[The regional model of three-level system of of medical social monitoring of children and adolescents: the pilot project in the Republic of Tatarstan].

The absence of system of medical social monitoring of children being in difficult life situations is one of main causes of preventable losses of health and life of children and adolescents. The plan of activities of the working group No3 under the Coordination council under the President of the Russian Federation of the national strategy realization of actions in interest of children for 2012-2017 includes a point: "The development and implementation of standard model of medical social monitoring of children and adolescents in the subjects of the Russian Federation". The implementation of this task is assigned to the Department of social pediatrics of The research center of children health of Moscow and the Ministry of Health of the Republic of Tatarstan. The research methods included analysis and generalization of advanced experience of medical social monitoring of children population; expertise technique; modeling. The regional model of three-level system of medical social monitoring of children population is developed and implemented. The model includes level I (consulting rooms of medical social care of children polyclinics, feldsher obstetric stations, first-aid centers), level II--inter-municipal (departments of medical social monitoring in central district hospitals, medical institutions, clinical diagnostic centers) and level III--regional (the Republican center of medical social monitoring of children and adolescents). The immediate tasks necessary for effective functioning of system of medical social monitoring were determined. Within the framework of implementation of the pilot project the legal and normative legislative acts were developed to regulate functioning of regional model of three-level system of medical social care. The other documents necessary for effective functioning of this system were elaborated. The practical significance of this system is in the implementation of effective three-level model of medical social monitoring of children and adolescents supporting decrease of morbidity, mortality and "risk behaviors" suicidal included. The model is to prevent child neglect and homelessness and cruel treatment of children and adolescents.

Change in lymph flow during low-grade fever and febrile fever under experimental conditions.

Experiments on rats showed that low-grade fever is accompanied by a decrease in the central lymph flow rate, which results from inactivation of lymphangion components in lymphatic microvessels of the small intestine mesentery. Lymph flow rate was shown to increase during pyrogenal-induced fever, which did not depend on the duration of the disease.

Content of trace elements in the lymph and blood during pyrogenal-induced fever and complete freund's adjuvant-induced low-grade fever.

Experiments on rats showed that complete Freund's adjuvant-induced low-grade fever and pyrogenal-induced fever are accompanied by an increase in the content of Mn, Cu, Zn, and Se in the thoracic duct lymph. Our results indicate that the lymphatic system supplies trace elements to the circulation, which compensates for a deficiency in trace elements and maintains their systemic circulation. The decrease in the content of some trace elements in the blood during fever is probably associated with their excessive consumption (e.g., to maintain the antioxidant defense system). During experimental low-grade fever and pyrogenal-induced fever, the lymphatic system serves as the reservoir for trace elements and plays a role in the regulation of trace element balance in biological fluids.

Antioxidant protection and lipid peroxidation in the lymph and blood during complete Freund's adjuvant-induced low-grade fever and pyrogenal-induced fever.

Experiments on rats showed that complete Freund's adjuvant-induced low-grade fever and pyrogenal-induced fever of different duration are accompanied by an increase in the content of lipid peroxidation products and components of the antioxidant system not only in blood plasma, but also in the central lymph. These changes reflect activation of drainage, evacuation, and transport function of the lymphatic system. We conclude that the lymphatic system plays an important role in the maintenance of the prooxidant-antioxidant balance under these pathological conditions.