[MODIFICATION OF CARDIOVASCULAR RISK WITH A COMBINATION OF METABOLIC SYNDROME AND VEGETATIVE NERVOUS DYSFUNCTION].

The aim of the study was to identify the effect of vegetative nervous dysfunction on the level of cardiovascular risk in persons with metabolic syndrome undergoing intensive monitoring. The survey involved 750 civil servants aged 35 to 70 years, including 476 men and 274 women. Diagnosis of the metabolic syndrome (MS) was carried out according to the IDF and AHA / NHLBI consensus criteria (2009). The investigation of the state of vegetative nervous regulation of hemodynamics was carried out by means of variational intervalometry. As the "end points" of the study, any form of acute coronary syndrome, acute impairment of cerebral circulation or other forms of peripheral arterial blood flow disturbance during the study period was considered. Statistical analysis was carried out using the Pearson's χ2 criterion the two-sided Fisher exact test and two-sided Dannet t-criterion. The frequency of metabolic syndrome in the group was 40.3%. Vegetative nervous dysfunction (VND) was detected in 45.6% of cases. The frequency of combinations of metabolic syndrome and VND was 21.7% and significantly exceeded the expected with an independent distribution of these pathological conditions. A significant excess of the frequency of development of acute violations of the regional circulation in the group of the presence of a combination of metabolic syndrome and autonomic dysfunction was observed over those surveyed with the absence of these pathological conditions. Significant differences were revealed by the results of the observation of the combination group of MS and VND in comparison with all the others: VND without MS (χ2 = 4.92, p = 0.046); MS without VND (χ2=4.26, p = 0.057); absence of MS and VD (χ2 = 8.35, p = 0.022). Between groups of patients without a combination of syndromes, no significant differences were revealed. Thus, autonomic dysfunction can be a factor associated with metabolic syndrome and modifying the risk of cardiovascular complications in the direction of its increase.

[REPRODUCTIVE HEALTH OF GIRLS-TEENAGERS - AS A MEDICAL-SOCIAL PROBLEM OF KAZAKHSTAN].

The purpose of the study - to evaluate the gynecological and somatic pathology of Almaty teenage girls in order to improve measures to improve the reproductive health of this category of the population. As research materials, statistical data on the prevalence of gynecological pathology among teenage girls in Almaty were used, who sought medical help from the Almaty City Center for Human Reproduction (SCCR) and reporting forms from the Almaty city branch of the Republican Center for Electronic Health in 2013 to 2018. In work were applied: analytical, epidemiological, statistical techniques. It is noted that the gynecological pathology of teenage girls in Almaty does not tend to decrease. In the structure of gynecological diseases, the leading place is occupied by abnormal uterine bleeding (specific gravity - 36.4%; prevalence per 1000 girls in Almaty is 0.55). Next in importance are inflammatory diseases of the internal genital organs (specific gravity - 15.3%; prevalence per 1000 girls - 0.24), dysmenorrhea (specific gravity - 10.0%; prevalence per 1000 girls - 0.17). In order to improve the reproductive health protection of adolescent girls, it is necessary to implement a multifactorial approach that provides for the correction of several factors affecting the reproductive potential. It is recommended to implement a set of medical and social measures: the integration of all services ensuring the reproductive health of adolescents; introduction of highly effective and high-tech forms of specialized gynecological care to this category of the population in the practice of public health in Kazakhstan.

[CAUSES OF LETHALITY OF ISCHEMIC STROKE AND WAYS TO IMPROVE PREVENTION METHODS].

In this article, the authors conduct an in-depth analysis of the causes of mortality from ischemic stroke in Almaty city of the Republic of Kazakhstan. Based on the materials of the city pathoanatomical bureau for 2015, 2016, and nine months of 2017. Autopsy materials and results of histological examination were analyzed. The materials of the study were processed using the methods of applied biostatistics. According to the results of the study, the authors came to the conclusion that the greatest number of patients who died of this pathology is in men aged 51 and older than 80 years, and in women 61 and older. When studying morphological features, atherothrombotic type AI met in 56% of cases, cardioembolic (36%) and hemodynamic type (8%). Taking into account the received data, the authors recommend defining the joint responsibility of patients, medical workers and the state for violation of the principles of management of the causes of the occurrence of ischemic stroke.