was carried out a tablet containing two release methods memantine – immediate release, citicoline – prolonged release. The compatibility of the pharmaceutical substances memantine hydrochloride and citicoline monosodium salt with each other and the excipients planned for use in the formulation has been experimentally revealed. Comparative pharmacokinetic studies of the developed combined drug have been carried out.The aim of the study was to study the possibility of using silicon dioxide(size 0.05 mm, purity 96-97%), obtained from metal manganese production waste, in the formulation of cosmetic creams and ointments. Silicon is a chemical element that is the second most abundant element on earth, surpassed only by oxygen in quantity. By the degree of prevalence in the human body, it is in third place. Silicon is part of collagen – the main protein of connective tissue in living organisms, including humans. The highest concentration of silicon in the human body is found in the surface of the skin, hair and nails. It actively participates in various biogenic processes, ensuring the bonding of collagen separate fibers and elastin and giving the connective tissue strength and elasticity. The degradation of collagen and elastin, the decrease in the amount of out cellular matrix proteins and fibroblasts, are associated with a decrease in the level of silicon in the connective tissue, i.e., it actually contributes to the initial stage of aging.Silicon dioxide and its organic compounds are widely used in cosmetic products, such as powders, masks, creams, peels and hair care products. Judging by the obtained results, cosmetic substances, containing silicon dioxide and plant substances have a sufficiently high colloidal and thermal stability, good osmotic properties, are easily spread, and are capable of penetrating into the agar-agar medium. It can be concluded, the silicon dioxide obtained from wastes from the production of metallic manganese, it is possible and appropriate in the production of cosmetic creams and ointments.It seems that safety of the impact of the UVA on the skin is associated with insidious identifying of early manifestation of damage and distant consequences of impact on the skin and the whole organism. The imagination of safety of UVA exposure has led to wide spread of radiator of UV rays of range A. This scientific research was devoted to identifying of positive and negative impact of UVA on the skin. The aim of the study was to investigate the morphological and functional state of the guinea pigs’ skin under the influence of local fractional UVA radiation. Materials and methods. Studies were conducted on albino guinea pigs that weight 300-350 g. The local fractional regime of exposure was obtained by UV radiator OUFK-03, which generates mainly UVA radiation with the aim of creating the model of exposure in the most similar to real conditions. The shaved area (2×2 cm) of animals’ skin (n=6) was exposed for 30 minutes for 5 days. Guinea pigs were located in a distance of 10 centimeters from the source of expoping of depending actions is to reduce negative UVA impact which will be the aim of our next researches.The aim of the study was to develop a new method of formation of biliodigestive anastomoses, which would make it possible to form anastomoses both on unchanged bile ducts and in conditions of their inflammation. An experimental study was carried out on 50 rabbits of the „Chinshila” breed, which formed biliodigestive and interintestinal anastomoses by the method of high-frequency (HF) electric welding using the „Patonmed EKVZ-300” coagulator. Anastomoses were formed both on non-inflamed tissues and under conditions of biliary peritonitis. In different terms after the operation macro- and microscopic examination of the formed anastomoses was carried out, their patency, tightness and strength were determined. With HF-electric welding the connection of biological tissues is achieved due to thermal adhesion, the mucous and serous layers in the area of the anastomosis are almost completely destroyed under the influence of electricity and the connection occurs due to the submucosal layer. The suture is well-established, hermetically sealed, the anastomoses have sufficient strength (40-100 mm Hg). The coagulation scar is narrow, thermal damage to the membranes is local (within 2700-3000 microns), the epithelialization of the suture was completed after 3 months and the maturation of the scar after 6 months. The method of HF-electric welding equally allows the formation of reliable biliodigestive and interintestinal anastomoses, both in conditions of unchanged and inflamed tissues. The everting weld connection prevents the occurrence of anastomotic strictures in the future.Objective – to evaluate changes in the structure and function of the liver and kidneys under non-lethal carbon tetrachloride intragastric administration. Experimental studies were performed on 46 white Wistar male rats. Within 7 days, the experimental group of animals underwent intoxication with the introduction of 0.5 ml of CCl₄. The state of liver function was evaluated by the activity of ALT and AST, the amount of bilirubin in the blood, the content of serum creatinine and urea, the amount of total serum protein. The state of renal function was assessed by changes in daily diuresis, glomerular filtration function, percentage of tubular reabsorption, serum creatinine and urea, indicators of chloride output and urine pH. The results of a study in experimental animals with the introduction of carbon tetrachloride showed that in the liver and kidneys there is a development of dystrophic lesions vacuoles in the hepatocytes and endothelial cells of the glomeruli, disorders of the structural and functional organiort function of red blood cells persists). The balance and intensity of lipid peroxidation processes and the antioxidant system are disturbed. Violation of the energy supply of the transmembrane potential, a decrease in ESR, and the content of total blood protein increases (the changes nomenclature of plasma proteins). With a non-fatal load of carbon tetrachloride, dystrophic changes in the liver and destructive changes in the kidneys were detected. The detoxification potential of the liver and urinary function of the kidneys decreased. Changes in nature were similar to those described in hepatorenal syndrome. However, taking into account that no nosology of liver damage was found, the activity of redox enzymes is preserved, the detected violations can be defined as pseudohepatorenal syndrome.The purpose of the study was to establish the dynamics of changes in morphometric parameters of the structural components of the rats’ duodenal wall with long-term use of a complex of food additives sodium nitrite, sodium glutamate and Ponceau 4R. The work was performed on 84 adult nonlinear male rats, which were given to drink 10% sodium nitrite solution, sodium glutamate was administered at a dose of 20 mg/kg in 0.5 ml of distilled water, Ponceau 4R – at a dose of 5 mg/kg in 0.5 ml distilled water 1 time per day orally. Thus, the use of a complex of dietary additives of sodium nitrite, sodium glutamate and Ponceau 4R led to changes in the morphometric parameters of all structural components of the rats’ duodenal wall. This reaction is aimed at neutralizing the alterative factor and restoring the morphofunctional state of the duodenum. By the end of the observation, complete recovery of structural components was not established due to the predominance of constant negative influence of the stimulus with the occurrence of dystophic-destructive changes.Objective – to study the ability of 2,6-dimethylpyridine-N-oxide to modify the cytogenetic effects in mouse bone marrow cells caused by the pro-oxidant mutagen Dioxidine. The cytogenetic activity and mutagen-modifying effect of the plant growth regulator 2,6-dimethylpyridine-N-oxide (Ivin) were studied by the method of accounting for chromosomal aberrations in the bone marrow cells of CD-1 mice (males) with a single joint exposure with Dioxidine. Ivin was administered single orally in the form of an aqueous solution at doses of 710, 71, and 0.7 mg/kg bw, which corresponds to 1/2, 1/20, 1/2000 of LD50 after intraperitoneally administered of Dioxidine at a dose 100 mg/kg. The animals of the positive control group were treated Dioxidine intraperitoneally at a dose of 100 mg/kg bw. Intact animals (negative control group) were orally administered purified, UV-sterilized, deionized water. It was shown that when combined with Dioxidine, Ivin at doses of 710, 71, and 0,7 mg/kg bw significally reduced the frequency of metaphases chromosome aberrations, relative to positive control by 55,56%, 66,70%, and 74,08% respectively. No multi-aberrant and polyploid cells were observed. In all variants of the experiment, only chromatid-type chromosome aberrations with single fragments were detected in the spectrum of chromosome aberrations. The severity of this effect had an inverse dose dependence with a decrease in the dose of Ivin, the cytogenetic effects of Dioxidine decreased to a greater extent than with high doses of Ivin. The high antimutagenic effect of Ivin was confirmed, which is expressed to a greater extent when it is combined with Dioxidine than with Cyclophosphamide. These findings may be associated with the genoprotective effect of Ivin, due to the stabilization of membranes and its antioxidant effect.High-resolution ultrasound (US) was used to examine 25 patients before the procedure and at the 2nd, 7th, 21st days and in 1.5 months after combined exposure to the skin of the face and neck with the ErYAG laser in cold ablation mode and with the neodymium (NdYAG) laser in long pulse mode. The maximum dermis thickness was noted in the middle third (the standard measurement point along the mid-pupillary line in the projection of the infraorbital foramen) and composed 1,75±0,29 mm, the minimum on the neck and in infraorbital area – 1,2 (1,15; 1,3) mm and 1,15±0,15 mm, respectively. On the second day after the procedure, there was a significant increase up to 2,63±0,33 mm in the dermal thickness in the middle third in the projection of the infraobital foramen and up to 1,57±0,23 mm in the submental area of the neck due to all its layers in comparison with the values given before the procedure (p=0.005, p less then 0.0001). Visualization of the dermis layers was difficult in B-mode during ultrasound, the toughness of the tissues decreased at compression elastography, pronounced vascularization was detected in the CDI mode in comparison with the initial one before the procedure and persisted up to 6 weeks. The ultrasound image in B-mode corresponded to the initial parameters starting from the 7th day.The purpose of the study is to explore the peculiarities of cognitive functioning in the depressive phase of BAS, taking into account the gender factor. The results of the study are based on data from a clinical and psychological examination of 27 men and 39 women with bipolar disorder (BAD) and undergoing treatment at the Yushchenko Vinnytsia Regional Psychoneurological Hospital from 2016 to 2020 in connection with the current episode of mild or moderate depression (ICD-10 code F31.3). The study revealed significant deteriorations of cognitive processes, including disorders of attention, memory, cognitive and executive functions. In the structure of cognitive clinical symptoms the signs of slow thinking (in 100% of patients), impaired concentration (88.9% of men and 82.1% of women, p>0.05), difficulties in planning and decision-making (85.2% and 79.5%, p>0.05), less rigid thinking (81.5% and 59.0%, p0,05), which testifies to a distinct effect of interference and significant rigidity of cognitive control processes in combination with a violation of the cognitive functions automatization and a decrease in the degree of their independent functioning.Hepatorenal syndrome is a severe complication of liver cirrhosis which is difficult to treat because of a very fast course and lack of adequate dosing recommendations due to the stage of the disease. In this study we aimed to refine the treatment of hepatorenal syndrome type I by modifying the dose of terlipressin, depending on the stage of acute kidney injury (AKI). Objective – to improve the treatment method of hepatorenal syndrome type I in patients with alcoholic liver cirrhosis by selecting the dose of terlipressin depending on the stage of acute kidney injury. For this study were enrolled 161 patients with diagnosis alcoholic liver cirrhosis, complicated with the hepatorenal syndrome. All patients were were randomly divided into control (group 1) (n=79) and study (group 2) (n=82) groups depending on the treatment received (terlipressin in the standard dosage or modified by the response-guided titration method). If the serum creatinine level decreased less than 25% from the baseline, the dose of terliprehe results of the treatment and reduce mortality in patients with hepatorenal syndrome type I.Diabetes Mellitus (DM) is one of the major public health issues worldwide causing a heavy burden on health systems and economies of many countries. In this regard, it is crucial to develop and implement low-cost interventions aimed to early prevention and effective management of DM (particularly T2DM). Various studies worldwide indicated positive effect of natural mineral waters on regulating blood glucose level. The present screening study aimed to 1) learn how T2DM patients are aware about their disease, study their demographic, social-economic profile and behavior; and 2) explore the impact of Georgian spring mineral water „Dzuguri” on blood glucose level among T2DM patients. The study results indicated that a considerable large amount of T2DM patients suffer from various social-economic problems and experience limited access to healthcare services. More encouraging was their attitude toward healthy life-style and related behavior. Considering this context, another finding of the study was particularly significant mineral water from spring „Dzuguri” demonstrated positive initial effect on regulating glucose level among T2DM patients. Consequently, similar studies should be continued in a larger scale with more robust methodology and covering more population from various regions of Georgia.This article describes a clinical case of prolactinoma, the onset of which was diagnosed after long-term use of eglonil, after the appearance of such side effects as galactorrhea. This clinical case is a unique one because of the peculiarities of diagnostic search. The first complaints of the patient were anxiety and fear, fatigue, frequent mood swings, memory disoders. She was examined by a family physician and prescribed eglonil (sulpiride) 200mg for 7 days. Because of the positive effect the patient decided on her own to continue treatment for another several weeks. But suddenly she revealed a leakage of milk from the mammary glands. The family physician assessed galactorrhea as a side effect of long-term use of eglonil, and cancelled this prescription. Simultaneously the family doctor canceled COCs, that the patient used for the last several years, because of pregnancy planning. But three months later the mensis didn’t occur. The menstrual cycle did not resume and pregnancy did not occur even 6 months latoma was small but manifests with severe symptoms of the central nervous system lesion (according to the results of HADScale and MoCA scale). The presence of concomitant pathology can mask or distort the symptoms of another disease that complicates the diagnosis. On the other hand, treatment of one of the comorbidities and improving its course leads to a reduction in the manifestations of the others.The aim – to analyze the relationship between leptin levels and morphometric, anthropometric, biochemical parameters in patients with hypertension and obesity and in healthy individuals. The study included 64 patients with obesity and hypertension and 21 healthy individuals. The groups were comparable in age and gender. Leptin was determined by enzyme immunoassay method. Data are presented as mean values and the error of the mean (M±m). Differences were considered statistically significant at p less then 0,05. It was found out a strong positive correlation in the group with hypertension and obesity between plasma leptin levels and total cholesterol (r=0.40, p=0.00004), strong negative correlation between leptin and HDL (r=-0 , 43, p=0.0005), uric acid (r=0.32 p=0.00092) and ionized calcium levels (r=-0.35 p=0.00027). Leptin levels in the group of healthy individuals correlated with a waist circumference (r=0.78, p=0.005), BFM, BMI and age (r=0.92, r=0.94, r=0.81, p less then 0 , 05), uric acid levels (r=0.94) and ionized calcium (r=0.91) at p less then 0.05. The present study provides evidence that BFM, TG, HDL, VLDL, atherogenic index, ionized calcium levels and uric acid have a significant impact on serum leptin in patients with hypertension and obesity.Anemia and iron deficiency (ID) are important and common comorbidities that often coexist in patients with heart failure (HF). Both conditions, together or independently, are associated with poor clinical status and worse outcomes. The aim of our research was to study prevalence and clinical impact of ID and anemia in HF patients attending cardiology department of our hospital. We studied 133 patients with HF who have been admitted to hospital since September 2019 78 (58.6%) patient had ID, 55 (42.4%) with HF and without ID were included in the control group. Patient baseline assessment included a standardized HF history regarding HF etiology (classified as ischemic or non-ischemic) and co-morbidities. All patients underwent a standardized clinical evaluation, including physical examination, determination of NYHA class. Blood samples were drawn for the assessment of a full blood count and clinical chemistry, including iron and serum ferritin and kidney function (creatinine). Assessment of exercise capacity was performed by a 6-min walk test. ID was present in 78(58.6%) patients. 70(52.6%) patients from 133 presented with anemia. Most patients in both groups are men, patients with ID were elderly, in both groups, most patients had arterial hypertension, more patients with ID had diabetes mellitus, HF etiology was predominantly ischemic in both groups, most patients were with NYHA class III, patients with ID had significantly low LVEF. No differences were recorded for body weight, diastolic blood pressure, platelets, eGFR or serum creatinine, no such differences were found regarding hypertension and chronic obstructive pulmonary disease. There was a highly significant association between hemoglobin and serum ferritin in patients with ID, but in patients without ID, this association was only of borderline significance. The presence of anemia, ID, or both was associated with significantly higher NYHA class. We found that gender, NYHA class, LVEF, the presence of anemia, eGFR all predicted lower exercise capacity.For several decades, highly refined cardiac implantable electronic devices (CIED) are used to prevent and manage various types of cardiac pathology, which have saved the lives of many patients. Cardiac implantable electronic devices help maintain and improve the quality of life by regulating the heart rate, terminating life-threatening arrhythmias, and improving systolic function, including pacemakers, implantable cardioverter defibrillators, and cardiac resynchronization therapy devices. Regardless of the benefits received after its implantation, in some cases, serious complication has appeared, such as CIED infections, associated with severe morbidity, mortality, financial expenses and changes in the quality of life. Exactly, in this article will be addressed the issues of prevention, diagnosis, and treatment of this condition, which will help specialists to properly assess the problem and to find a way to effectively solve it.Vitamin D deficiency has been identified as a common metabolic/endocrine abnormality. There aren’t any published data about vitamin D plasma level in Georgian population. Present study was conducted to reveal vit D status among Georgian children with high acute respiratory morbidity. The prospective observational study was performed by comparing serum vitamin D levels in children with recurrent respiratory infections (Upper respiratory infections, bronchiolitis, bronchitis, pneumonia) and healthy children in two cities of Georgia – Tbilisi and Rustavi. The 2 cohorts of 277 children at age from 3 months to 15 years were investigated. First cohort formed – 147 children with recurrent respiratory infections. 130 healthy children were included in control group (II cohort). One moment blood concentrations of 25-hydroxyvitamin D was determined in every study participant. The mean serum 25(OH) vitamin D level in the I age group with respiratory infections was 14.47±5.44 ng/ml and control group data were – 35.54ng/ml±8.66. In II age group with respiratory morbidity vit D level was 12.43±5.27 ng/ml and control group data were 27.71±18.29 ng/ml. In III age group mean serum 25(OH) vitamin D level was – 14.39±4.60ng/ml. Control group data – 28.31±12.59ng/ml. Comparison of serum 25(OH) vitamin D levels between the study groups (I cohort vs II cohort) revealed a statistically significant difference (p less then 0.05). In 14% of healthy adolescents from group III the vit D plasma level was less then 20 ng/ml (16±11.5 ng/ml). 25(OH)D deficiency in children was associated with high morbidity with respiratory infections. After 5 years of age most of the healthy children with the low respiratory morbidity in Georgian rural regions reveal Vit D insufficiency, especially in adolescent period.Article discussed the clinical evidence of children with attention deficit hyperactivity disorder (ADHD) living in different regions with polluted air. We have revealed the correlation between severity of neurological impairment and level of Hg, Pb, Zn and Cu in blood of children of three different age group (2-5y, 6-9 y and 10-13y). According to our results we found correlation between living area and level of xenobiotics and essential microelements. Thus we have concluded that beyond the level of xenobiotics and essential microelements in child’s blood their primary and secondary role in the development of neurological disorders in regions of various anthropogenic impact has to be considered.Cow’s milk protein allergy is an urgent problem in young children. Early diagnostics and formation of therapeutic tactics are the basic priorities in allergy treatment among young children. Oral provocation tests, which can be performed only in medical establishments, are a golden standard for diagnosing food allergy. Active search continues for optimal scheme of diagnosing cow’s milk protein allergy in children in the first year of life. The aim of our research was to create the algorithm of diagnosing cow’s milk protein allergy in children younger than one year of age, which will optimize obtaining reliable data on a patient’s condition and decrease a load of laboratory examinations on young children using elimination and provocation food test. To complete the set goal, a record of allergological anamnesis, examination, assessment of physical condition and determination of specific IgE to cow’s milk proteins were conducted to diagnose cow’s milk protein allergy. Then, based on the obtained results, eliminat practice.Aim of study – to determine the composition of the essential macro and microelements in the hair and dental hard tissues and to study the influence of their imbalance on the general and dental health of the child. To assess the state of dental hard tissues, 375 children aged 3 to 12 years were randomly examined in Batumi. Monitoring of the examined children was carried out using standard indices provided by the World Health Organization. To determine the composition of the chemical elements in hair and dental hard tissues, according to the caries status 48 children were chosen from the examined 375 children. We used X-ray fluorescent spectroscopy method to study the qualitative and quantitative content of the chemical elements in the hair and dental hard tissues. The comparative analysis of the dental experience (dmft/DMFT) and the composition of chemical elements in dental hard tissues showed a statistically significant difference depending on caries status. The effect of some essential elements on the general health of the child has also been identified. The study into the composition of the essential macro and microelements in the hair and dental hard tissues revealed a high coefficient of correlation both with the mineralization of dental hard tissues and with the general health of the growing body.The method of dental implantation in patients with generalized periodontitis is one of the priority areas requiring in-depth study. The aim of the study was to increase the efficiency of dental implantation in prosthetic rehabilitation of patients with generalized periodontitis. A study of 240 patients with chronic generalized periodontitis and partial edentulous upper and lower jaw was carried out, who subsequently underwent complex periodontal treatment and dental implantation. The patients were divided into groups depending on the severity of generalized periodontitis (I, II, III) and the method of treatment. Evaluation of the results of the effectiveness of the proposed method of surgical treatment of patients with generalized periodontitis of the first stage of development with one-stage and staged dental implantation and targeted osteotropic therapy showed that after 12 months all implants (100%) were preserved. In patients with grade II generalized periodontitis, who underwent periodontal treatment and dental implantation in stages, the safety of implants was 92.1%, and in patients who underwent one-stage dental implantation with surgical treatment of periodontal disease, the safety of implants was 89,4%. In patients with stage III generalized periodontitis who underwent staged periodontal treatment and dental implantation, the safety of implants was 80,2%, and in patients who underwent one-stage dental implantation and periodontal treatment – 51,7%.Diseases of the oral cavity are considered as a health problem for the population of the whole world, in particular, Ukraine. Purpose of the study – to analyze the risk factors, legislative, financial, personnel support for the prevention and treatment of oral diseases of the population of Ukraine; to develop a national conceptual model for the organization of dental care. State statistics data, regulatory documents, scientific sources; methods of systems approach and analysis, conceptual modeling, graphic. A low standard of living is typical for 23.1% of the population of Ukraine; high levels of tobacco smoking, alcohol consumption, sugar consumption, insufficient amount of fruits and vegetables in the diet are common in the population. Low fluoride content in drinking water is a threat to the development of caries. The legal regulation of oral health needs improvement. A national conceptual model of the organization of dental care has been developed on the basis of an analysis of world experience and WHO recommendations, the main components of the model are determined improving geographical and financial accessibility; improving quality; preventive focus; state regulation. The world experience in the provision of dental care and the national characteristics of the health care system made it possible to substantiate and develop a conceptual model for organizing dental care for the population of Ukraine.The aim of our study was to investigate the effectiveness of osteoplastic material based on MMSC – AT for the restoration of bone defects. To study the processes of bone remodeling, in the replacement of bone defects after tooth extraction, patients were divided into three groups. Group A – 26 patients where used „Kolapan-L” to fill the bone defect; group B – 28 patients where for augmentation used osteoplastic composition „Kolopan-L” + MMSC-AT + PRP; group C – 25 patients in whom the healing of the bone defect occurred under a blood clot. In the patients group B, after 1 year of observation, the activity of acid phosphatase was 13,35% p> 0.05 and 33,40%, p>0,05, p10,05, p2 less then 0,05. When conducting histological examination of bone biopsies after 6 months of observation, in patients of group B, the obtained trepan biopsies had the structure of bone tissue bone marrow spaces and sometimes small particles of osteoplastic material were determined between trabeculae. Therefore, based on the results of the study, it is safe to say that our proposed osteoplastic composition based on MMSC – AT is a good alternative to traditional osteoplastic materials for use in modern dentistry.Oral manifestations of HIV infection are diverse and not still not completely studied. HIV-associated diseases can occur as the first symptoms of infection, these are characterized by high frequency, clinical polymorphism and pronounced course. Periodontal aspects are also neglected in the literature. No papers on the condition of different areas of the oral mucosa, tongue and periodontium where they were studied simultaneously and according to various criteria have been found in the available literature. The objective of the research is to evaluate the condition of periodontium and the oral mucosa in different parts of the oral cavity in HIV-positive patients. Total number of the HIV-positive patients observed was 90, among them 81 males and 9 females between the age range of 24-62. An average age of the patients was 45.2±8.34, with male patients prevailing (p less then 0.001). HIV infection was diagnosed by Western-blot reaction. Clinical examination as well as probing and determination of the pocket depth by means of the periodontal probe was carried out to assess the health status of the oral cavity. Periodontal indices were also determined. It has been found that immunocompromised condition due to HIV infection contributes to the oral mucosa lesions. Namely, coated tongue was observed in 100% of cases, the oral mucosa relief impairment was seen in 75.6% of cases, lip cracks of different location and bright red color of the mucous membrane were observed in 73.3% and 82.2%, respectively (р less then 0.001). Examination of the tongue revealed the symptoms which were not found in the control group, such as tongue coating – in 100% (90 patients observed), epithelial desquamation foci – in 54.4% (49) (p less then 0.001). Inflammatory diseases of periodontium, particularly catarrhal and hypertrophic gingivitis and periodontitis of moderate severity were also revealed.Objective – to study the species composition of microflora and its sensitivity in patients with odontogenic maxillary sinusitis. The study included 230 patients of both sexes aged 18 to 70 years, who were treated at the Moscow Regional Scientifics Research and Clinical Institute named after M. F. Vladimirsky with a diagnosis of Odontogenic maxillary sinusitis. Of these, there were 155 patients with odontogenic sinusitis, complicated by perforation of the maxillary sinus and the presence of an oro-antral fistula, and 75 patients with maxillary aspergillosis. All patients underwent microbiological examination of smears and flushes from the maxillary sinus cavity with the determination of the species composition and antibiotic sensitivity. In the majority of the patients with perforative forms of odontogenic maxillary sinusitis, coccal flora (streptococci and various species) was detected, in a smaller number compared to it – facultative and obligate anaerobes, pathogenic fungi (Candida). A comparative analysis of the microflora, depending on the duration of the maxillary sinus perforation, showed that the rhinogenic microorganisms (Moraxella spp.) were found only in intraoperative perforations (up to 20% of cases). The presence of obligate anaerobes (Fusobacterium spp. Bacteroides spp.) was typical for long-existing perforations. In patients with maxillary aspergillosis facultative and obligate anaerobes were found less frequently and in a smaller variety than in patients with perforative maxillary sinusitis. There were no cases of sinus contamination by pathogenic fungi of the genus Candida in this group. At the same time, rhinogenic microgranisms (Moraxella spp.) were detected with a higher frequency (up to 27.3%) in this group of patients.The function of the outer hair cells (OHC) in patients with euthyroid autoimmune thyroiditis (AIT) was investigated in frequency range of 1000 – 8000 Hz. Our aim was to measured of AIT factors influence on auditory function in patients with no subjective sensations of hearing loss. For this study we selected patients with euthyroid AIT. Patients average age on 33,25±6,32 years. The main group consisted of 59 people. The control group was presented by 29 relatively healthy individuals, without AIT and normal hearing function. Each patient was determined the levels of thyroid stimulating hormone (TSH), free thyroxine (T4), free triiodothyronine (T3), thyroid peroxidase antibodies (TPAb), thyroglobulin antibodies (TGAb). The function of OHC of the inner ear was assessed by the registration of distortion product otoacoustic emission (DPOAE) and auditory brainstrem response (ABR) evaluation. We estimated dependency of DPOAE data on TPAb and TGAb levels in the patients’ blood tests. We used program Statistical Package for the Social Sciences 17 for statistical data.